Answer:USMLE step 2 Mcq 149:A 40 year old female notices that her menstrual cycle has stopped

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Correct Answer: E

Explanation:
A pituitary tumor can lead to an increase in prolactin production. A common cause of galactorrhea and amenorrhea is a prolactin secreting pituitary tumor. Hypothalamic amenorrhea (choice a) would not be associated with galactorrhea, acne, or an elevated prolactin level.Polycystic ovary syndrome (choice b) consists of the triad of hirsutism, amenorrhea, and obesity. An elevated prolactin level is not associated with polycystic ovarian syndrome. Pregnancy (choice c) is the most common cause of amenorrhea. However, pregnancy is not associated with galactorrhea; milk production does not occur until after childbirth. HCG (human chorionic gonadotropin) is the hormone tested for in pregnancy tests, and this would be positive in pregnancy.Conn's syndrome (choice d) is due to an adrenocortical adenoma. Conn's syndrome would present with symptoms and signs of hyperaldosteronism, not hyperprolactinemia.


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