1 scenario with normal fsh and lh and 1 of increased fsh and lh. Cause asked for both
SCENARIO OF SECONDARY AMENORRHEA all her investigations was normal (FSH AND LH are within normal range and no increase in LH/FSH ratio )… her WEIGHT IS 45kg …. Whats the most likely cause
-idiopathic hypothalameic dysfunction ans
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A pt was on resperidone consta has amennorhea from one yr want to conceive labs were given lh was normal fsh low tsh low normal range prolactin raised around 1465. what is the reason?
a) pituitary microadenoma??? ans
b) hypo pituitary dysfunction
c) pri hypothyroidism
Other common conditions to exclude include a nonfasting sample, excessive exercise, a history of chest wall surgery or trauma, renal failure, and cirrhosis. Postictal patients also develop hyperprolactinemia within 1-2 hours after a seizure. These conditions usually produce a prolactin level of less than 50 ng/mL.
Hypothyroidism, an easily treated disorder, also may produce a similar prolactin level.
Detailed drug history should be obtained because many common medications cause hyperprolactinemia, usually with prolactin levels of less than 100 ng/mL. Drugs Drugs that may cause the condition can include the following  :
• Dopamine-receptor antagonists (eg, phenothiazines, butyrophenones, thioxanthenes, risperidone, metoclopramide, sulpiride, pimozide)
• Dopamine-depleting agents (eg, methyldopa, reserpine)
• Others (eg, isoniazid, danazol, tricyclic antidepressants, monoamine antihypertensives, verapamil, estrogens, antiandrogens, cyproheptadine, opiates, H2-blockers [cimetidine
• If no obvious cause is identified or if a tumor is suspected, MRI should be performed.
• Although no single test can help determine the etiology of hyperprolactinemia, a prolactinoma is likely if the prolactin level is greater than 250 ng/mL and less likely if the level is less than 100 ng/mL.  Although medications can cause significant elevation of prolactin, a level of 500 ng/mL or greater is diagnostic of a macroprolactinoma.
• Prolactin-secreting adenomas are divided into 2 groups: (1) microadenomas (more common in premenopausal women), which are smaller than 10 mm and (2) macroadenomas (more common in men and postmenopausal women), which are larger than 10 mm or more ……>>>>medscape