A 13-year-old girl presented with irregular menstrual cycles occurring every 5-6 weeks and bleeding for 10-15 days. Her mother was concerned. On examination, the girl's secondary sexual characteristics were well developed and her menarche was 6 months prior. Her blood tests showed abnormal hormone levels, including low estrogen and LH. The document asks questions about the potential causes of her condition, appropriate additional tests, and treatment options.

1. FOUNDATION MODULE CBL SEM-01, WEEK-07 (16-12-2013)
CBL-03ASID:WEEKLY TIME TABLES051=16-12-2013
Page 1 of 2
CASE:
13 year old girl has come to the doctor’s office with her mother. Her mother is
worried about irregularity in the menstrual cycle. She says that the cycles are
infrequent that is occurring every 5 to 6 weeks, she also complains that
sometimes the bleeding continues for 10-15 days. Her mother is very anxious and
seeks advice.
On history mother explains the doctor
that: Menarche was 6 months back
She is at present in the12
th
day of her current menstrual cycle
Secondary sexual characters are well developed
Her blood reports show:
FSH 10.5 IU/L N= (6.42 IU/L)
Estrogen100 IU/L N=(149.74 IU/L)
LH 1.00 IU/L N=(3.96 IU/L)
Progesterone 0.01 IU/L N=(0.64 IU/L)
Q1. What is DUB?
Q2. What is the differential diagnosisin this patient?
Q3. What other tests should be further carried out ?
Q4. What could be the commonest cause of hypothalamic
dysfunction in this patient?

2. FOUNDATION MODULE CBL SEM-01, WEEK-07 (16-12-2013)
CBL-03ASID:WEEKLY TIME TABLES051=16-12-2013
Page 2 of 2
Q1) Why is this girls period irregular?
Q2) What do you expect to see in the endometrium and ovaries at this stage of
the cycle?
Q3) What is LH surge or leutinization?
Q4) How the cyclical changes in ovary are related to phasic changes in the
estrogen and progesterone?
Q5) What can be done for this patient?