Approach to secondary amenorrhea Quiz: Ace Your Exams
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A 31-year-old woman, gravida 1, para 1, who is actively trying to conceive, presents to a clinic with amenorrhea for 3 months. Previously, her cycles came once every 30 to 32 days, then she had a 48-day cycle and has not bled since. On review of systems, she reports increasing headaches and occasional breast tenderness and feels like she needs a new prescription for her glasses. Past medical history is notable for a single uncomplicated vaginal delivery 3 years ago and mild asthma for which she uses a rescue inhaler once per month. Her only other medication is ibuprofen as needed for headaches. Temperature is 36.9°C (98.4°F), pulse is 72/min, respirations are 16/min, blood pressure is 118/80 mmHg, and body mass index is 25 kg/m2. On exam, her visual acuity decreased. Neck, skin, chest, abdominal, and pelvic exams are unremarkable. A urine pregnancy test is negative. Based on the history and physical exam findings, which of the following laboratory values is most likely to be abnormal?
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