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Re: Puzzling case From: Charlie Chambers (cchamber@gorge.net) Tue Oct 8 11:48:06 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Charlie Chambers: "Re: Puzzling case" Previous message: Lynn D. Montgomery, M.D.: "New one on me" In reply to: Joe Cutchin: "Re: Puzzling case" Next in thread: Charlie Chambers: "Re: Puzzling case" Joe, Please enlighten me on what you hope to gain by the testosterone level. Thanks On Tuesday, October 8, 2002, at 05:40 AM, Joe Cutchin wrote: > I would get a free testosterone and some type of scan of ovaries. > > "Richard Chudacoff, MD" wrote: > >> I have a patient who came to see me today, for a second opinion, >> because of amenorrhea and headaches. She was noted to have irregular >> cycles, and therefore FSH and LH were performed.Both FSH and LH were < >> 0.7 mIU/ML.Quantitative beta HCG was negative.Provera challenge times >> 3 noted no withdrawal bleeding. Prior to one year ago, she had regular >> withdrawal bleeding on oral contraceptive pills.Approximately one year >> ago withdrawal bleeding ceased. Comprehensive metabolic panel was >> normal, with a fasting glucose of 97 mg per deciliter, and a normal >> prolactin.I had seen patient previously, a considered a diagnosis of >> polycystic ovarian syndrome, and she was started on Glucophage.An >> endocrinologist and Dallas ordered a 3-hour glucose tolerance test, >> which had an elevated two-hour specimen of 162 mg per dl. MRI of the >> brain noted no evidence of pituitary mass, nor absence of the >> pituitary gland. >> >> Physical exam notes in obese 31-year-old female, 239 pounds, 5 ft. 6 >> in..She is mild right lower quadrant pain, and although difficult to >> evaluate, there is an impression of a mass.She is scheduled for a >> pelvic ultrasound in two days. >> >> By question is this, other than in estradiol level, and an Inhibin >> level, which other studies should be drawn?Can one draw a GnRH level? >> >> Richard Chudacoff, MD, FACOG >> >> Chudacoff Obstetrics & Gynecology, PLLC >> >> 15200 Southwest Freeway, #270 >> >> Sugar Land, TX 77478 >> >> Tel: 281-277-3900 >> >> Fax: 281-277-3901 >> >> rchudacoff@mylinuxisp.com >> >> Richard.Chudacoff@obgyn.net >> >> http://www.mdhub.com/281-277-3900 >> >> http://www.chudacoffobgyn.yourmd.com >> >> ********************************************************************** >> >> Neither the confidentiality nor the integrity of this message >> >> can be guaranteed following transmission on the Internet. >> >> ********************************************************************** >> > > ************************************************************************* Charlie Chambers Hood River, OR -- cchamber@alumni.rice.edu "No matter where you go... there you are." Dr. Buckaroo Banzai ************************************************************************ Next message: Charlie Chambers: "Re: Puzzling case" Previous message: Lynn D. Montgomery, M.D.: "New one on me" In reply to: Joe Cutchin: "Re: Puzzling case" Next in thread: Charlie Chambers: "Re: Puzzling case"

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