Instructions
You are a medical student on placement in general practice. Your next patient is Kavya Sharma, 37, an office manager with hot flushes and no periods for eight months. She is back for her blood test results, which are below.
Explain the results and your management plan to the patient
- You do not need to take a further history or examine the patient.
- The examiner will ask you one question at the end.
From her first visit
Also night sweats and vaginal dryness. Regular periods until eight months ago; never pregnant. No chemotherapy, radiotherapy or pelvic surgery. No hormonal contraception.
Blood tests (first sample 6 weeks ago; repeat 2 weeks ago)
| Item | Value | Reference range |
|---|---|---|
| FSH, first sample | 78 IU/L | 3-10 IU/L |
| FSH, repeat 4 weeks later | 84 IU/L | 3-10 IU/L |
| Oestradiol, repeat sample | 45 pmol/L | 100-900 pmol/L |
| Serum hCG | Less than 5 IU/L | <5 IU/L |
| TSH | 1.9 mIU/L | 0.4-4.0 mIU/L |
| Prolactin | 240 mIU/L | 100-500 mIU/L |
Reference ranges for FSH and oestradiol are for the follicular phase of a regular cycle.