During the evaluation of secondary amenorrhea in a 24-year-old woman, hyperprolactinemia is diagnosed. Which of the following conditions could cause increased circulating prolactin concentration and amenorrhea in this patient?

a. Stress

b. Primary hyperthyroidism

c. Anorexia nervosa

d. Congenital adrenal hyperplasia

e. Polycystic ovarian disease

the answer is below…

The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.

The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.

This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.

The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.

All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.

Medical doctors with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States of America

The correct answer is a; Stress.[1]

In anorexia nervosa, prolactin, thyroid-stimulating hormone (TSH), and thyroxine levels are normal, FSH and LH levels are low, and cortisol levels are elevated. Prolactin is under the control of prolactin-inhibiting factor (PIF), which is produced in the hypothalamus. Many drugs (e.g., the phenothiazines), stress, hypothalamic lesions, stalk lesions, and stalk compression decrease PIF. In hypothyroidism, elevated TRH acts as a prolactin-releasing hormone to cause release of prolactin from the pituitary; hyperthyroidism is not associated with hyperprolactinemia. There are many other conditions, such as acromegaly and pregnancy, that are associated with elevated prolactin levels. Hyperandrogenic conditions such as congenital adrenal hyperplasia or polycystic ovarian disease are not typically associated with hyperprolactinemia.