FSH, LH, testosterone, and DHEAS levels. The patient
in the above vignette exhibits signs and symptoms of polycystic
ovarian syndrome (PCOS) as the cause of her dysfunctional uterine
bleeding. The child is overweight, hypertensive and has findings
of hirsutism, acne, and acanthosis nigricans. Although the results
of the FSH, LH, testosterone and DHEAS levels will not be known
immediately, these tests will be helpful and diagnostic in this
patient. Although, we recommend a pregnancy test in all females
with irregular vaginal bleeding, this test would not explain all
of her other physical findings. Stool for blood would not be helpful.
There are no history or physical findings consistent with a coagulopathy
in this child. Although, patients with hypothyroidism have symptoms
of weight gain, apathy, depression, and hair and skin changes, thyroid
disease would not completely explain her physical findings and thyroid
function tests would not be diagnostic.