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Case: A 29-year-old woman G0P0 comes to your clinic and complains of trying to conceive with her husband for over a year. She reports no prior health problems or surgeries. Her height is 5'6" and her weight is 165 lbs. with a BMI of 26.63. Her vital signs are WNL. Her LMP was 2 months ago, but she reports they have never really been regular since menarche (coming approximately every 6 weeks for the first 10 years), but have been irregular (coming at random intervals-sometimes 1 month, 2 months, or 3 months apart) for approximately 7 years. Her pregnancy test is negative. Upon physical examination, you note some acne and hirsutism on her face, as well as acanthoses nigricans on her neck. All other physical exam aspects are WNL.
What are your differential diagnoses?What is your plan of care, and why?What patient education is pertinent during this visit?
Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including the inclusion of complementary and OTC therapy, referrals, and other team members needed to complete patient care.
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