QBANK A 31-year-old woman comes to the physician because she has not had a menstrual period for 7 months. She previously had normal cycles. She also states

[DianaZ]

A 31-year-old woman comes to the physician because she has not had a menstrual period for 7 months. She previously had normal cycles. She also states that over the past year she has felt increasingly weak and tired. She notes that she always feels cold and that her hair has been thinning over the course of the year. She also complains of constipation, weight gain, and depression. Her temperature is 36.7C (98F), blood pressure is 100/60mm Hg, pulse is 56/minute, and respirations are 10/minute. Examination is significant for brittle hair and delayed deep tendon reflexes. Urine human chorionic gonadotropin (hCG) is negative. Thyroid stimulating hormone (TSH) is 20 μU/mL. Prolactin is normal. Which of the following is the most likely cause of this patient's amenorrhea?

A. Hyperprolactinemia
B. Hypothyroidism
C. Kallmann syndrome
D. Polycystic ovarian syndrome
E. Pregnancy