<prompt> A female with primary amenorrhoea with negative progesterone challenge test but positive combined progesterone estrogen test. Diagnosis may be:Mullerian agenesisPCODAsherman syndromeProlactinoma  <response>: Ans. D Female is having amenorrhoea dt hypothalamic or pituitary cause, so prolactinoma is only answer among optionsProgesterone Challenge Test Indications ; Amenorrhea evaluation Procedure : Administer Progesterone Assess for Menstrual Bleeding after Progesterone Anticipate within 7 days of Progesterone completion Interpretation Withdrawal bleeding within Progesterone deficiency See Normogonadotropic Hyprogonadism for causes Enddometrial Caner risk with unopposed Estrogen- Requires Progesterone replacement No withdrawal bleeding Perform Estrogen-Progesterone Challenge Test- No withdrawal bleed suggests outflow obstruction Obtain Serum FHS and Serum LH FSH 20 and LH 40: Hypergonadotropic hypogonadism FSH and LH 5: Hypogonadotropic HypogonadismEstrogen-Progesterone Challenge Test Indications Secondary Amenorrhea evaluation No withdrawal bleeding with Progesterone Challenge test Procedure Administer Estrogen-Progesterone Assess for Menstrual Bleeding after stopping medication Anticipate within 7 days of medication completion Interpretation No withdrawal bleeding occurs Suggests uterine bleeding outflow obstruction Withdrawal bleeding but not after Progesterone alone Obtain Serum FSH and Serum LH- FSH 20 and LH 40: Hypergonadotropic hypogonadism- FHS and LH 5: Hypogonadotropic hypogonadism 