There are a few possible reasons for this.
1. You have two Monitor Captures pointing at the same monitor. One in Recording, one in Transmission. Delete one and 'add existing' to re-use the existing one. MCs are notorious for poor performance and conflicting with other captures... including other MCs.
2. Your monitors are running mismatched rates. There is a long-standing Windows bug with 3D accelerated applications on multiple monitors at different refresh. Supposedly fixed in the v2004 patch, it did not fix it for everybody. The fix is to run all monitors at the same refresh (so 60hz in your case) or right-click the Preview window in OBS and choose 'disable'.
3. Judder. Your main monitor is running at 144hz, which will not provide a clean pull-down to the 30/60fps streaming framerate. Run the monitor at 120hz so OBS will just take every other frame, instead of 1-2-skip-a-few.
4. AMF. AMF is awful. Truly, there are no words. AMD stopped providing support for it. The main dev maintaining it walked away because it got so bad. Quality is poor, and it uses game-rendering resources for encoding, causing an in-game performance hit. Swap to x264, or swap to an nVidia GPU with NVENC (which has stellar quality, and is a separate part of the GPU *just* for video encoding, with no in-game performance impact).
5. Dropped frames are 100% ALWAYS a network issue. Bear in mind that sites like speedtest.net are worthless for livestreamers. They test PEAK speed, and ignore the minimum-constant speed that livestreaming relies on. It's like jumping and touching the highest spot on a wall that you can, and saying you're that tall. Additionally, those tests are to different servers than the streaming ingest servers, so if your connection to the YouTube ingest is problematic, you can test fine and still have connection issues. Twitch allows bandwidth/quality testing directly to their servers (resulting in the excellent
R1ch's Twitch Test tool). Youtube specifically blocks bandwidth testing to their servers in their ToS.
Hope some of this helps, man.