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  #1  
Old 08-17-2012
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Arrow Belindalimm Daily Questions: Embryology #1

Hi there,

I'm deciding to post a question here every business day (Mon--Friday) to help each other strengthen basic knowledge and clear blind spots in our understanding. I'm not the master here, and still in the middle of preparation for the step 1 exam, so I'm not the pro in this field. Some of the questions will be post here are within my current knowledge, some of them may be not. But I really want to share my opinions towards the question and would like to hear from yours too. In this way, I believe, we can make progress together, no matter how prominent those progresses are they indeed will build up together and give us more chances to do better in the real battle.

Okay, here goes the today's question:

An 18-year-old woman comes to the physician because she has not yet menstruated. Physical examination shows normal external genitalia with sparse pubic hair and breast development at Tanner Stage V, but the cervix is not seen during a pelvic examination. Which of the following additional findings is most likely to be present in this patient?

A. A 46,XX genotype
B. Adrenal cortex hyperplasia
C. Clubbed feet
D. Defects in alpha-reductase
E. Testes in the inguinal canal
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  #2  
Old 08-17-2012
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Does somebody know how to rule out adrenal cortex hyperplasia?
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Old 08-17-2012
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E. Androgen Insensitivity.
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Quote:
Originally Posted by Step-step View Post
E. Androgen Insensitivity.
Yes, the correct choice is E.

Could you explain a little bit? For example, how to choose between adrenal hyperplasia and androgen insensitivity?
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Quote:
Originally Posted by Step-step View Post
E. Androgen Insensitivity.
I don't understand why "she" has the normal external genitalia? If "she" is non responsible to androgen, "she" probably cannot maintain the male genitalia, right? Is the "normal external genitalia" mentioned in the question stem referring to the female one?

Being so confused towards this fact. Thanks a lot!
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Old 08-17-2012
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Originally Posted by belindalimm View Post
I don't understand why "she" has the normal external genitalia? If "she" is non responsible to androgen, "she" probably cannot maintain the male genitalia, right? Is the "normal external genitalia" mentioned in the question stem referring to the female one?

Being so confused towards this fact. Thanks a lot!
yes, the pubic hair... the breast development, and external genitalia mentioned in the stem are referring to the characteristics of a normal female. But she's missing a uterus since the sertoli cell were not affected and were able to produce MIF making her vagina end into a blind pouch.
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Old 08-17-2012
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Androgen insensitivity synd is a loss of func mutatn in d androgen receptr (x linkd)--so, fetal DHT n test not abt to exert its effects..

1)testis present (cz of presence of Y chr)
2)Absent fallopian tubes,uterus,cervix,upeer vagina ( cz testis does produce MIF, wich normally cz regressn of these structures in males)
3) No male accesory structures-vas deferens, seminal vesicl, epididymis ( cz testosterone cannot exert effect)
4)no DHT effect- so external genetalia remain female- vagina ends in blind pouch (remembr, genitalia is phenotypically female B4 DHT is producd)..


dis a video abt 2 women wt AIS...watch it if u hv time..

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Old 08-19-2012
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Default need help...

Guys can you tell me what books are you studying in embryology??
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is this question from kaplan qbank
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Quote:
Originally Posted by belindalimm View Post

An 18-year-old woman comes to the physician because she has not yet menstruated. Physical examination shows normal external genitalia with sparse pubic hair and breast development at Tanner Stage V, but the cervix is not seen during a pelvic examination. Which of the following additional findings is most likely to be present in this patient?

A. A 46,XX genotype
B. Adrenal cortex hyperplasia
C. Clubbed feet
D. Defects in alpha-reductase
E. Testes in the inguinal canal
d)Defects in alpha-reductase

qbank question: feminization till pubrty,if not treated at which time virilization penis at 12 syndrome..
DHT absent, internal male genitalia present,testes present within abdominal cavity
(no internal female genitalia)...
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A. A 46,XX genotype
B. Adrenal cortex hyperplasia
C. Clubbed feet
D. Defects in alpha-reductase
E. Testes in the inguinal canal

a) normal genotype
b)no testosterone,extrnal female genitalia,wolfian and mulerian duct degenrates,patient presents with HTN ( BUT Here i would like to ask how mulerian duct degenrates???)
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Quote:
Originally Posted by belindalimm View Post
Does somebody know how to rule out adrenal cortex hyperplasia?
no internal sex organs, condition must be genetic
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Quote:
Originally Posted by riya_rai84 View Post
A. A 46,XX genotype
B. Adrenal cortex hyperplasia
C. Clubbed feet
D. Defects in alpha-reductase
E. Testes in the inguinal canal

a) normal genotype
b)no testosterone,extrnal female genitalia,wolfian and mulerian duct degenrates,patient presents with HTN ( BUT Here i would like to ask how mulerian duct degenrates???)
MIF by testes
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Quote:
Originally Posted by ehtisham View Post
is this question from kaplan qbank
Yup. You've encountered the same question? They really provide some good questions!
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Quote:
Originally Posted by belindalimm View Post
Does somebody know how to rule out adrenal cortex hyperplasia?
no internal male or female genitalia,only have external female genitalia and patient can also present with HTN
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Embryology-, Endocrine-, Pathology-, Reproductive-, Step-1-Questions

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