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  #1  
Old 08-06-2016
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Default Qbank question help

Attached is the stem of the question. Can anyone tell how you DDx androgen insensitivity from Mullerian agenesis from the stem alone?

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Old 08-08-2016
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You will know the difference looking at the Tanner Staging, scant pubic and axilary hair is due to androgen insensitivity syndrome. This case seems to be Mullerian dysgenesis because they say she is Tanner stage 4.
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Old 08-08-2016
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Quote:
Originally Posted by Ina2990 View Post
You will know the difference looking at the Tanner Staging, scant pubic and axilary hair is due to androgen insensitivity syndrome. This case seems to be Mullerian dysgenesis because they say she is Tanner stage 4.
I see, so you are saying that if it's androgen insensitivity, the Tanner stage especially for pubic hair will be less than a stage 4?
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Old 08-08-2016
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For exam purposes if the question says axillary and pubic hair are present, it is mullerian agenesis and if it says axillary and pubic hair absent, it is androgen insensitivity.
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Old 08-08-2016
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Quote:
Originally Posted by Step-One View Post
I see, so you are saying that if it's androgen insensitivity, the Tanner stage especially for pubic hair will be less than a stage 4?
Yes. Also they could say they did a karyotype which turned out to be 46 XY, measured testosterone levels which were very elevated or found inguinal masses making a reference to undescended testes.
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Old 08-09-2016
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Awesome! Thank a lot everyone!
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Old 09-11-2016
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Late reply, sorry!
Yes, the presence of Tanner stage 4 axillary and pubic hair does rule out androgen insensitivity because hair growth is androgen dependent in both sexes. But the biggest clue in the stem, for me is the fact that she has a short vagina and uterus is not palpable. Since uterus and upper 2/3rds of vagina are derived from Mullerian Ducts, this is a case of Mullerian Agenesis.

Also, ambiguous external genitalia and undescended testes would have been present in androgen insensitivity. Her external genitalia are normal on examination.
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