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* Q@Q Drill time ③
 #836116  
  cardio69 - 01/09/17 19:20
 
  A 22 y/o F present to your because concern for not reaching menstrual period in her 22 yrs life. On PE you place your hand midway abdomen between the umbilicus & symphysis pubis while you trying to elevate the cervix & uterus with your pelvic hand you hand on abdominal in & down you notice nothing to grasp on. Assessment of sexual maturity you notice absent pubic & axillary hair and small breasts. Future evolution include a Karyotype 46, XY. Surgical resection of gonadal structures reveal seminiferous tubules with present norm/ http://www.ouhsc.edu/histology/Glass%20slides/104_03.jpg Loss of function mut in coding sequence for androgen R found. Which of the following sets of lab findings/serum match your pat prior to surgery?

---LH---TESTOSTERONE
a)-High------Low
b)-High------High
c)-Low-------High
d)-Low-------Low
e)-Norm-----Norm
_______________________________________72sec___________________________________
 
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* Re:Q@Q Drill time ③
#3323513
  cardio69 - 01/09/17 19:25
 
  Time's UP>  
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* Re:Q@Q Drill time ③
#3323514
  corpulmonale - 01/09/17 19:26
 
  D  
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* Re:Q@Q Drill time ③
#3323517
  cardio69 - 01/09/17 19:30
 
  @cor, your pick characteristic of a defect what?  
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* Re:Q@Q Drill time ③
#3323519
  corpulmonale - 01/09/17 19:36
 
  17 alfa hydroxylase def?  
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* Re:Q@Q Drill time ③
#3323521
  corpulmonale - 01/09/17 19:37
 
  I'm confused with this question. Plz explain  
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* Re:Q@Q Drill time ③
#3323522
  cardio69 - 01/09/17 19:54
 
  Base on your ans here http://www.usmleforum.com/files/forum/2017/1/836111.php tell me that form of hypogonadism that is due to a problem with?  
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* Re:Q@Q Drill time ③
#3323523
  cardio69 - 01/09/17 19:57
 
  I need to get back to work now, I need u to ans last/above drill here when u get chance, Later.  
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* Re:Q@Q Drill time ③
#3323526
  acestep11 - 01/09/17 20:06
 
  B? Androgen insensitivity $  
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* Re:Q@Q Drill time ③
#3323527
  corpulmonale - 01/09/17 20:10
 
  @cardio- that's hypogonadotropic hypogonadism - kallman syndrome. Main problem in GnRH . Dec GnRH > decrease LH FSH > Dec testosterone  
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* Re:Q@Q Drill time ③
#3323623
  cardio69 - 01/10/17 14:37
 
  @core
SO, that would be hypothalamus OR pituitary gland problem.
*B* would be right ans.

We got pat here “Complete AIS” that gender of F with genitalia appearance of and on PE-> clear pic of absent of uterus & 2nray sexual hair sparse -> Absent. On pat like it u can find gonads in abdominal or inguinal> Note Vagina can be short but here I told you pat “Loss of function mutation in coding sequence for androgen R/AR found” & also preach that DNA analysis tell you pat MALE “karyotype identified as 46, XY.
Now, you should know in infant/& newborn the Lab dx is bit difficult. (But pat here 22 y/o) so, u know LH basal levels may be LOW & TESTOSTERONE ONLY ↑ after tickling with exogenous HCG.
After puberty (we assume as case here) if gonadectomy has not been done-> Serum TESTOSTERONE conc -> HIGH norm to slightly elevation range for POSTpubertal bodys
Estradiol levels are in upper norm in MALE
- That been said if our pat lack or response to testosterone during the fetal period -> FEMALE external genitalia
- What happen to breast? Aromatization of testosterone -> breast dev
- R in hypothalamic & pituitary also defective & norm suppression of pituitary gonadotropin ( LH ) NOT there
- HIGH HL -> ↑testosterone production by norm slide/leyding that I embedded in stem

The End.
___________________________________________________
Q) Can you tell me if pat was pinted PARTIAL AIS Female time of gonadectomey would favored?

a) Post pubertal
b) No gonadectomy
c) No gonadectomy/but u check on pat
d) Pre pubertal

72sec for those online.
 
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