what is the answer to this Q ? - goodjob07

[ArchivalUser]

the q below was posted in this forum, no one replied yet..?help with the ans please.thanks

A 14-year old girl visits her pediatrician because of primary amenorrhea. Breast development occurred as expected at puberty, but axillary and pubic hair is still fine and unpigmented. She is 5' 5" tall and weighs 105 lb. Pelvic examination reveals a shortened vagina with no discernible cervix or uterus. Serum LH concentration is markedly increased compared to normal. Which of the following is the most likely cause of the amenorrhea?
A. 17-alpha-hydroxylase deficiency
B. Complete androgen resistance
C. Constitutional delay in the onset of menses
D. Hyperprolactinemia
E. Turner's syndrome

[ArchivalUser]

B.

[ArchivalUser]

A is incorrect simply becuase in 17 hydoxylase deficiency there is no sex steroids at all so it is not possible to develop breast because breast development need esrtogen
C doesnot explain abscence of the cervix and uterus
D again doesnot explain absence of uterus and cervix and also in hyperprolacteinemia there is decrease of LH and FSH
E is incorrect because in Turner syndrome the patient has normal uterus and cervix but streaky ovaries and again breast canot develop because no estrogen is produced by ovaries

[ArchivalUser]

Yes i agree its B..this is testicular feminisation...testosterone levels will be high and karyptype will be 46XY.LH is increased because androgen receptor is defective everywhere and it fails to exert a negative feedback...

[ArchivalUser]

good going amir.. your explanations are always clear..keep it up!

[ArchivalUser]

thank you yo Amir 2000 and draashna GL