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* Q@Q Drill time ③
  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/ 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?

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* Re:Q@Q Drill time ③
  cardio69 - 01/09/17 19:25
  Time's UP>  
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* Re:Q@Q Drill time ③
  corpulmonale - 01/09/17 19:26
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* Re:Q@Q Drill time ③
  cardio69 - 01/09/17 19:30
  @cor, your pick characteristic of a defect what?  
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* Re:Q@Q Drill time ③
  corpulmonale - 01/09/17 19:36
  17 alfa hydroxylase def?  
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* Re:Q@Q Drill time ③
  corpulmonale - 01/09/17 19:37
  I'm confused with this question. Plz explain  
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* Re:Q@Q Drill time ③
  cardio69 - 01/09/17 19:54
  Base on your ans here tell me that form of hypogonadism that is due to a problem with?  
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* Re:Q@Q Drill time ③
  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
  acestep11 - 01/09/17 20:06
  B? Androgen insensitivity $  
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* Re:Q@Q Drill time ③
  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
  cardio69 - 01/10/17 14:37
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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