NBME Qs discussion - wishesbest2009

[ArchivalUser]

a 16yrs old girl is brought by her mother because she has nerve had a menstrual period. she is 140cm and weighs 45kg; BMI is 23kg/m2. physical examination shows little development of 2nd sexual characteristics. which of the following is most likely on the ovaries?
1. atrophy
2. corpora lutea
3. Gonadoblastoma
4. Polycystic ovarian disease
5. Teratoma

[ArchivalUser]

1. atrophy

[ArchivalUser]

Breast present- Uterus present ...that mean patient has xy dysgenesis....I would call sewer syndrome which is related to Gonadoblastoma

[ArchivalUser]

XY karyo type is typically related to Swyer syndrome......related to Primary Amenorrhea

[ArchivalUser]

why not a Turner`s syndrome here?

[ArchivalUser]

possible......which is most common cause

[ArchivalUser]

can it be pcod- prepubertal type? am i right?

[ArchivalUser]

111..........streak ovary

[ArchivalUser]

if its streak, u dont get secondary sexual characters completely. so it should be pcod- prepubertal..

[ArchivalUser]

33333333333 gonadoblastoma exists early in life.

Most of these tumors are identified within the first 2 decades of life. A review of the literature noted that 94% of cases of neoplasia that arise in dysgenic gonads are diagnosed when the patient is younger than 30 years; in one case, a neoplasm was diagnosed when the individual was aged 6 months.3 Patients with complete male pseudohermaphrodism (46,XY) present after puberty, with primary amenorrhea often the initial clue leading to the diagnosis. However, in patients with partial androgen insensitivity and male pseudohermaphrodism (46,XY), abnormal appearance of genitalia at birth allows for earlier detection. Unless diagnosed soon after birth, most gonadoblastomas are identified in postpubertal individuals when they present with primary amenorrhea.