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MRCOG PART 2 SBAs and EMQs

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MCQ on Primary amenorrhoea.

MCQ on Primary amenorrhoea. Posted by Jamil Ahmad A.
Options for Questions 2-3

 

A Prolactinoma B Pre-mature ovarian failure
C Asherman?s syndrome D Ovarian hyper-stimulation syndrome
E Polycystic ovary syndrome F Hypothyroidism
G Androgen secreting tumour H Cervical stenosis
I Hypothalamic amenorrhoea J Hyperthyroidism
K Androgen insensitivity syndrome L Pure gonadal dysgenesis

Instrunctions:For each of the case histories described below, choose the single most likely cause of amenorrhoea from the above list. Each option may be used once, more than once, or not at all.
Explanation

 

Question 2 An 18 year virgin has been referred to the gynaecology clinic because she has not started menstruating but she has no other symptoms. Clinical examination showed that her height was 1.67m with BMI of 23. She had normally formed breasts but no axillary or pubic hair. There was a 2-3cm mass palpable in each inguinal canal.
Question 3 A 17 year old woman with primary amenorrhoea has been investigated with the following results: FSH = 9mIU/ml, LH = 20mIU/ml, oestradiol = 200pg/ml, free testosterone = 5.0ng/dl (1-4.3ng/dl). Karyotype is 46XY.  

For Q 3, can the answer be K , pure gonadal dysgenesis. How can we differentiate between K and L. 

Posted by Farrukh G.

Karyotype: 46XY cannot be pure gonadal dysgenesis where karyotype is 46XX.