Reproduction

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Question 1
Which of the following features is NOT seen in hyperandrogenism?

(A) Raised haematocrit
(B) Androgenetic alopecia
(C) Post-menopausal bleeding
(D) Hirsuitism
(E) Thrombocytocis

E: Raised haematocrit occurs as a result of testosterones downregulation of hepcidin. Circulating angrogens trigger the synthesis of hair but also supresses the growth of hair on the scalp, which is known as male-pattern baldness, or androgenetic alopecia. Abnormal uterine bleeding occurs because the circulating testosterones are converted to oestrogens, triggering endometrial hyperplasia. Endometrial hyperplasia without concomitant progesterone will cause abnormal bleeding. N Engl J Med 2015; 373:1660-1666

Question 2
A 17 year old female presents with failure to menstruate. She has never had a period. There is no history of anosmia, although there is a history of bilateral inguinal hernias. She has absent pubic and axillary hair however her breast development is normal. Her height is also normal for her age. There is no sign of intellectual impairment. What is the most likely diagnosis?

(A) Kallmans syndrome
(B) Klinefelters syndrome
(C) Androgen insensitivity syndrome
(D) Turners syndrome
(E) Asherman's syndrome

C: Kallmans syndrome occurs due to failure of development of the olfactory bulb. Anosmia is a predominant component. The presence of breast development in the absence of secondary sexual hair, with a history of hernias as a child is suggestive of a diagnosis of androgen insensitivity syndrome. It is likely that the hernias were related to undescended testes. The vagina is blind ended, and there are no ovaries.

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  • About
  • Written
    • Respiratory Medicine
    • Medical Oncology >
      • Colorectal Cancer
      • Lung Cancer
      • Urogenital Cancers
      • Emergencies
      • Melanoma
      • Breast
    • Haematology >
      • Anaemia
      • Coagulation
      • Malignancy
    • Cardiology >
      • General Cardiology
      • Coronary Artery Disease
      • Heart Failure
      • Valvular Heart Disease
      • Arrhythmia
    • Endocrinology >
      • General Endocrinology
      • Reproduction
      • Pituitary
      • Diabetes
    • Clinical Immunology
    • Clinical Toxicology
    • Genetics
    • Geriatrics
    • General Medicine
    • Statistics
    • Gastroenterology >
      • Pancreas
      • Inflammatory Bowel Disease
      • Oesophageal Diseases
      • Stomach and Small Intestine
      • Liver
    • Infectious Diseases >
      • Viruses
      • Bacteria
      • Parasites
      • Fungus
    • Neurology >
      • Anatomy
      • Nystagmus
      • Myopathies
      • Stroke
      • Neurodegenerative Disorders
      • Neuropathy
    • Nephrology >
      • Glomerulonephritis
      • General Nephrology
      • Chronic Kidney Disease
    • Psychiatry
    • Palliative Care
    • Pharmacology
    • Rheumatology >
      • Rheumatoid Arthritis
      • Connective Tissue Diseases
      • Spondyloarthropathies
      • Crystal Arthropathy
  • Clinical
    • Short Cases >
      • Haematology
      • Endocrine
      • Neurology
      • Rheumatology
      • Renal
      • Gastroenterology
      • Cardiology
      • Respiratory
    • Long Cases >
      • Addiction & Psychiatry
      • Cardiology
      • Endocrinology
      • Geriatrics
      • Gastroenterology
      • Renal
      • Haematology
      • Infectious Diseases
      • Oncology
      • Rheumatology
      • Respiratory
      • Neurology
      • Set pieces
  • Medical Students
  • Respiratory
    • Asthma >
      • Acute Exacerbation
    • COPD >
      • Exacerbations
    • Lung Cancer >
      • Targeted therapy
    • Tobacco
    • Questionnaires