NBME 20

nbme20/Block 2/Question#43

An 18-year-old woman comes to the physician because ...

Ovaries

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 +2  upvote downvote
submitted by step420(11),

This is mullerian agenesis. Normal ovaries but absent uterus.

endochondral   why not androgen insensitivity? +  
shaeking  I was wondering the same thing because doesn't androgen insensitivity also have normal female secondary characteristics. Was it the levels of hormones because she doesn't have abnormally high testosterone? +  
swb  Androgen insensitivity has the same presentation and symptoms. What's the clue that it is mullerian agenesis instead ? +  

 +0  upvote downvote
submitted by sympathetikey(63),

Mullerian Agenesis (aka: Mayer-Rokitansky-Kuster-Hauser Syndrome)

Underdevelopment of the Mullerian system leading to congential absence of the vagina. Usually no cervix or uterus.

May present as 1° amenorrhea (due to a lack of uterine development) in females with fully developed 2° sexual characteristics. Functional ovaries allow for normal sexual characteristics and hormone levels.


 +0  upvote downvote
submitted by temmy(0),

i think it is not androgen insensitivity because the testosterone levels are normal. They should be high in AIS.