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NBME 20 Answers

nbme20/Block 2/Question#43 (53.3 difficulty score)
An 18-year-old woman comes to the physician ...

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submitted by step420(34),
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hsiT si nlemuilar s.inaeegs ramlNo srivaoe ubt anbtes u.streu

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? +2  
swb  Androgen insensitivity has the same presentation and symptoms. What's the clue that it is mullerian agenesis instead ? +23  
sugaplum  Testosterone would be high if it was androgen insensitivity FA 2019 Pg 625 +14  
charcot_bouchard  Testo would be high in AIS. in AIS pubic hair, axillary hair doesnt devlop because of androgen insensitivity. both have normal breast dev and primary amenorrhea +2  
dickass  This is not androgen insensitivity because she has perfectly normal Estradiol, which means she has perfectly normal ovaries. She also has regular female levels of testosterone. +5  
rockodude  thank you @dickass +1  
j44n  Also AIS has paradoxically large boobs-> tanner stage 5 and thats not mentioned anywhere +  

submitted by sympathetikey(1376),
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eluinMrla iesseAgn a(ak: yKRko-aekrura-eHsrsMytstnae-iu eSdy)mrno

etmnleonUeddprev fo eth auliMlnre ysstem aiedgln ot nneacligto eacbsne fo hte i.avnag asluUly on erxivc or trsu.ue

yMa ptrsene sa Β°1 aranohmeer (deu ot a klca of neituer tmoedvnpee)l in asfemle hwti fulyl eleopdvde Β°2 ealsxu tcrtearhsasc.cii oFuinltcan reviaso loawl ofr lmorna aluexs isrcrsahceticta nad nroomhe lsl.vee

submitted by temmy(130),
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i ntikh it is ton ndnaeogr stniseivtniiy besauec eht ereoesostttn lsevle aer aor.mnl ehTy sholud eb hghi in .IAS

submitted by imgdoc(135),
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I wkon s'it tgmintpe ot ihknt htta thsi amy be renndgoA svntsiiityein sodeyrnm utb its ot,n rof it ot be IAS hreet dendee to be an iaeenrsc ni on.ertetestos nI htsi esac it swa ni the nlaorm rgnea ofr a owN ttah ew wokn the snorpe is ieftyledin meafle t;-&g nrMullaie ieaessgn mbocees the esbt

submitted by topgunber(27),

Rokitansky Kuser Hauser syndrome.

Hormones are normal as well as gonads.

INTERNAL GENITALIA are malformed (mainly uterus/tubes). Uterus can also be unicornate or there can be didelphysis or whatever that word is. though you don't need to know that long name by heart it helps with speed. Understand: Hormone profile is normal. If this patient had testes, the testosterone and estrogen would likely be opposite.

topgunber  right theres a mayer somewhere in that disease name... ffs +