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USMLE · Question #582

A 15-year-old female is brought to the physician by her mother because she is concerned that she has not started menstruating. Physical examination reveals the patient's vagina is very shallow…

The correct answer is D. Mullerian inhibiting factor. Androgen insensitivity syndrome also known as testicular feminization is a disorder of sexual development characterized by uterovaginal agenesis. Patients appear phenotypically female and may have breasts but lack a uterus and other female internal reproductive organs. They…

Normal Structure and Function

Question

A 15-year-old female is brought to the physician by her mother because she is concerned that she has not started menstruating. Physical examination reveals the patient's vagina is very shallow without a palpable uterus. There are also palpable masses in the labia majora. Karyotype analysis reveals a 46, XY genotype. Which of the following was most likely present during the early fetal life of this patient?

Options

  • AA uterus
  • BAn oviduct
  • CDecreased androgen levels
  • DMullerian inhibiting factor
  • EStreak ovaries

How the community answered

(44 responses)
  • A
    2% (1)
  • B
    9% (4)
  • C
    5% (2)
  • D
    82% (36)
  • E
    2% (1)

Explanation

Androgen insensitivity syndrome also known as testicular feminization is a disorder of sexual development characterized by uterovaginal agenesis. Patients appear phenotypically female and may have breasts but lack a uterus and other female internal reproductive organs. They also have XY chromosomes and are genotypically males. The gene for testes-determining factor (TDF) is on the Y chromosome and it causes the indifferent gonads to develop into testis- Sertoli cells. Sertoli cells secrete Mullerian inhibitory factor (MIF), a substance that suppresses the development of paramesonephric ducts, preventing the formation of female internal reproductive organs.

Topics

#androgen insensitivity syndrome#Mullerian inhibiting factor#sexual differentiation#46 XY female phenotype

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