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Question 1
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A 15 year old girl is being investigated for primary amenorrhoea. She has normal FSH,LH and E2 levels on hormone profiling and normal secondary sexual characteristics. An ultrasound shows no uterus. What is the likely diagnosis?
Your Answer: Rokitansky-Kuster-Hauser syndrome
Explanation:Mullerian agenesis occurs in 1 in 5000 to 1 in 40000 girls. The Mullerian system does not develop which results in an absent uterus and upper vagina. This condition is also known as Rokitansky-Kuster-Hauser syndrome, The ovarian function is normal and so the most common presentation is amenorrhea in the presence of an otherwise normal pubertal development.
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This question is part of the following fields:
- Embryology
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Question 2
Correct
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Ootidogenesis refers to which process during Oogenesis?
Your Answer: 1st and 2nd Meiotic Divisions
Explanation:During the early fetal life, oogonia proliferate by mitosis. They enlarge to form primary oocyte before birth. No primary oocyte is form after birth. The primary oocyte is dormant is the ovarian follicles until puberty. As the follicle matures, the primary oocyte completes its first meiotic division and gives rise to secondary oocyte. During ovulation the secondary oocytes starts the second meiotic division but is only completed if a sperm penetrates it. This 1st and 2nd meiotic division is known as ootidogenesis.
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This question is part of the following fields:
- Embryology
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Question 3
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A Bicornuate uterus is due to which of the following?
Your Answer: Abnormal fusion and reabsorption of the paramesonephric ducts
Explanation:A Bicornuate uterus (heart shaped) is the result of abnormal fusion and reabsorption of the paramesonephric ducts during embryogenesis. Mullerian agenesis typically results in failure to form a uterus. Mullerian duct fusion abnormalities can cause a bicornuate malformation. PKD-1 gene abnormalities are associated with PCOS. Crossed fused ectopia result in Horseshoe kidney.
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This question is part of the following fields:
- Embryology
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Question 4
Correct
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Which one of the following statements regarding Turner's syndrome is true?
Your Answer: Usually presents with primary amenorrhea
Explanation:Turner syndrome patients present with primary amenorrhea, have non functional or streak ovaries and cant conceive. They are 45X genetically.
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This question is part of the following fields:
- Embryology
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Question 5
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Which one of the following statements best suits Androgen insensitivity syndrome?
Your Answer: Gonadectomy must be performed after puberty because of the increased risk of malignancy
Explanation:Androgen insensitivity syndrome patients have 46XY chromosomes. They are males by genotype but appear as female because of insensitivity to male hormones. It is advisable to perform gonadectomy in these patients after puberty because these patients are at increased risk of developing malignancy.
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This question is part of the following fields:
- Embryology
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Question 6
Correct
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Question 7
Correct
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From which germ layer does the myenteric plexus of the GI tract developed:
Your Answer: Neural crest of Ectoderm
Explanation:During the 5th week, the neural crest cells migrate along each side of the spinal cord where they form ganglions located dorsolateral to the aorta. Some of these cells migrate ventrally and form neurons in the preaortic ganglia as the celiac and mesenteric ganglia.
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This question is part of the following fields:
- Embryology
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Question 8
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Regarding the closure of the ductus arteriosus (DA) after birth which of the following most accurately describes the mechanisms leading to closure of the DA?
Your Answer: Increased arterial pO2, increased bradykinin & decreased Prostaglandin E2
Explanation:Functional closure of the ductus arteriosus is neonates is completed within the first few days after birth. It normally occurs by the 12th postnatal week. It has been suggested that persistent patency of DA results from a failure of the TGF-B induction after birth. Due to increased arterial pO2, constriction of the DA occurs. In addition to this on inflation the bradykinin system is activated with cause the smooth muscles in the DA to constrict. A decrease in the E2 prostaglandin is also an important factor as raised levels have been indicated in keeping the patency of the DA.
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This question is part of the following fields:
- Embryology
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Question 9
Correct
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Which of the following statements is FALSE regarding Turner's syndrome?
Your Answer: Buccal smear is chromatin positive
Explanation:Turner syndrome patients have high FSH levels and low oestrogen levels. They have a short stature and buccal smear is chromatin negative.
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This question is part of the following fields:
- Embryology
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Question 10
Correct
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All of the following statements are true regarding Turner's syndrome except?
Your Answer: The streak ovaries should be removed surgically due to 25% tendency to be malignant
Explanation:Girls with Turner’s syndrome (45,X) are not at risk for malignancy. Patients with feminizing testicular syndrome with XY chromosome composition and patients with mixed gonadal dysgenesis are at risk for malignancy, and bilateral gonadectomy is performed.
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This question is part of the following fields:
- Embryology
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