OB/GY q "periodic low-volume vaginal bleeding"

[MudPhud20XX]

A 34 yr old female is being evaluated for periodic low volume vaginal bleeding. A cytological finding on cervical smear microscopy will most likely show:

A. Endometrial cell
B. Clue cell
C. Parabasal cell
D. Glandular cell
E. Koilocyte

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[MudPhud20XX]

Here is another q I would like to hear your thoughts.

A 15 yr old girl is brought in for evaluation of amenorrhea. She has never menstruated, but her mother had menarche at age 14. The pt has no other medical problems or allergies. She takes no medications and does not use tobacco, alcohol, or drugs. The pt plays the violin for her high school orchestra and is the captain of her junior varsity tennis team. She is not sexually active. Her height is 175 cn, weight is 64 kg, and BMI 21.1 kg/m2. Examination shows fully developed secondary sexual characteristics. Pelvic ultrasound shows a shortened vaginal canal with a rudimentary uterus. Which of the following is the most likely diagnosis in this pt?

A. 21-hydroxylase deficiency
B. 47, XXX karyotype
C. Androgen insensitivity syndrome
D. Kallmann syndrome
E. Klinefelter syndrome
F. Turner syndrome
G. Vaginal agenesis

 

[seminoma]

A 34 yr old female is being evaluated for periodic low volume vaginal bleeding. A cytological finding on cervical smear microscopy will most likely show:

A. Endometrial cell
B. Clue cell
C. Parabasal cell
D. Glandular cell
E. Koilocyte

Not enough information to answer this question.

Here is another q I would like to hear your thoughts.

A 15 yr old girl is brought in for evaluation of amenorrhea. She has never menstruated, but her mother had menarche at age 14. The pt has no other medical problems or allergies. She takes no medications and does not use tobacco, alcohol, or drugs. The pt plays the violin for her high school orchestra and is the captain of her junior varsity tennis team. She is not sexually active. Her height is 175 cn, weight is 64 kg, and BMI 21.1 kg/m2. Examination shows fully developed secondary sexual characteristics. Pelvic ultrasound shows a shortened vaginal canal with a rudimentary uterus. Which of the following is the most likely diagnosis in this pt?

A. 21-hydroxylase deficiency
B. 47, XXX karyotype
C. Androgen insensitivity syndrome
D. Kallmann syndrome
E. Klinefelter syndrome
F. Turner syndrome
G. Vaginal agenesis

Sounds like vaginal agenesis to me.

A - doesn't have structural effects
B - as above
C - my second choice, but would probably look for mention of testes in the stem (mass in labia)
D - no
E - nope
F - nope

 

[MudPhud20XX]

The answer is "vaginal agenesis," but from the question stem, I don't see why that is a better answer choice over "androgen insensitivity syndrome."

 

[seminoma]

The answer is "vaginal agenesis," but from the question stem, I don't see why that is a better answer choice over "androgen insensitivity syndrome."

Uterus would be absent, not just rudimentary. Androgen insensitivity are XY.

 

[MudPhud20XX]

Uterus would be absent, not just rudimentary. Androgen insensitivity are XY.

yup, I got confused with "rudimentary vagina", uterus should be absent! thanks!