USMLE Forum Archives - USMLE Step 1 - Pathology 5
Pathology 5
TheOne - 09-23-06 15:19
A 14-year-old female is evaluated for delayed puberty and short stature. Her height is 3 standard deviations below the mean for her age. She exhibits a webbed neck, low-set ears, fish-like mouth, and ptosis. Biopsy of her ovary reveals the presence of fibrous stroma arranged in whorls. Chromosomal analysis shows a 45,XO karyotype. Which of the following laboratory findings would be most likely in this individual?
A. Decreased plasma growth hormone
B. Decreased plasma thyroid hormone
C. Increased plasma follicle stimulating hormone
D. Increased plasma inhibin
E. Increased plasma estrogen
TheOne - 09-23-06 15:19
A 14-year-old female is evaluated for delayed puberty and short stature. Her height is 3 standard deviations below the mean for her age. She exhibits a webbed neck, low-set ears, fish-like mouth, and ptosis. Biopsy of her ovary reveals the presence of fibrous stroma arranged in whorls. Chromosomal analysis shows a 45,XO karyotype. Which of the following laboratory findings would be most likely in this individual?
A. Decreased plasma growth hormone
B. Decreased plasma thyroid hormone
C. Increased plasma follicle stimulating hormone
D. Increased plasma inhibin
E. Increased plasma estrogen
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#1
Re: Pathology 5
TheOne - 09-25-06 13:10 Explanation: The correct answer is C. The 45,XO karyotype results in Turner's syndrome, which is characterized by ovarian dysgenesis and a variety of somatic abnormalities including micrognathia, a fish-like mouth, a shield chest, low-set ears, ptosis, and a webbed neck. Other findings can include coarctation of the aorta, hypertension, and renal abnormalities. Short stature is invariably present; the cause is not known because plasma levels of growth hormone (choice A) and thyroid hormone (choice B) are typically not decreased. Clinical studies have shown, however, that injections of human growth hormone can increase the final height. The ovaries are usually streak-like and exhibit only fibrous stroma. The ovarian dysgenesis leads to decreased secretion of estrogen (not increased, choice E) and inhibin (not increased, choice D) and persistent infantilism. Plasma levels of FSH are markedly increased due to the lack of feedback inhibition by ovarian secretions. FSH levels are high during infancy and again after 9-10 years of age. Combination estrogen and progesterone replacement therapy can induce the development of secondary sex characteristics and menses.
#2
Re: Pathology 5 galaxy - 05-27-10 18:13 Increased plasma follicle stimulating hormone , decreased estrogen is seen in patients with turner's syndrome...syndrome of 45XO...
#3
Re: Pathology 5 babbu5508 - 06-21-10 14:41 C. Increased plasma follicle stimulating hormone due to loss of negative feedback from estrogen which is deficient in turner's syndrome
#4
Re: Pathology 5 bingousmle - 06-30-10 22:45 webbed neck, low-set ears, fish-like mouth, and ptosis. Biopsy of her ovary reveals the presence of fibrous stroma arranged in whorls.--- turners so raised FSH
#7
Re: Pathology 5 babbu5508 - 09-24-10 06:53 short stature,webbed neck, low-set ears, fish-like mouth, and ptosis with streak ovaries...diagostic of turners syndrome....
#10
Re: Pathology 5 babbu5508 - 09-28-10 04:34 health concerns are also frequently present, including congenital heart disease, hypothyroidism (reduced hormone secretion by the thyroid), diabetes, vision problems, hearing concerns, and many autoimmune diseases.Finally, a specific pattern of cognitive deficits is often observed, with particular difficulties in visuospatial, mathematical, and memory areas.
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