Questions for self-control . Amenorrhea: definition and classification. Primary amenorrhea: definition and classification. Hypergonadotropic primary amenorrhoea. Eugonadotropic primary amenorrhoea. Hypogonadotropic primary amenorrhoea. Primary amenorrhea: investigation. Turner's syndrome. Causes, clinical features. Turner's syndrome. Management. Prognosis for reproductive function. Klinefelter's syndrome. Causes, clinical features, management. Virilism: adrenogenital syndrome. Causes, clinical features Adrenogenital syndrome Management. Prognosis for reproductive function Testicular feminizing syndrome (androgen insensitivity syndrome). Causes, clinical features Testicular feminizing syndrome Management. Prognosis for reproductive function Mayer-Rokitansky- Kuster syndrome: Causes, clinical features. Mayer-Rokitansky- Kuster syndrome Management. Prognosis for reproductive function TESTS 1.Which statement about primary amenorrhoea is true? menstruation does not occur even after 18 years of age; menstruation does not occur even after 16 years of age; menstruation does not occur even after 14 years of age. 2. Primary amenorrhoea is a feature of all, EXEPT: polycystic ovarian disease; Turner's syndrome; Swyer's syndrome. 3.Which of the following is management of adrenogenital syndrome? administration of cortisone; small plastic operation; all of the above; no correct answer. 4. The chromosomal complement in persons with testicular feminizing syndrome is: 45 XO; 46 XY; 47 XXY; 47 XXX. 5.In primary amenorrhoea the cause cold be: Sheehan's syndrome; polycystic ovarian disease; Turner's syndrome; 6.Physiological amenorrhoea is present in all of the following, EXEPT: pre-puberty; pregnancy; lactation; post-puberty. 7. The chromosomal complement in persons with Klinfelter's syndrome is: 45 XO; 46 XY; 47 XXY; 47 XXX. 8. Which of the following is NOT a diagnostic criterion for Turner's syndrome? the chromosomal complement 45 XO; high stature; the neck is short and wedded; vagina and uterus are underdeveloped. Clinical cases Case 1. Patient B., 19 years old, complaining on amenorrhoea. She is somatically well. The phenotype is female. The breasts are well developed. The axillary and pubic hairs are scanty. The external genitalia appear female. Bilateral inguinal hernias are defined. Vaginal examination: the uterus is absent, a blind vagina in length to 2 cm is felt. Chromosomal study reveals XY chromosome. LH level is high, but FSH is normal. Diagnosis? What additional investigations are necessary to confirm the diagnosis? Plan of management? Case 2. Patient Sh., 14 years old, complaining on of absence of menstruation and short stature. There were rubeola, epidemic parotiditis and scarlet fever in infancy. Intellectual development corresponds to age. Skin and visible mucous are normal discoloration. Her height is 125 sm. She has got a shield chest. Her trunk is muscular, the neck is short and webbed. Mammary glands are not developed. The external genitalia are infantile. The axillary and pubic hairs are scanty. Hymen is intact. Rectal examination: very small uterus is defined, instead of ovaries is fibrous tissue. Diagnosis? What additional investigations are necessary to confirm the diagnosis? Plan of management Case 3. Patient V., 18 years old, has addressed with complaints to absence of menstruation and symptoms of virilization. No internal organs pathology found. Hirsutism is defined. The patient has got coarse hair on the upper lip, the chin, on apeola. Mammary glands are developed insufficiently. The distribution of pubic hair is on male type. Clitoris is slightly enlarged. Vaginal examination: uterine cervix is conical form without pathological changes. Uterus is in normal size, mobile, painless. Adnexa are not detectable from both sides. Discharge is white. Diagnosis? What additional investigations are necessary to confirm the diagnosis? Plan of management? Answer me accounting to New edition of obgyn books in detail with points