Cases for July 1, 2015 : Congenital abnormality of the female genital tract Instructions: There are 2 cases for all the groups to study and discuss. There are 4 questions for each case. Since there are 8 questions all in all, one group will be assigned to report on question number 2 of both case. The students who did not present yet will be assigned to present and discuss with their powerpoint presentation. Interactive session will ensue. 1. Evaluation of a newborn infant reveals ambiguous genitalia. The newborn was born to a Gravida 1 Para 1 mother via Normal spontaneous delivery ~ EINC protocol without antenatal and postnatal complications. There is no evidence of maternal androgen producing tumor and maternal androgen ingestion is denied. There is no family history of ambiguity and a female sibling 9 yo has normal sexual development. ‘On examination the newborn has a fused labia and clitoral hypertrophy. There are no palpable gonads in the inguinal area and labia. The rest of the physical examination findings were normal The NB was active with good suck until on the 16"” hour of life, vomiting of previously ingested breastmilk was noted. 1.What is the most likely diagnosis based on the clinical presentation? How will you arrive at a specific diagnosis? 2.Explain the pathophysiology of this condition? 3. What are the Differential diagnosis? How will you rule in and rule out? 4,How do you holistically manage the case? An 18 years old single, nulligravid consulted because of primary amenorrhea. She claims to experience monthly crampy, tolerable, hypogastric pains for 4 years now, Sexual history revealed painful and difficult intercourse. Physical examination revealed normal female sexual characteristics at Tanner stage 4 Vulva, labia majora and minora, and clitoris are normal. Speculum exam revealed a short vaginal pouch , cervix and uterus cannot be palpated, no adnexal mass nor t¢Questions: Chae 1. What is the most likely diagnosis based on the clinical presentation? How arrive at a specific diagnosis? 2.Explain the pathophysiology of this condition? 3. What are the Differential diagnosis? How will you rule in and rule out? 4. How do you holistically manage the case?