16. No withdrawal bleeding Est,progest.challenge test Hypothalamic- pituitary failure hypoestrogenic outflow tract. Withdrawal bleeding No Prog.challenge test
17.
18.
19.
20.
21.
22.
23.
24. Tanner Staging Stage 1 : prepubertal Stage 2 : breast bud Stage 3 : further enlarge of breast & areolar ,no seperation Stage 4: areolar & papilla form second mound Stage 5 : mature, only projection of papilla
25. Tanner Staging Stage1 : villus hair Stage 2 : Sparse growth of slightly pigmented hair along labia (11.9 years) Stage 3 : C oarser, curled and pigmented; spreads across pubes (12.7 years) Stage 4 : Adult-type hair but no spread to medial thigh (13.4 years) Stage 5 : Adult-type hair with spread to medial thigh but not up linea alba (14.6 years)
26. Secondary sex characteristic No Yes Pubic hair Yes Uterus No Androgen insentivity syndrome Imperforate hymen Yes No Mullerian agenesis As secondary amenorrhea PV
27. Secondary sex characteristic No ( normal cervix and uterus not include ambiguous) FSH E Primary Gonodal failure Constitutional delay Kallman sd Hypothalamus-pituitary Karyotype XX,XY,XO