Discuss the management of disorders of sexual differentiation DSD.pptx

2. Nafisa Ibrahim 635567
• 18 year old JSS 1 female student of GGSS Garundan,
• Lives with her parents in Gano village, Dawaki L.G Kano state
• C/O abnormal female external genitalia since birth.
• Has no history of LUTS
• No hx of recent or childhood hematuria, no weight loss
• No any systemic symptom
• Has not commence mensturation , no change or increase in breasts
development.
• She is the 2nd child to her mother in a polygamous family of 4 wives, 15
children, her elder brother died in his early neonatal period, 3 more died in
early childhood, but hx of similar abnormality in her siblings.

3. • On account of above problem she was taken to AKTH 15 years ago
where she had lower abdominal surgery – details not known.
• DM*, HTN*, Blood transfusion*, Alcohol* ,Smoking*
• O/E; Young, afebrile, not pale , anicteric, acyanosed
• PR = 1OObpm
• BP =100/70mmhg.
• RR =18cpm
• TEMP =37*C

4. • ABD: full, moves with respiration, healed suprapubic scar
• L* K*S*
• GUS: Abnormal vulva and small vaginal orifice, with presence of labia
majora, absent minora, macropenis about 17cm long, with chodae,
stenosed vaginal orifice and absent palpable testes.
• A diagnosis: XXDSD
• Plan: FBC, Urinalysis, EUCR, Hb- genotype,urine mcs, abdominal
USS,FLUSH genitogram, buccal smear , Hormonal profile.

7. • A 12yr old primary 3 pupil, hausa, muslim, lives with her parents in Kuka
village , Nasarawa L.G. A.in Kano state.
• C/O: abnormal female external genitalia sice birth.
• Has no any systemic symptom
• Is a product of term gestation, pregnancy booked at Murtala Muhammad
SH, Delivered at home via SVD unsupervised.
• No hx of maternal febrile illneses, exposure to chemicals or radiation
• No hx of consumption of unprescribed drugs.
• Achieved her developmental milestones normally.

8. Not fully immunized
No hx of similar abnormality in the family
5th child to her mother in polygamous family of 4 wives 15 children
3 of her siblings died at 1-3 yrs of age.mother is a house wife and the
father is a brick layer
No hx of surgery, traditional intervention or blood transfusion.

9. • O/E: Female child, not in any distress, afebrile, not pale
• PR=110 bpm,
• BP=80/50mmhg
• RR=18cpm
• Abd: Normal
• GUS; Abnormal external genitalia, small penis-like structure at the site of clitoris, 4cm,
abnormal vulva and vagina, absence of labia minora
• Presence of labia majora.
• Diagnsis: XXDSD
• Plan; admitted in FSW under urology
• FBC, EUCR, ABD USS, HB Genotype, Urinalysis,Buccal smear, Hormona profile,
• flush genitogram.