Reproduction: androgen insensitivity: practice question

A Physiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Physiology · Reproduction: androgen insensitivity

Sample item

A phenotypically female 17-year-old has primary amenorrhoea, normal breast development, scanty pubic hair and a blind-ending vagina with no uterus. Karyotype is 46,XY. Which hormone profile is expected?

ALow testosterone and low LHBLow testosterone and raised FSHCRaised oestradiol and low LHDRaised testosterone and raised LH

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Raised testosterone and raised LH

Testes produce AMH, so the Mullerian structures regress and there is no uterus. The androgen receptor is defective, so testosterone cannot act and feedback is lost, raising LH and testosterone, some of which is aromatised to oestrogen giving breast development.

Option by option

A. Low testosterone and low LH
Low testosterone and LH would indicate hypogonadotropic hypogonadism.
B. Low testosterone and raised FSH
Low testosterone with high FSH is testicular failure.
C. Raised oestradiol and low LH
Low LH with raised oestradiol does not fit the feedback in this syndrome.
D. Raised testosterone and raised LH (correct)
Correct. Resistance to androgen leaves LH and testosterone raised.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is D, Raised testosterone and raised LH. Testes produce AMH, so the Mullerian structures regress and there is no uterus.

Why is "Low testosterone and low LH" not the answer?

Low testosterone and LH would indicate hypogonadotropic hypogonadism.

Why is "Low testosterone and raised FSH" not the answer?

Low testosterone with high FSH is testicular failure.

Why is "Raised oestradiol and low LH" not the answer?

Low LH with raised oestradiol does not fit the feedback in this syndrome.

What concept does this question test?

It tests Reproduction: androgen insensitivity in Physiology. The androgen receptor is defective, so testosterone cannot act and feedback is lost, raising LH and testosterone, some of which is aromatised to oestrogen giving breast development.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Reproduction: androgen insensitivity?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.