PCL 8: IT'S A BOY....NOT!!!

DDx:
1. Congenital Adrenal Hyperplasia (CAH)

Learning issues
1. definitions, incidence, prevalence (Why might there have been some doubt at the assignation of Kamal sex at the time of birth?) - Prish
2.signs and symptoms (Why might Kamal be losing salt?, What other things might go wrong other than losing sodium?) -Huey Ting
3. pathophysiology (If Kamal has been exposed to excess androgen in fetal life and has a deficiency in the production of mineralocorticoids, how could have these come about?, Why is a genitalia ambiguous? What causes this?, What do you think Kamal's internal reproductive organs may have been like?, Why both of glucocorticoid and mineralocorticoid are necessary?) -Alex, Kee Hao

5. commonest causes and provoking factors - Karthik

7. investigations, genetics (Can prenatal diagnosis be achieved?) - Shakir
8. treatment, management and prevention -Mona
9. Psychosocial randoms (What are the parental issues? What sources of information they could identify with?Comment on the quality of those sources of information, What are the arguments for and against raising Kamal as a girl?, What do you think of the decision to raise the baby as a girl or boy?)- JB
What were the specific instructions that Lisa and Omar receive regarding the medications for Nabila(Kamal as a girl) when she became sick and what was the rational behind that advice?, Doctor-patient interaction regarding this condition,
If the parents present to Dr. Yasmin with a large quantity of information, how should the doctor respond and how should the parents act upon it?,- FUAD
How would you as a doctor to help the parents make this difficult decision? What sort of question would you put to them and how would you help work through it? Would or should you give advice or recommendation?, - TJ KOH
What sort of impact might be raised on Nabila on her mental health and social functioning? What ethical issues can you identify regarding Nabila's decision to have a surgery? - py
-Ewe Jin, Fuad, Pik Yin, JB


www.rch.org/cah_book