<prompt> A 19 year old patient presents with primary amenorrhoea. She has well developed breasts and axillary and pubic hair. Uterus and vagina are absent. The diagnosis is most likely:XYY syndromeGonadal dysgenesisMullerian agenesisKlinefelters syndrome  <response>: Mullerian agenesis Mayer-Rokitansky-Kuster-Hauser syndrome is the second most common cause of primary amenorrhea. Clinical features: Normal ovarian development Normal endocrine function Normal female sexual development Shoened or absent vagina in addition to absence of the uterus Individuals have 46,XX karyotype Ref: Rosen M.P., Cedars M.I. 2011. Chapter 13. Female Reproductive Endocrinology and Infeility. In D.G. Gardner, D. Shoback Eds,Greenspans Basic Clinical Endocrinology, 9e. 