**Question:** In Turner's syndrome which of the following is NOT seen

A. Short stature and growth hormone deficiency
B. Primary amenorrhea and hypogonadism
C. Osteoporosis and reduced bone mineral density
D. Diabetes mellitus and insulin resistance

**Core Concept:**
Turner's syndrome is a congenital disorder caused by the partial or complete absence of one X chromosome in females. The condition presents with a range of clinical manifestations, including growth hormone deficiency, primary amenorrhea, hypogonadism, and osteoporosis due to reduced bone mineral density.

**Why the Correct Answer is Right:**
Option D (diabetes mellitus and insulin resistance) is not typically seen in Turner's syndrome because these conditions are primarily associated with insulin resistance and obesity, which are not common features in patients with Turner's syndrome. While some patients may develop glucose intolerance or impaired fasting glucose, full-blown diabetes mellitus is rare. Insulin resistance may be present, but it is not specifically mentioned as a feature of Turner's syndrome.

**Why Each Wrong Option is Incorrect:**
A. Short stature and growth hormone deficiency are common features of Turner's syndrome, as the disorder leads to impaired growth due to reduced growth hormone production and pituitary function.
B. Primary amenorrhea and hypogonadism are also common features in Turner's syndrome, as the absence of one X chromosome results in impaired gonadal development and reduced sex hormone production.
C. Osteoporosis and reduced bone mineral density are seen in Turner's syndrome due to the decreased estrogen levels and impaired bone remodeling.

**Clinical Pearl:**
Turner's syndrome warrants a thorough evaluation for endocrine deficits, including growth hormone and gonadotropin levels, to identify and address these deficiencies appropriately. Treatment options include hormone replacement therapy, which can improve growth and overall health outcomes in affected individuals.