Practice sessionHEALTHCARE & MEDICAL EXAMSMEDICAL LICENSING

USMLE (United States Medical Licensing Examination) Practice Exam 10

Practice exam for USMLE (United States Medical Licensing Examination).

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Question 1 of 1000%

Time remaining120:00

Attempts allowedUnlimited

Difficulty mixE • M • H

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Question 1

MEDIUM

120:00

A 29-year-old woman comes to the clinic for evaluation of infertility. She and her partner have had unprotected intercourse for 18 months. Her cycles are regular every 28 days. She uses a home ovulation predictor kit that consistently turns positive on day 14. Mid-luteal (day 21) serum progesterone is 2 ng/mL (reference: >10 ng/mL indicates ovulation). She has no galactorrhea. BMI is 22 kg/m2. Which of the following is the most likely explanation for this discrepancy?

A positive ovulation predictor reflects an LH surge, but low mid-luteal progesterone suggests anovulation or luteinized unruptured follicle/poor luteal function; inadequate LH surge amplitude can prevent normal ovulation/corpus luteum progesterone production. The kit detects LH (not subunits) and is generally specific; sustained high estradiol would trigger (not suppress) the LH surge via positive feedback.

Select one answer

Cross-reactivity of the kit with luteinizing hormone subunits leading to false positives

Failure of corpus luteum formation due to inadequate luteinizing hormone surge amplitude

Increased peripheral conversion of progesterone to cortisol in the adrenal cortex

Premature luteinization due to elevated follicle-stimulating hormone

Sustained high estradiol levels suppressing gonadotropin-releasing hormone

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USMLE (United States Medical Licensing Examination) Practice Exam 10

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