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USMLE (United States Medical Licensing Examination): Step 1: Basic sciences assessment Practice Exam 27

Practice exam for USMLE (United States Medical Licensing Examination): Step 1: Basic sciences assessment.

Active sessionUSMLE Step 1 practice testUSMLE Step 1 practice examUSMLE Step 1 practice questionsUSMLE Step 1 basic sciencesUSMLE Step 1 foundational sciences+5
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Question 1 of 1000%
Time remaining120:00
Attempts allowedUnlimited
Difficulty mixE • M • H
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Question 1

MEDIUM

A 30-year-old woman presents to her physician with difficulty becoming pregnant for 14 months. Her menstrual cycles are regular every 28 days. She has no history of sexually transmitted infections and takes no medications. She exercises moderately and has a BMI of 23 kg/m². Her partner’s semen analysis is normal. Mid-luteal serum progesterone is low. Basal body temperature charting shows no sustained post-ovulatory rise. Which of the following best explains this patient’s infertility?

Low mid-luteal progesterone and absence of a sustained post-ovulatory basal temperature rise suggest anovulation. Ovulation requires a midcycle LH surge triggered by sustained high estradiol (positive feedback) leading to follicular rupture and corpus luteum formation. A prolactinoma typically causes oligomenorrhea/amenorrhea. Premature ovarian insufficiency usually causes elevated FSH and irregular/absent menses.

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