USMLE (United States Medical Licensing Examination): Step 1: Basic sciences assessment Practice Exam 32
Practice exam for USMLE (United States Medical Licensing Examination): Step 1: Basic sciences assessment.
Question 1
MEDIUMA 29-year-old woman presents to her physician with irregular menstrual cycles and difficulty conceiving for 18 months. She has gained 9 kg (20 lb) over the past year and reports increased facial hair growth. She takes no medications. Temperature is 36.8°C (98.2°F), blood pressure is 128/78 mm Hg, and pulse is 76/min. Physical examination shows acne and mild hirsutism. Laboratory studies show elevated total testosterone and an increased LH:FSH ratio. Which of the following best explains the ovarian dysfunction in this patient?
This presentation is consistent with polycystic ovary syndrome (PCOS): oligo/anovulation, hyperandrogenism (hirsutism, acne, elevated testosterone), and often increased LH:FSH ratio. Increased LH stimulates theca cells to produce androgens; relative FSH deficiency reduces granulosa cell aromatization, contributing to androgen excess and anovulation. Hyperprolactinemia can cause anovulation but would feature elevated prolactin and often galactorrhea. Primary ovarian insufficiency would have high FSH and low estrogen.
Question 1 of 100
Community
Loading ranked answers and discussion...