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Retired NBME 16 Answers

nbme16/Block 3/Question#25 (reveal difficulty score)
A 27-year-old nulligravid woman comes to the ...
Clomiphene ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—bingcentipede(359)
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Clomiphene is a SERM that antagonizes estrogen receptors in the hypothalamus.

If estrogen is antagonized there, there is decreased negative feedback to improve FSH and LH release to stimulate ovulation. This is very important in PCOS and other disorders with decreased fertility.

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notyasupreme  I guess I wasn't sure because it said FSH and LH levels were normal, so I assumed the problem was with progesterone. But I thought too deep into it and should've just went with my gut. +2
feochromocytoma  Clopmiphene is usually the answer for infertility with NORMAL anatomy and NORMAL appearing labs +4
drdoom  very nice +
cheesetouch  FA18 p 637 +
sexymexican888  Yeah I made the same mistake by choosing progesterone BUT they are used for contraception (pill, IUD etc) and for the PROGESTIN challenge EXCLUDES (if +withdrawl bleed its hormonal PCOS etc) uterine bleeding due to anatomic defects (which will have no withdrawal bleeding i.e asherman) so as far I know its not used as fertility treatment +



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