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NBME 24 Answers

nbme24/Block 3/Question#33

A 12-year-old boy is brought to the physician by ...

Nocturnal luteinizing hormone pulses

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 +7  upvote downvote
submitted by lsmarshall(181),

"In the years preceding physical puberty, Robert M. Boyar discovered that the gonadotropin pulses occur only during sleep, but as puberty progresses they can be detected during the day. By the end of puberty, there is little day-night difference in the amplitude and frequency of gonadotropin pulses.

Some investigators have attributed the onset of puberty to a resonance of oscillators in the brain.[89][90][91] By this mechanism, the gonadotropin pulses that occur primarily at night just before puberty represent beats." - Wiki

 +1  upvote downvote
submitted by nwinkelmann(59),

Does anyone have a good explanation for why decreased levels of inhibin is wrong? From my understanding, inhibin and activin work together, in that inhibin binds and blocks activin leading to decreased feedback on hypothalamus and activin increases FSH and GnRH production.. thus, if you decrease inhibin then you would have increased activin which would lead to increased GnRH and FSH, right? I found one article talking about it in regards to puberty, but it seems to be a hypothesis/not confirmed at this point... is that why? But still... how do I rule it out on a test?

yb_26  I also picked decreased inhibin. may be it was one of the "experimental questions", which are not even counted on the real exam +  
artist90  Inceased FSH will lead to spermatogenesis and spermiogenesis NOT Increase in Testosterone which is causing increased Height of this pt +  
artist90  Inhibin B only has negative feeback on FSH not GnRH. see the diagram on the topic of semineferous tubules in FA. Testosterone has a negative feedback on BOTH LH and GnRH +  

 +0  upvote downvote
submitted by davidw(9),

Is this found in other resources other then Pub med articles?