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Retired NBME 22 Answers

nbme22/Block 2/Question#20 (reveal difficulty score)
A 26-year-old nulligravid woman comes to the ...
Hypothalamus ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +2  upvote downvote
submitted by โˆ—jackie_chan(34)
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If estrogen is low and FSH/LH high, the problem at ovaries. FSH/LH both low so problem with the pituitary gland releasing FSH/LH or even higher up with GnRH in the hypothalamus. Best answer hypothalamus

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 -3  upvote downvote
submitted by mguan1993(13)
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can someone explain why the answer is not adrenal gland? I feel ike if adrenal gland was the issue there would also be decreased concentrations of FSH, LH, and estrogen right?

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mguan1993  ^nvm had a brain fart and go adrenal gland mixed up with anterior pituitary lmao +5
nor16  ovaries are #1 estrogen producer no estrogen no lubricant = dyspareunia no estrogen and no fsh/lh --> there must be a "higher" problem, up there in the brain +3
pg32  I agree that hypothalamus is the most logical answer, but if she had overactivation of the adrenal gland (cortisol secreting tumor), that could also inhibit GnRH and cause these same symptoms. +1
drzed  @pg32 the physical examination would not be normal with either a ACTH or cortisol secreting tumor. +



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