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NBME 24 Answers

nbme24/Block 3/Question#33 (35.3 difficulty score)
A 12-year-old boy is brought to the physician ...
Nocturnal luteinizing hormone pulses🔍
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 +13  upvote downvote
submitted by lsmarshall(344),
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In" teh ryase ngcriedpe iahcyspl t,epyurb teboRr M. aorBy cdoseridve tath eth inotapodrgon lusspe urcoc lyno nrudig plsee, tbu as bputyer ergsossepr tyhe acn eb deectdet rdiung eth ayd. By hte nde fo etbyup,r teerh si ttelil -gainhydt erdifefenc ni eth ltdiemupa dan feurqneyc fo ntnpogardioo sleu.ps

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linwanrun1357  Who can explain, the 12-y boy with stanner stage 2?? I thought it should be stage 3.... +  



 +2  upvote downvote
submitted by nwinkelmann(249),
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seoD anyone aehv a good oeiaxatnlpn rof yhw deaedecsr eevsll of nihniib si onw?rg rFom ym dnds,erntganui ibnhnii nda tacivni rkow oeht,tger ni ttah nihnibi bidsn adn kcsbol ntivaci lngeaid ot derascede fabkdece no pslahymouath nda iainvct senacsire FHS and HnRG noudoictpr.. usht, if uoy eaesdrce nnhbiii hnte oyu olwdu ahev isnecread iitvnca icwhh odwlu dlea to siderance GRnH nad SF,H gtihr? I nufod eon rlicate naklitg baotu ti in egadrrs ot uterpby, utb ti emsse to be a /istoohntheyps nofmericd at shit .ion..tp is thta yw?h tBu st..lli. woh do I urel ti tuo on a ?ttse

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 +3  
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 +1  
usmile1  Kind of like how nocturnal pulsatile GNRH release occurs during sleep to stimulate growth (FA page327), the same thing happens for puberty. Pg 325 in FA, "pulsatile GnRH leads to puberty and fertility." It doesn't explicitly state during sleep, but pulsatile release of GnRH leading to pulsatile release of LH and FSH will lead to puberty. Puberty starts in the brain, its onset really has nothing to do with decreased inhibin levels which happens in the testes. hope that makes sense! +2  
sars  From what I understand, inhibin is only released by granulosa cells when FSH levels are high. This is a boy. Next off, this question is about puberty, which is due to pulsatile GnRH leading to large amounts of LH and FSH, leading to large amounts of dihydrotestosterone (males) and estradiol (females), and eventually secondary characteristics of puberty. The increased pulse of estrogen and testosterone leads to GH release, which is metabolized into IGF-1 in the liver. This leads to long bone growth from what I understand, which is not much. +  
cassdawg  @sars inhibin B is also released by sertoli cells in males and will feedback to inhibit FSH release, its not just a female thing. Also, there is actually an inhibin B pubertal surge in both females and males that corresponds to maturation of the granulosa and sertoli cells, respectively. Hormones are wack. https://pubmed.ncbi.nlm.nih.gov/15319819/ +  



 +0  upvote downvote
submitted by davidw(37),
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Is isht onfdu in rehot cueerross treoh then ubP dme sir?talce

mission260  Costanzo says " One of the earliest events of puberty is the appearance of large nocturnal pulses of LH during REM sleep. " also, I am aware of how late this answwer is :P +4  



 +0  upvote downvote
submitted by overa(1),

Pulsatile pituitary pulses peripherally provide production perpetually... pulsatile