Reproduction-Related Disorders

Question 1

1. An elevated serum concentration of which of the following
   hormones is most useful in distinguishing between a pituitary versus placental source of hCG?

a. FSH
b. TSH
c. Estradiol
d. Progesterone
e. ACTH

Answer 1

a. FSH

Question 2

2. Which of the following best describes the application of
   mass spectrometry to steroid hormone measurement?

a. Mass spectrometry is easily automated and does not
require highly trained technologists.
b. All mass spectrometry–based methods generate equivalent results.
c. Mass spectrometry–based methods are usually more
sensitive and specific than immunoassays.
d. Mass spectrometers do not require routine maintenance.
e. Mass spectrometry–based methods should not be used
in women with low estradiol concentrations.

Answer 2

c. Mass spectrometry–based methods are usually more
sensitive and specific than immunoassays.

Question 3

3. Which of the following laboratory tests would be most
   appropriate to assess anovulation?

a. FSH on cycle day 4
b. Estradiol on cycle day 10
c. LH on cycle day 28
d. Progesterone on cycle day 21
e. Estrone on cycle day 14

Answer 3

d. Progesterone on cycle day 21

Question 4

4. Which of the following accurately describes free and bioavailable testosterone?

a. Free testosterone represents the majority of circulating
testosterone.
b. Free testosterone provides an accurate reflection of androgen status in patients with altered SHBG concentrations.
c. Measurement of free testosterone using a direct immunoassay generates the most accurate results.
d. Free testosterone is not biologically active.
e. Fluctuations in circulating SHBG do not affect free testosterone concentrations

Answer 4

b. Free testosterone provides an accurate reflection of androgen status in patients with altered SHBG concentrations.

Question 5

5. Which of the following is a likely diagnosis in a female
   patient experiencing primary amenorrhea characterized
   by delayed puberty with low serum FSH and LH concentrations?

a. Gonadal dysgenesis
b. 17α-hydroxylase deficiency
c. Pituitary failure
d. Uterine outflow abnormality
e. FSH insensitivity

Answer 5

c. Pituitary failure

Question 6

6. What is the most common cause of secondary amenorrhea?

a. Prolactinoma
b. Fragile-X primary ovarian insufficiency
c. Autoimmune adrenal insufficiency
d. Hypothyroidism
e. Pregnancy

Answer 6

e. Pregnancy

Question 7

7. Which of the following correctly describes polycystic
   ovary syndrome?

a. Women with PCOS experience hyperandrogenism and
anovulation with no other known cause.
b. Women with PCOS have undetectable serum estrogen
concentrations.
c. Women with PCOS have a decreased risk of developing diabetes.
d. Women with PCOS have a decreased risk of developing coronary heart disease.
e. Women with PCOS can be diagnosed with a single
definitive laboratory test.

Answer 7

a. Women with PCOS experience hyperandrogenism and
anovulation with no other known cause.