Gynaecological endocrinology: puberty induction in Turner syndrome: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological endocrinology: puberty induction in Turner syndrome

Sample item

How is puberty induced in a 13-year-old with Turner syndrome and hypergonadotropic hypogonadism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Low-dose oestrogen, increased gradually, with progestogen added later

Starting oestrogen low and increasing slowly over about 2 to 3 years mimics normal pubertal breast and uterine development and protects final height. Progestogen is added once breakthrough bleeding occurs or after a couple of years, to protect the endometrium.

Option by option

  • A. Testosterone

    Testosterone is not used to induce female puberty.

  • B. Full adult-dose combined pill from the start

    Starting full doses early can impair breast development and accelerate bone age.

  • C. Low-dose oestrogen, increased gradually, with progestogen added later (correct)

    Correct. Gradual oestrogen escalation mimics normal puberty, with progestogen added later.

  • D. Cyclical progestogen alone

    Progestogen without oestrogen does not induce breast or uterine growth.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Low-dose oestrogen, increased gradually, with progestogen added later. Starting oestrogen low and increasing slowly over about 2 to 3 years mimics normal pubertal breast and uterine development and protects final height.

Why is "Testosterone" not the answer?

Testosterone is not used to induce female puberty.

Why is "Full adult-dose combined pill from the start" not the answer?

Starting full doses early can impair breast development and accelerate bone age.

Why is "Cyclical progestogen alone" not the answer?

Progestogen without oestrogen does not induce breast or uterine growth.

What concept does this question test?

It tests Gynaecological endocrinology: puberty induction in Turner syndrome in OBG. Progestogen is added once breakthrough bleeding occurs or after a couple of years, to protect the endometrium.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological endocrinology: puberty induction in Turner syndrome?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.