Reproduction: hyperprolactinaemic amenorrhoea: practice question

A Physiology 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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Physiology · Reproduction: hyperprolactinaemic amenorrhoea

Sample item

A 28-year-old woman with a prolactinoma has amenorrhoea with low oestradiol and low LH and FSH. How does raised prolactin cause the amenorrhoea?

AIt raises dopamine to inhibit the ovary directlyBIt blocks FSH receptors on granulosa cellsCIt suppresses pulsatile GnRH release from the hypothalamusDIt directly destroys ovarian follicles

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

The answer and the reasoning

C. It suppresses pulsatile GnRH release from the hypothalamus

Excess prolactin acts on the hypothalamus and reduces GnRH pulse generation, partly by suppressing kisspeptin neurons. LH and FSH fall, follicles do not mature, oestradiol is low and ovulation and menstruation stop.

Option by option

A. It raises dopamine to inhibit the ovary directly
Dopamine inhibits prolactin and is not the mediator in this condition.
B. It blocks FSH receptors on granulosa cells
Low FSH is the finding here, so the problem lies upstream of FSH receptors.
C. It suppresses pulsatile GnRH release from the hypothalamus (correct)
Correct. Prolactin suppresses GnRH pulses, lowering LH, FSH and oestradiol.
D. It directly destroys ovarian follicles
Prolactin does not destroy follicles, and the amenorrhoea is reversible.

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.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is C, It suppresses pulsatile GnRH release from the hypothalamus. Excess prolactin acts on the hypothalamus and reduces GnRH pulse generation, partly by suppressing kisspeptin neurons.

Why is "It raises dopamine to inhibit the ovary directly" not the answer?

Dopamine inhibits prolactin and is not the mediator in this condition.

Why is "It blocks FSH receptors on granulosa cells" not the answer?

Low FSH is the finding here, so the problem lies upstream of FSH receptors.

Why is "It directly destroys ovarian follicles" not the answer?

Prolactin does not destroy follicles, and the amenorrhoea is reversible.

What concept does this question test?

It tests Reproduction: hyperprolactinaemic amenorrhoea in Physiology. LH and FSH fall, follicles do not mature, oestradiol is low and ovulation and menstruation stop.

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 Reproduction: hyperprolactinaemic amenorrhoea?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.