COMSAE PHASE 1 REPRODUCTIVE
PHYSIOLOGY PRACTICE EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1.
A 22-year-old woman has regular 28-day menstrual cycles. During the
mid-follicular phase, increasing estradiol concentrations stimulate
proliferation of endometrial glands and stroma. Which hormonal change
most directly accounts for the transition from the proliferative phase to
the secretory phase after ovulation?
A. Increased FSH secretion
B. Increased LH secretion
C. Increased progesterone secretion from the corpus luteum
D. Increased inhibin B secretion
E. Decreased GnRH pulse frequency
Answer: C. Increased progesterone secretion from the corpus
luteum
Rationale: Progesterone produced by the corpus luteum after
ovulation converts the estrogen-primed proliferative endometrium into
a secretory endometrium. It promotes glandular secretion, stromal
edema, and vascular changes necessary for potential implantation.
Estrogen predominates during the proliferative phase, whereas
progesterone predominates during the secretory phase.
2.
1
,A reproductive-age woman is being evaluated for infertility. Her
physician explains that follicular development depends on coordinated
signaling between the hypothalamus, pituitary, and ovary. Which
hypothalamic hormone directly stimulates pituitary secretion of both LH
and FSH?
A. Gonadotropin-releasing hormone
B. Gonadotropin-inhibitory hormone
C. Progesterone
D. Inhibin
E. Estradiol
Answer: A. Gonadotropin-releasing hormone
Rationale: GnRH is secreted in a pulsatile fashion by hypothalamic
neurons and stimulates anterior pituitary gonadotrophs to release LH
and FSH. The frequency and amplitude of GnRH pulses influence the
relative secretion of LH and FSH. Continuous GnRH exposure, in
contrast, suppresses gonadotropin secretion after an initial stimulatory
period.
3.
A 14-year-old girl experiences menarche and subsequently develops
regular ovulatory menstrual cycles. Which endocrine event is most
responsible for initiating puberty?
A. Increased ovarian progesterone secretion
B. Increased adrenal aldosterone secretion
C. Reactivation of pulsatile hypothalamic GnRH secretion
D. Increased placental hCG secretion
E. Increased prolactin secretion
Answer: C. Reactivation of pulsatile hypothalamic GnRH secretion
2
,Rationale: Puberty begins with reactivation of pulsatile GnRH
secretion from the hypothalamus. GnRH stimulates LH and FSH
secretion, which activate the ovaries and increase sex steroid
production. Gonadal steroid production then produces the physical
and reproductive changes characteristic of puberty.
4.
A woman with a normal menstrual cycle undergoes ovulation
approximately 14 days before menstruation. Which event most directly
triggers ovulation?
A. Sustained fall in estradiol
B. Progesterone withdrawal
C. FSH suppression by inhibin
D. LH surge induced by sustained high estradiol
E. Increased prolactin secretion
Answer: D. LH surge induced by sustained high estradiol
Rationale: Sustained high estradiol secretion by the dominant follicle
switches from negative to positive feedback on the hypothalamic-
pituitary axis. This produces a large LH surge, accompanied by a
smaller FSH surge. The LH surge induces completion of oocyte
meiosis I, follicular rupture, and luteinization of the follicular cells.
5.
A 27-year-old woman has a serum estradiol concentration that has
remained elevated for approximately 48 hours immediately before
ovulation. What effect does this prolonged elevation have on the
hypothalamic-pituitary axis?
3
, A. It completely suppresses GnRH secretion
B. It converts estrogen feedback from negative to positive
C. It selectively suppresses LH secretion
D. It stimulates progesterone secretion from the adrenal cortex
E. It directly causes follicular atresia
Answer: B. It converts estrogen feedback from negative to positive
Rationale: At low-to-moderate concentrations, estradiol generally
exerts negative feedback on GnRH, LH, and FSH secretion. Sustained
high estradiol concentrations immediately before ovulation instead
produce positive feedback, generating the LH surge that triggers
ovulation.
6.
A woman has undergone ovulation. Which ovarian structure is primarily
responsible for progesterone secretion during the luteal phase?
A. Primary follicle
B. Corpus albicans
C. Corpus luteum
D. Zona pellucida
E. Theca externa
Answer: C. Corpus luteum
Rationale: Following ovulation, the remaining follicular cells undergo
luteinization and form the corpus luteum. Granulosa lutein cells
produce substantial progesterone, while theca lutein cells contribute
androgenic steroid precursors. Progesterone prepares and maintains
the endometrium for implantation.
7.
4
PHYSIOLOGY PRACTICE EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1.
A 22-year-old woman has regular 28-day menstrual cycles. During the
mid-follicular phase, increasing estradiol concentrations stimulate
proliferation of endometrial glands and stroma. Which hormonal change
most directly accounts for the transition from the proliferative phase to
the secretory phase after ovulation?
A. Increased FSH secretion
B. Increased LH secretion
C. Increased progesterone secretion from the corpus luteum
D. Increased inhibin B secretion
E. Decreased GnRH pulse frequency
Answer: C. Increased progesterone secretion from the corpus
luteum
Rationale: Progesterone produced by the corpus luteum after
ovulation converts the estrogen-primed proliferative endometrium into
a secretory endometrium. It promotes glandular secretion, stromal
edema, and vascular changes necessary for potential implantation.
Estrogen predominates during the proliferative phase, whereas
progesterone predominates during the secretory phase.
2.
1
,A reproductive-age woman is being evaluated for infertility. Her
physician explains that follicular development depends on coordinated
signaling between the hypothalamus, pituitary, and ovary. Which
hypothalamic hormone directly stimulates pituitary secretion of both LH
and FSH?
A. Gonadotropin-releasing hormone
B. Gonadotropin-inhibitory hormone
C. Progesterone
D. Inhibin
E. Estradiol
Answer: A. Gonadotropin-releasing hormone
Rationale: GnRH is secreted in a pulsatile fashion by hypothalamic
neurons and stimulates anterior pituitary gonadotrophs to release LH
and FSH. The frequency and amplitude of GnRH pulses influence the
relative secretion of LH and FSH. Continuous GnRH exposure, in
contrast, suppresses gonadotropin secretion after an initial stimulatory
period.
3.
A 14-year-old girl experiences menarche and subsequently develops
regular ovulatory menstrual cycles. Which endocrine event is most
responsible for initiating puberty?
A. Increased ovarian progesterone secretion
B. Increased adrenal aldosterone secretion
C. Reactivation of pulsatile hypothalamic GnRH secretion
D. Increased placental hCG secretion
E. Increased prolactin secretion
Answer: C. Reactivation of pulsatile hypothalamic GnRH secretion
2
,Rationale: Puberty begins with reactivation of pulsatile GnRH
secretion from the hypothalamus. GnRH stimulates LH and FSH
secretion, which activate the ovaries and increase sex steroid
production. Gonadal steroid production then produces the physical
and reproductive changes characteristic of puberty.
4.
A woman with a normal menstrual cycle undergoes ovulation
approximately 14 days before menstruation. Which event most directly
triggers ovulation?
A. Sustained fall in estradiol
B. Progesterone withdrawal
C. FSH suppression by inhibin
D. LH surge induced by sustained high estradiol
E. Increased prolactin secretion
Answer: D. LH surge induced by sustained high estradiol
Rationale: Sustained high estradiol secretion by the dominant follicle
switches from negative to positive feedback on the hypothalamic-
pituitary axis. This produces a large LH surge, accompanied by a
smaller FSH surge. The LH surge induces completion of oocyte
meiosis I, follicular rupture, and luteinization of the follicular cells.
5.
A 27-year-old woman has a serum estradiol concentration that has
remained elevated for approximately 48 hours immediately before
ovulation. What effect does this prolonged elevation have on the
hypothalamic-pituitary axis?
3
, A. It completely suppresses GnRH secretion
B. It converts estrogen feedback from negative to positive
C. It selectively suppresses LH secretion
D. It stimulates progesterone secretion from the adrenal cortex
E. It directly causes follicular atresia
Answer: B. It converts estrogen feedback from negative to positive
Rationale: At low-to-moderate concentrations, estradiol generally
exerts negative feedback on GnRH, LH, and FSH secretion. Sustained
high estradiol concentrations immediately before ovulation instead
produce positive feedback, generating the LH surge that triggers
ovulation.
6.
A woman has undergone ovulation. Which ovarian structure is primarily
responsible for progesterone secretion during the luteal phase?
A. Primary follicle
B. Corpus albicans
C. Corpus luteum
D. Zona pellucida
E. Theca externa
Answer: C. Corpus luteum
Rationale: Following ovulation, the remaining follicular cells undergo
luteinization and form the corpus luteum. Granulosa lutein cells
produce substantial progesterone, while theca lutein cells contribute
androgenic steroid precursors. Progesterone prepares and maintains
the endometrium for implantation.
7.
4
