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Old 07-29-2013
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Question Hypogonadism and FSH Level!

Any one can help me with this USMLE World no 3595 ,
how can we have secondary hypogonadisim and impotence while the FSH is normal , what does he mean by inappropriately normal serum gonadotropin level ???
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Old 07-29-2013
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Inappropriately normal means in this case that is lower limit of normal. FSH is 4 which is the lower limit of normal value.
Is a case of secondary hypogonadism (FSH AND LH SHOULD BE LOW). If you check LH is low and FSH is low limit of normal
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Old 07-30-2013
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didn't look at the question but sounds like you just trippin out because FSH is still within normal range but should be low in secondary hypogonadism, which is true, and if you look carefully, it is low... low range of normal. a bit of a low blow by uworld i agree, but remember that normal ranges are just that, ranges. low end of the normal range should still be concerning, especially if the LH is low.

i remember a similar tactic used by uworld on a DIC question in a woman who had an abortion. you look at fibrinogen levels to see if she is at risk of DIC and the fibrinogen level was not below normal range, but rather low end of normal range and hence, still concerning.

so you got to have your guard up, read carefully, use clinical judgement and always play it safe. low end of normal is concerning and should be treated as a result lower than normal range.
"inflammable means flammable!? What a country."
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Endocrinology-, Internal-Medicine-

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