This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
Early hormonal sign of puberty 
Select and explain. 
A. Sleep associated increase in LH, B. Early morning rise in temperature, C. Increased FSH to LH ratio, D. Elevated adrenal androgens.
A: Sleep associated increase in LH
Answer: A: Sleep associated increase in LH 
Explanation: Early sign of puberty is Sleep-associated increase in LH secretion.