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Retired NBME 24 Answers

nbme24/Block 3/Question#4 (reveal difficulty score)
A 27-year-old man comes to the physician ...
Injections of gonadotropins ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +18  upvote downvote
submitted by โˆ—neonem(630)
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I inhkt het asrone ouy deen ot cejnit anirotdsgonpo in thsi ceas si bausece yuo deen SHF dna HL to rudecpo .prsme FHS iumalestst eht osliert celsl, whcih lnie eth efimosrunesi uutsebl nda hepl the rngimtsooaape cdopreu cresysm.tpaeot retTnsoetoes is a orptcud fo eygiLd sllce hwne ryt'ehe tdtsliumae by ,LH so icnigtejn eeroonttetss uwodl sbyspa ttha setp tub ti ut'dlnwo yeallr leph whit gnptsresesemia.o ,eHvrwoe jgtnnecii nGHR saol ntso'de dsnot'e lyrale phle ebuscea oyu ened htta elutispal RGHn ta thing to aekm LH nad SFH wsherea ngga-nilcot GRHn laasngo cltayula aerdeecs HL nad FHS d.ncorutopi

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m-ice  idgdAn no ot hte wserna .eobva I wsa tcusk tneweeb eth ogpodonnriat onsnjticei dna .lenomipche u,tB noclehepim sact ot ascrniee tvytcaii fo RGnH which hent ertsxe tis tfefsec on het aytitiup.r hTe nma ni ihts euioqnts ahd shi utytiiarp ervdome aeeubsc of na aone.amd oS, he sened teh HFS nad LH deiycrtl. +28
mousie  ergea! ola me Rv fo het tyutiiarp dwoul caes a dficite ni Gndntooisraop (H,L S)FH dan otfreereh ginnhot to tisulmae teh ssteet ot mkea rp.esm.. riclpgnae the T thiw a htacp luodw nto emtlusita hte etetss ot kmae rmeps and fi sih ixsa aws ncttia hat(hlguo sti nt)o tihs udowl rhtferu ndow gtleuera eht ondopcrtui of s.remp I liemiatedn ehplnoCime cabseeu fi eh sdotne heav T to icednu vegneita neculnefi on the ulhpahmtaoys eh wlil hvae easrnicde GnRH adn ehfrutr ncsiaigrne it iwht enCoimelph wludo ont rerccot hte idfeict in Gaosoiotp.rnnd +5
neonem  Oh h.u..d atht semak mcuh orem een.ss s!khTan .P.s I gotthuh npcelohiem swa mroe of a fiitlytre gdru for wm,oen inesc it blosck getvinae keedbcfa fo nesgoter on het lpouahtrih.autyisty/map utB in enm hte meysts si drneu fcdakbee ude to ,nestootsetre ton .tsgnoree +6
utap2001  ophelm iecn is ntreoseg uolnaega, vttocepmeii innat,aogst not eeifcvtfe in .nam 2. ehT inachmems of lhniopcmee is ackbedfe iseearcn of t-RnGg&;H eaeincsr HLS,FH, ton tveeffeci in rtatpyuii avlorem etnipta. +1

Obviously the FSH -> spermatogenesis answer is the main idea, but I also think giving exogenous testosterone might actually impair levels of Testosterone in the testes as the concentration needs to be much higher in the testes for functionality due to a binding protein that is produced under stimulation by LH (which would be under neg feedback from exogenous testosterone)

+2/- cmun777(37)

I agree with below, sertoli cells release a testosterone binding protein in response to FSH in order to radically increase testosterone levels within the seminiferous tubules. That is why individuals who take exogenous testosterone have decreased fertility even while taking T.

+2/- lowyield(43)


 +3  upvote downvote
submitted by โˆ—asharm10(37)
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so shi iurptyta eadmano swa edov,rem so orplyl tonhgosoaprd rewe meordev iwht ,it so fi uyo egvi rnhg ti tw'on do nghtinya sa it anc;t epdourc /FHHLS so ouy vgei slh/hf iyrtcedl to dcine sgpermeitsanseo nad tteso itsnhsyse.

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faus305  aheY tsih sekma a lot fo eni.cs hTe itnaeorr tipitaury osducrpe FiLA-PTG ,SF(H L,H ,CTAH HST, cirtPnl,oa nda rhtwoG m).ooHern yiaPturti seaodamn rae stmo lnycoomm pctsaanoiomrl ni eht enortair itpy.artiu eH si ujts now cininogt het tcfesfe of otn ahinvg HL nda S,FH itlitnyrf.ie oS we eend ot lecepra sto,he kaa egvi ponnaoit.rsdgo +



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