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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(629)
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I tnhik teh sonrae uoy eedn to eicjtn dsnnoiogratpo in tihs ecsa si uscaebe oyu ened FHS adn HL to upecord .srpem HSF ulttsmisea eth istolre llsec, chwih neil eht rousmfeieisn elustbu nad lhep hte sogatiprenmao oerpdcu os.acmytespret oenTssteeotr is a ducprto of deyLig sllec ehnw hy'reet tdiamuetsl by HL, so ntcnijige ottreestesno wdlou bpasys hatt estp ubt ti nlwdotu' erllay pleh iwht aimrptgsese.nose ,veerHwo icinjntge nHRG oasl d'tosen sdteon' yearll phel beseacu uoy ende ahtt sletiupal RGnH ta htgni ot kame LH dan HFS esehawr nc-gliantgo GHnR ngalsao yulactal adserece HL nda FHS dutopoinrc.

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m-ice  dgdniA on ot eht wearsn .bovae I wsa tkusc bentwee the oipotrdgnoan ncieisotjn nda elm.chnipoe ,tBu eiophmlnce acts to eiensacr ytvictia of RnHG chhiw then trseex ist fesfcte no eth ytur.iitap Teh amn in siht uqnostie adh hsi ituytpari omeedvr seebcua fo na ema.onda So, eh ndese the HSF adn HL icleydrt. +28
mousie  !ragee Rmae vo l fo hte tryiaiptu wuldo eacs a etcidif ni odaptoGsrionn (HL, HSF) adn treefrohe hnointg to sailutme teh estset ot akme .esrp.m. granlipce teh T whti a ctpah wludo tno lttusimae eth tesste to kmea ermsp nad fi sih saxi swa cintat uo(htgahl ist to)n htis lowud erfhrtu nwdo ertalgeu hte dutinocpro fo se.prm I dneilmieat hemCiopeln eaebcus if he tendso ahev T ot cundei ngvaitee neiunecfl on eth houptylmahsa eh lwli ehva dcarisnee HnRG dan frteuhr nngcrieisa it twih iChpeomlen loduw tno octcrre hte diiftec ni noon.Gstoiadpr +5
neonem  hO .d.hu. thta samek mhuc ermo esn.se n!shTka s.P. I hhuottg oneiplmche was orem fo a trelitiyf rgud for onme,w csnie ti lksbco egaeintv cdfekaeb of sntgeero on het tlpmophr.auaashitui/yty But in emn teh msstey si rneud ecbfkaed due ot ore,ntetsesot tno rtenoes.g +6
utap2001  neeo ihlmpc si nreetosg gnlaaeou, vepeimotcit sngaa,otitn nto ceietevff in na.m .2 Teh mnihmcase of cpoeenilhm is baceekdf eicsraen of &RG-Hn;gt rcnsaiee ,,HFLHS not cetvieffe ni iitaupytr almreov t.anepit +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)

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 +3  upvote downvote
submitted by โˆ—asharm10(37)
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os hsi yipurtat naoedam asw eov,edrm os lolyrp anothrodopgs erwe vrodeem hwit ti, so fi yuo veig nrhg it 'owtn do nyhiangt as ti cn;ta crupeod SHH/FL os uyo gevi /lsfhh lciryetd ot nidec tresogpneaissem adn soett yhsessitn.

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faus305  Yahe thsi samek a tol of .einsc The nierrato tayripuit eosprcdu APFTiGL- HF(S, ,LH HCAT, ,SHT nci,Palrto nad orthGw on)oH.rme atPiyruti odnaesam ear ostm ymcolonm cipsnmltroaoa ni the riarotne riat.iyutp He si ustj won gntnoiic the tcfefes of nto ingavh LH dna F,SH ril.tyientif So ew need ot elcpera ohe,st aka iveg gptosadonrion. +


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