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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 khtin the ornsae yuo edne ot jtienc pisoagnrtodno in tshi esca si aesbcue oyu nede HFS dan HL to pderuoc msepr. HFS stsmltieau eht elisrto lec,sl hcihw leni hte emiinusosfer elutbsu and pleh het trmiaeopgason rdpouce esyo.smaterptc tntosTeeores is a upctord fo dgyLie elslc ehwn e'tryhe euadttislm by H,L so tneignijc ttneresesoot ouwld aybsps ttha etps btu it ndlt'wuo rlyela hlpe twih mtse.neopsgsiaer rveoew,H iietcgnjn RGnH olsa sdn'teo todsn'e ellyra pleh ueabsce you nede thta ipulalset RHGn ta nigth to eakm LH and HFS haeeswr -onngalcgti RGHn gaaslno cuylltaa dsecaere HL adn SFH c.otirupdon

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m-ice  gdAind no ot the rwaesn abveo. I asw suctk weenebt het odtngrpoiona cinoesjnti nad oi.henclmep Bt,u polnicehem satc ot ersecian caitviyt of RHGn cihwh hten ertesx its ecftfes on het .uarityitp Teh nam in htsi nteosqiu dha sih ytriiuatp rmveode aecesub of na e.nmaoad ,So eh edsne eht HFS nda HL cydli.etr +28
mousie  reae!g lm ve Rao fo eth uyptiaitr uoldw seca a fcdiite in nooirtsodpaGn (HL, )HSF dna rtreeoehf nnhitgo to saletium eht etests to kaem p.r.sme. laecprgin eth T htiw a hcatp odluw not ustmtieal het ttesse ot emak prmse adn fi ihs xasi saw catnit (hltughoa ist )otn htis lduwo rrfehtu dwno ratgeelu the poidrcuont fo prms.e I aeiimnldet peoiemhlnC ebecsau if he etnosd vaeh T ot dinuce vgetiane feiunelcn no teh hmatopsaylhu eh lwli evha dancrseei HnGR nad ruerhft gcainnersi it tiwh Cinehomelp dwluo ton eocrctr the tiidcef ni nod.sotGopanri +5
neonem  hO ..du.h atht skame chum orme n.eses ahkTns! s..P I guthoth nhmpolceei wsa orem of a tyrtiiefl urdg orf ,newmo cines ti olkbsc gtinevae dbefckae fo ngseoetr no teh u/tpyptaa.ruahsimhoitly But ni nem eth esytms is ndrue edeakfcb ued to eee,osttstrno not rgnoest.e +6
utap2001  henicomple is gesernto oa,genalu eiecptoivtm so,itnatgan ton eeectviff ni m.an .2 hTe amsnimehc of hnleicmope si adekecfb seriecna of -&gRntH;G isrceean ,,SLFHH nto iceetevff ni ytapruiit evmlaro attn.pei +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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so shi uyattpir aaomned saw ovdee,rm so rlploy gorondpotahs ewre meordve htiw i,t os fi uoy veig grhn ti wont' od inantyhg as it can;t reudpco HHSFL/ so uyo geiv /hshfl ltdcyrei to idcen nmeoesregsaptsi adn tteso isheys.nst

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faus305  ahYe shti emask a otl of nicse. ehT tnariroe taiiptury eudpsocr TAGFP-iL ,S(HF HL, TAH,C ,THS acnolt,irP adn hoGtrw Honorme.) tiPayitru snmdoaea ear most nmcolymo stcmailpanoor ni eth eoianrrt .aittrpyiu He is sujt won icnnigto eht eesffct fo not iahvng LH and FHS, tiltfnieiy.r So ew ndee ot leeprac t,ehos aak vgie ionp.sgootdanr +


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