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NBME 20 Answers

nbme20/Block 4/Question#1 (46.3 difficulty score)
A 32-year-old man comes to the physician ...
Tissue: testicle; Effect: estradiol production🔍,📺

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submitted by step420(32),
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-GCBH and HLHF,,SSHT rshae esma phaal u,sbunit so GHC cna catveait sheto pecersort fi tsi ni hhgi hnueog tnai.ytuq iAtncgavti HL rtcepeor llwi adle to omre eotoTetsesrn frmo teh eLgdiy cs.lel eroM ortesstotene anc laed ot moer seornegt onimoftra iav esam.oatra

dickass  bHCG directly increases testicular aromatase activity, it's not because of the increased amount of testosterone. +6  
vulcania  And for those who were wondering (cause I was), Sertoli cells have aromatase (FA 2019 p. 614) +7  
godby  It's a slightly different question, on the stem, what's the purpose of the hCG to him, for infertility or increased sexual demand ? Just curious. +  

submitted by divya(63),
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rwould q di - 825 orf ortnpefdo eoscnarereign eiarencs otaeaasrm i.vctaiyt

otameasrA tatycivi si idnrseace by )- 1 e g)a2 3i)sbte yo )niins l4u )itdasponr oogn5 lcoohla

submitted by dickass(103),
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sisTctlee eahv agincnitfsi atoeaasrm .cyattivi sTih yiamczetn iavtcyti si rtgeauled yb LH (dan fo cruoes bG)HC


submitted by trazobone(59),

For anyone who was like me and clicked Liver Testosterone Metabolism, yes you would see gynecomastia in a liver pathology, but that’s because the liver metabolizes ESTROGEN not testosterone, leading to an overall imbalance of estrogen:testosterone levels.