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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 iknht eht esaonr uyo edne to etjnic dointorgasopn ni tshi ecas si saueceb yuo eedn FSH dna HL to perudoc p.srme FSH aisultetsm eht strieol selcl, whcih leni hte iemsnofeirus luetubs adn phle teh eampnooitrasg orcdeup srpyosce.ematt nsettrosToee si a tcopudr fo idgeLy elcsl nweh 'etheyr astiutlmde by HL, so njgnctiei tteoenesotsr udowl sbyaps tath ptse tbu ti 'nduwotl arleyl lphe whit onpasstm.egrseie ov,Hrewe ecjgntnii nGHR laso teson'd d'notse leylra pelh seubcae uyo eedn ttah ptluaesil GHRn ta hignt to ekam LH dan FHS srheewa gli-ntnaogc GHnR goalans yataucll eseecrad LH nad HFS uir.pnodcto

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m-ice  ignAdd on ot eht raeswn baoev. I saw kctus newebte the gntapirodoon iscnenjoti adn mpe.cienhlo tBu, cphenleoim satc ot ncsaeire ciiatvty fo nHRG hcwih nhet eresxt tsi esfeftc no eth pr.tiuayti The mna ni hsti sntequoi had ihs pyitiutar dvremoe aueebcs of na dmea.nao oS, eh nsede eth HSF adn HL l.yrtiecd +28
mousie  reega! avmRo l e of eht yipirtuta duolw esac a cditeif ni pnratodiosGon ,HL( H)FS and reftehroe ohitnng ot italmeus eth sstete ot amke psmr..e. narlgpcie het T hwti a hptac wolud nto tasemtuli het sstete ot eamk emrps adn fi his axsi aws cintta t(ahhuglo its to)n ihst olwud hrfuert wdon ugaerelt teh dponorituc of .remps I nileidtame opChnemiel suebaec fi he oenstd veha T to cedniu eaeitngv nnelficeu no eth aymsptohlahu eh wlli vahe rsnedcaei GRHn dna rtferuh negsiincar ti tihw poehCineml ldwuo not tcorrec hte icieftd in r.dotoiponnaGs +5
neonem  Oh .h.du. ahtt eksma muhc erom ense.s ksna!hT ..Ps I ghthtou mnchlpeoei saw oerm of a ttiilrfye udrg rfo nw,meo nseci ti ksbloc vagtiene edfckabe fo tneserog on het o/tta.hauyppirmyasutilh uBt ni nme the ytessm is nedru bkcdefea ued ot nsetoosr,ette tno tnegors.e +6
utap2001  milneohcep si sgeronte ag,uealon ivcoemttipe ngaso,tinta otn cfetiveef ni m.na 2. Teh meshamnci fo inpmceeolh is afbkceed asnieecr of RHt;g&n-G eniraecs LF,S,HH ton ceveetfif ni apiytitru oaevmrl aitt.pen +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 ihs tupariyt daoenam wsa ro,dmeev os roplly asohgrtdonpo erew eerdmov hwit ,ti so fi yuo ievg rngh it 'nowt od nghinyat as it ant;c uedcopr H/SLHF so oyu iegv l/shhf ytiderlc to cenid greesssonaemitp nad estot eshntsi.ys

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faus305  aeYh thsi keasm a otl fo sc.ein hTe taniorer taytpirui rpsdcueo FTGiA-PL FH,S( LH, C,AHT ,TSH corlt,aPni nad owthGr .nro)meoH yitPatuir osdmnaae rae stom mmnyloco ramlotsaonpic in het nrotriae tiry.uitap He is ustj wno iiontcng the fsefcet of not haginv LH and HF,S iintrifteyl. So ew eden ot repclea hsto,e aak gevi dgroanns.itopo +



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