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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 tinkh het sanreo ouy ndee to incjte pditnaoosrgon in tshi easc is ucebase uyo ndee HSF dan LH ot cepdrou rps.me SHF aestmistlu eht toesril c,ells hiwhc lein eth ursiefsnemoi uubestl dna ehpl the ianotpagreoms dpcureo cmysr.sattpeoe Tsnreeoteots si a rtcuodp fo Ldyige celsl nhwe eerh'yt msueiattdl yb H,L so itceingnj reeottstoesn wodlu byssap that tpse utb it o'lwntud yrllea phel htiw meng.reseiotsaps H,overwe ntncieigj GRHn osal etsd'on esot'dn rellya hepl eueacsb uoy ened that slupteali GnHR at hnigt ot amek LH dan HFS weserha ngaoti-lcgn HGnR aosangl ltycaaul dcrseeea HL dan FSH od.cnoupirt

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m-ice  diAngd on ot hte esnraw abvo.e I was utskc wbnteee het groninaotodp sintcjoein and h.inlpocmee ,tuB icepmlehno scta ot iensrcae tiyiatcv of GRnH hihwc tnhe sexert sti fsetecf no teh ruaitty.pi heT amn in ihts qnusiteo adh hsi truipiayt oevrmed csuaeeb of an maaeon.d oS, he sdnee teh FHS dna HL t.derclyi +28
mousie  !greea Rl mav eo of eht uiptityar udowl asec a ifdtiec ni pnotoiGsndaor H(,L H)FS nda rtheoefre ontnigh ot umaielst teh etstes ot meak emr.p..s ecanrlpgi eht T with a thcpa lwodu otn atletmius teh tstees to ekam emprs dan fi hsi aisx swa ttianc lhgotau(h its )not hist dlwuo hreufrt dwon lergaeut eth dtpricuono of p.msre I neielitdam lpCeeonmih sbeaceu if eh ntsdeo eahv T to nuiced eineavtg enifcenul on teh uhmlytpasaho he will eavh seednrcai GRnH adn hreuftr icsgreinna it itwh hneComlepi duowl nto cerotcr the fiicetd in .rpotoinanosdG +5
neonem  Oh h..d.u htta esmka mchu orme nes.es nk!aTsh Ps.. I ghhtuto lcepinmhoe wsa moer fo a teiyrftli urgd rfo om,enw iensc ti oklbcs ateivgne fbeakedc of nstegoer no hte shlh/toatiumitpyua.pyra But ni men eht mstyes is uedrn ekbefcda edu ot seo,stteorten ont .etorgnes +6
utap2001  oine lphcme si teoesngr n,uaalgeo ievottmeipc tatsan,inog ont cffevtiee in na.m .2 ehT mschemian of olhmpeiecn si edfbecak acneirse fo RnHgG;t&- rasecnie H,HLFS, otn eicftveef ni tapitiury arovlme etap.int +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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os shi rtipyuta aemndoa was emerdvo, so plorly odpnoarsgoht were reodevm htwi ,it os fi you gevi nrgh ti now't od ygnitahn as ti tcan; eorudcp /SHFLH so ouy evgi /fslhh ycirltde to niecd srenoetgpsseaim nda ttoes syntsshei.

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faus305  Yhea ihst asmek a tol fo i.secn The rieonrat ittuaiypr erpdcuos TLiAF-GP SH,F( H,L AC,TH TSH, ,Pctnoalir dan Gwohtr er).nHomo ayPtruiti sadnomea rea smto yoolcnmm acoosplatrimn ni hte aoneirrt .riyutpita H e is juts won giitoncn het seecfft of tno higvna LH nda H,FS lnite.iifrty oS we dene ot epaeclr steoh, aak vieg gno.tnisoadorp +



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