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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 hnkit het nreaos ouy ened ot tnjiec dnosgontrapio in stih caes si ebucaes yuo ende FHS nda LH to drepocu prsme. SHF atusietlsm the lseroti csl,el iwhch neil het esomfunrisei tuubsel adn lehp hte maaingsoeptor pdrecou tea.rsesmyoptc ntsereestooT si a duotprc fo eLigdy elslc enhw ehyetr' tmdsetluia by ,HL so ninecgjti oeostetresnt lwduo bsspay tath setp utb it lt'unwod laeyrl pehl wiht gtopamis.seeersn ,Howerve ntjincieg GnRH lsao etnos'd neo'dst lelayr hepl abeuces yuo dnee htta slptauiel HGnR ta hitgn to akme LH and HFS ehresaw licn-agngto RnGH naolsga luylctaa esdearce LH nda SFH cuondrpito.

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m-ice  Adndgi on ot eht asrewn beo.av I was scutk weeetbn het ganndrtiooop ninijectos and clhemeipn.o t,Bu icnpeloehm acst to cieesarn yiativct fo nHRG ichwh neth rseetx sti eeftsfc on eht ptra.iyiut ehT nma ni htis ienqtuso ahd ish tiyrpuiat veoremd uesaebc of an ode.mnaa ,So eh esned het FSH dan LH lcid.etyr +28
mousie  aer!eg ev Raolm of het iuyatitpr dulow esac a tifdeic ni oGotsidarnopn L,(H S)HF and ortefeher nghinot to auimetls the ssette to amek .s.emr.p airclnepg teh T thiw a htcap dlwuo ton lsautmtei teh tsetse to mkae rmeps and if hsi axsi aws tcanti aghhu(lot tis )otn hist wloud ftrrhue onwd eetuglra hte dtocpiourn fo .mrpes I aednelimti lopChimene sebeuca if eh esdont vaeh T ot cnuied eegtnaiv euefcinnl no the mlspyaaouhht eh llwi ahve easdirnec nHRG adn tehrufr raininsecg ti wtih peeCohmlin ludow otn cocetrr eth dietfic ni dpon.itnaoorGs +5
neonem  hO .u.dh. thta aksem uhmc roem e.esns h!anTks .P.s I tuhhogt hclemiepon asw eorm of a fitetlriy rgdu orf owenm, eicns it sclkbo tneegiav dfkabcee of rteenogs no eht lhpoh.ptaiautyits/aurmy tuB ni men eht msyest is denur eecfbkda eud ot etntooe,ssert not oenr.steg +6
utap2001  ce ilempnho si tnreoges aleugn,oa ctvepieimot n,aniastogt nto fteeivfce ni m.na 2. Teh cismnmhae fo noclhpieme is eafkdecb cnsraeie fo GRgntH;-& ercnasie SHLF,,H otn icefeeftv ni utitrpayi earmovl ittae.np +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 sih itupytra mnaodae aws mrvdoee, so lylpor soopraghontd eerw edomevr with t,i os fi yuo give rgnh ti owt'n od nyhngati as it nca;t cepodur HH/FSL so you iveg shf/lh ediltycr ot iencd gsmepesonsirtea and etsto ny.eistssh

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faus305  eYha hits ksmae a tol fo ns.cie eTh tnrraeoi trypitiau udpeocrs GLT-AiFP SF,(H LH, ATC,H TS,H ltroc,aniP and rhtwGo mr)e.nooH itytruiaP deomasan rea stmo ocyommln nrisaaoomtlcp in the retorain puriti.tay He is jsut wno niogtcni eht ceetfsf fo not gavnih HL dna ,HSF tiieliynt.rf oS we edne ot cleeapr tesh,o aka vgie inoto.psnaogdr +


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