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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 nthik the oarens oyu ndee ot icejnt nanotgiodsrpo ni htis caes is eausecb uyo deen SHF dan LH ot ruecpdo .msrep SHF atusielsmt teh rsiotle ellcs, hwihc nile eth nesofiuseimr ebuslut nda lpeh teh gsaoentmapiro oreupdc reeco.mtapytss seroeTseontt is a rcdupot fo ideLgy eclls nehw 'eyhert atmdslteiu by HL, os igninjtec etttesrnesoo oldwu ypassb thta spet ubt it notwudl' lelary leph tiwh si.apgnotsremees vreeHw,o cjigtnein HRnG sloa d'nseot edston' rllyea ephl eueasbc uyo deen htat tlsaeuilp HnGR at thgni to akem HL and FSH haweser tnolgc-iang nGHR olngaas alytcaul aeercdes HL dna SFH no.uopdcirt

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m-ice  ddingA no to het wsrane b.vaeo I aws ktcsu betwene teh ndtoiapnoorg sionjentci dan nehlmpe.ico u,Bt nelohcmpie cast ot nieacesr ciavyitt fo GHnR ihcwh tenh steerx sit cseftef on eth utaipti.yr eTh mna ni shit etuioqns adh hsi ityirutpa meedovr abuecse of na em.aaond oS, he esned teh HSF adn HL e.tidrlcy +28
mousie  gr!eea l Rveoam of teh atyurpiti wuodl ceas a eitfcdi in oosditonGnpra L,(H SHF) adn feotrreeh tgohinn ot muasltie hte setste to emak smer..p. alrcngepi teh T hwit a pcath uodlw otn mttiaslue teh ettess ot keam epsrm and if ish xsia asw nttcia ghahotlu( sit )tno htsi lwduo trefurh wodn erulaegt teh dcopoirntu fo em.prs I miaetlnied enCmheloip cbseaue if eh dnteos avhe T to ncdieu vgeeitan ueilnencf on eth tamulayhsohp he iwll veah cradneeis nGRH dan rhtuefr iganciresn it hwit Chniloeepm loudw nto ccrtero the ftdeiic in .aooGpsdonrint +5
neonem  Oh hd.u.. atht aksme umch omer ssene. n!hsaTk .sP. I htgutoh ehimcenlpo was remo fo a telrifity udrg fro mn,oew nices it lcoksb gieentav eefcdbka fo ergeostn on eth aruu.ptya/ompyihasitlht Btu in nem hte tsesym is erudn cbeafdke deu ot etoerss,oettn not getnes.ro +6
utap2001  mn epiohcle si nrgoeest olna,euag mivtpceieto nnsa,oatgti otn ifveeetfc in am.n .2 eTh caemsmnih fo iomelepchn si beckdeaf nsrceaei fo ;tGgRHn-& cainrsee H,SLFH, ton ivffetcee ni ituatriyp ralmveo .eitnpta +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 hsi iarttyup dmaaoen wsa rve,emod os lpryol dposonotghar erew edrovme iwth it, so if uyo giev hrng ti wot'n do ignhytna sa ti a;tcn ecrpdou SH/FLH os uyo vige fhs/lh cirdtlye ot cidne asnetgprsemseio nad toset sis.hnyest

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faus305  hYea tihs ekmas a otl of seci.n eTh rrenotai aiipytutr odpuecsr LTFG-iAP ,S(HF ,LH TC,AH ST,H t,alrcoiPn dan hGrwto )nemorHo. iurPtayti edasnoam are omst onlymmoc corolapmtinsa ni eht riroaten p.ttaiyrui He si tsuj onw inoticgn eth fctefes of nto ivaghn HL nad HS,F fniiletiy.rt So we ened ot relepac sh,teo aak evgi dnoaontprs.iog +


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