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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 kihtn hte rnaeso you eden to ncijet onsooapintdrg ni htis acse is suaeecb ouy eedn FSH nad LH ot oeurcpd es.prm SHF tsustieaml eth rtselio lce,ls chhwi leni eth imensifesrou ubleust nad lpeh hte ageoopaimtsnr eodpcru s.yerotpatmecs rtteoesenTso si a pdotrcu of yiedgL lcsel ehnw eyteh'r tdeliasmtu by LH, os gncinejti eoesonetrtts udolw pybsas thta tsep btu it w'ulodtn areyll hple htwi airosgetsnempse. eeHowvr, egijinnct GRHn losa 'tosden so'etdn llayre leph cubasee yuo eend atth tlalesupi GnRH at gniht ot kmae HL dan SHF aerhesw ilgnancgto- GHRn nlsoaag ulayatcl sdaceree LH and FSH dtrcou.nipo

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m-ice  idgnAd no to het rsnawe ebo.va I aws kcuts etwnbee the iaotdgonnpro nncijsioet dan lcp.oihmeen ,But omelpienhc tsac to aesiecnr ticaitvy fo nRHG hcwih hnte serxte sit fceetsf on teh yiptiuart. heT nam ni isth enistuqo had ihs iptirtuay rvemoed esceaub of na daeo.nma o,S he eedns eht FSH and LH y.edlcrit +28
mousie  !erage oRv lema of hte urpttaiiy owudl ceas a eiitdfc in oranpondosGti ,(LH HSF) and feeroreth nohntig to lumaites hte eesstt ot mkea sm.r.e.p agpenclri hte T iwth a tacph lwodu ont mtsiateul the steest to amek rpems dna if ish xais asw tantic tgalhu(oh sti )ton tihs uwdol erhftur dwon legutera eth ruocpintdo of rmspe. I meidielant lepCmeonih aesebuc if eh doetsn vhae T to icendu iaevgtne funcieeln no het thusmyaploha eh illw heva edscaneri RnGH nad rruehft ceaingisnr it ihtw eCloehmnpi udowl nto otrcrce eth itfedic ni onpdiot.aoGsnr +5
neonem  hO ud..h. ahtt amesk cuhm remo sne.se hTnka!s Ps.. I tuhhgto eloihcmenp was erom of a trylitief grdu rof me,onw nesic ti scklob gienveta cebedkfa fo gtrsneoe on het yyaipphtl/rouhsamtutai. But ni mne eth stysem si neudr eekdafcb ued ot t,eseosettron otn ento.ergs +6
utap2001  onhecmlei p si eeogtrsn lgeoa,una ttiimcopeev naitaon,tgs nto cvitfeefe in anm. .2 The emshnimac of eplicohmne is bkafeced rcnsieea of t;&Gn-RHg cresenia LFH,HS, nto fveteecfi in puaiittyr mavrole itp.tean +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 his uraytipt odnaame saw rm,evode os rlplyo onposgadhrot eerw odvemer twih t,i so if uoy egvi hrng ti n'two od gtyihann as ti n;cat deuocpr HL/SHF so uyo gevi sflhh/ tcidreyl ot cedni rtenaipemsegsso adn soett syten.ssih

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faus305  eYah iths eamks a tol fo iscn.e ehT rieraont puitiyatr opcrdsue PA-TFLGi (F,SH L,H HC,TA H,TS iPrtoan,lc dan Gorhtw Ho.ner)mo atPrtiiuy omdaenas rae omts moynolmc smitooapcanrl ni eth niertora uyapitrit. e H si ujts nwo iginontc eth fcesfte fo nto givahn HL dna FH,S tilfryien.ti So ew ndee to celpaer ot,she kaa egiv and.prntigsooo +


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