Block 7 Problem Quest
.JPG "Block 7 Problem Quest - Quiz")
Questions and Answers
- 1.
Endometrial hyperplasia and excessive bleeding during and between menses can be caused by anovulatory cycles. How do anovulatory cycles produce these effects?
- A.
Prolonged stimulation of the endometrium by estrogen
- B.
Prolonged stimulation of the endometrium by progesterone
- C.
Prolonged stimulation of the endometrium by estrogen and progesterone
- D.
Lack of stimulation of the endometrium
Correct Answer
A. Prolonged stimulation of the endometrium by estrogenExplanation
Normally, before ovulation, the corpus luteum produces only estrogen to prepare the uterus. After ovulation, the corpus luteum normally produces both estrogen and progesterone. If pregnancy occurs, human chorianic gonadotropin (HCG) from the placenta prevents the corpus luteum from atrophy. If pregnancy doesn't occur, the corpus luteum simply regresses and estrogen and progesterone production drop. In the anovulatory cycle, the corpus luteum continues to produce estrogen. This continued bath in estrogen causes the symptoms of menometrorrhagia (excessive bleeding at irregular intervals).Rate this question:
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- 2.
MM, a 38 year old female, is in her 19th week of pregnancy. For this time period, what protein produced by her placenta is the most important in replacing the function of LH in her nonpregnant state to maintain her progesterone secretion at appropriate levels?
- A.
Estradiol
- B.
Prolactin
- C.
Human chorionic gonadotropin
- D.
Human chorionic somatomammotropin
- E.
Dopamine
Correct Answer
C. Human chorionic gonadotropinExplanation
Human chorionic gonadotropin interacts with the LHCG receptor and promotes the maintenance of the corpus luteum during the beginning of pregnancy, causing it to secrete the hormone progesterone. Progesterone enriches the uterus with a thick lining of blood vessels and capillaries so that it can sustain the growing fetus. Due to its highly-negative charge, hCG may repel the immune cells of the mother, protecting the fetus during the first trimester. It has also been hypothesized that hCG may be a placental link for the development of local maternal immunotolerance. For example, hCG-treated endometrial cells induce an increase in T cell apoptosis (dissolution of T cells). These results suggest that hCG may be a link in the development of peritrophoblastic immune tolerance, and may facilitate the trophoblast invasion, which is known to expedite fetal development in the endometrium. It has also been suggested that hCG levels are linked to the severity of morning sickness in pregnant women.
Because of its similarity to LH, hCG can also be used clinically to induce ovulation in the ovaries as well as testosterone production in the testes. As the most abundant biological source is women who are presently pregnant, some organizations collect urine from pregnant women to extract hCG for use in fertility treatment.[10]
Human chorionic gonadotropin also plays a role in cellular differentiation/proliferation and may activate apoptosis
Human chorionic gonadotropin (hCG) is a hormone produced during pregnancy that is made by the developing embryo after conception, and later by the placental component syncytiotrophoblast. Some cancerous tumors produce this hormone; therefore, elevated levels measured when the patient is not pregnant can lead to a cancer diagnosis. However, it is not known whether this production is a contributing cause or an effect of tumorigenesis. The pituitary analog of hCG, known as luteinizing hormone (LH), is produced in the pituitary gland of males and females of all ages.Rate this question:
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- 3.
Dr. Buxbaum An 18-month old with a history of recurrent bacterial and viral infections, failure to thrive, developmental delay, and tremors is submitted to your care. On exam you notice a lack of peripheral lymphoid tissue. Blood analysis reveals lymphopenia with normal B-cell count and normal immunoglobulin levels. Patient is most likely suffering from
- A.
Hypoxanthine guanine phosphoribosyl transferase (HGPRT)
- B.
Purine nucleoside phosphorylase
- C.
Adenine phosphoribosyl transferase (APRT)
- D.
Adenosine desaminase (ADA)
- E.
Adenosine kinase
Correct Answer
B. Purine nucleoside pHospHorylaseExplanation
The correct answer is Purine nucleoside phosphorylase. This is because the patient's symptoms, such as recurrent infections, failure to thrive, developmental delay, and lack of peripheral lymphoid tissue, are characteristic of purine nucleoside phosphorylase deficiency, also known as PNP deficiency. PNP is an enzyme involved in the purine salvage pathway, which recycles purine nucleosides. Without PNP, there is a buildup of toxic metabolites, leading to immunodeficiency and other symptoms seen in the patient.Rate this question:
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- 4.
You are a neonatologist working in a tertiary care hospital in a state capital. A 4-week old male is transferred to you with severe jaundice that appeared at birth and has been worsening ever since. The boy is the first child of a healthy Jewish couple, pregnancy and vaginal delivery were unremarkable. The boy is of average height and weight for his age, in no acute distress, but shows marked jaundice and slight hepatomegaly. Lab: CBC normal, indirect bilirubin high, low fecal urobilinogen. What is the most likely diagnosis?
- A.
Neonatal jaundice
- B.
Dubin-Johnson syndrome
- C.
Rotor (-Manahan-Florentin) syndrome
- D.
Uridyl glucuronyl transferase deficiency
- E.
Glucose-6-phosphate dehydrogenase deficiency
Correct Answer
D. Uridyl glucuronyl transferase deficiencyExplanation
The most likely diagnosis for the 4-week old male with severe jaundice, high indirect bilirubin, low fecal urobilinogen, and slight hepatomegaly is Uridyl glucuronyl transferase deficiency. This condition is also known as Crigler-Najjar syndrome, which is a rare genetic disorder characterized by the absence or deficiency of the enzyme uridyl glucuronyl transferase. This enzyme is responsible for conjugating bilirubin, a waste product of red blood cell breakdown, making it water-soluble and allowing it to be excreted in the bile. Without this enzyme, bilirubin levels become elevated, leading to jaundice.Rate this question:
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- 5.
Dr. Sands What mutational event is often associated with Burkitt’s lymphoma?
- A.
The ras protooncogene is mutated at one nucleotide so that it is less able to hydrolyze bound GTP
- B.
The 3’ end of the c-src gene is deleted so that the SRC protein is always activated
- C.
There is a translocation of the c-myc gene to one of the immunoglobulin loci
- D.
There is a deletion of the p16 gene which allows unregulated passage through the G1 restriction point
- E.
. EBV causes the Her-2 protein to dimerize without a ligand binding to the receptor
Correct Answer
C. There is a translocation of the c-myc gene to one of the immunoglobulin lociExplanation
To assure the rapid loss of c-Fos and c-Myc after their induction in normal cells, both proteins and their corresponding mRNAs are intrinsically unstable. Some of the changes that turn c-fos from a normal gene to an oncogene involve loss of sequences in the gene that make the Fos mRNA and protein short-lived. Conversion of the c-myc proto-oncogene into an oncogene can occur by several different mechanisms. In cells of the human tumor known as Burkitt’s lymphoma, the c-myc gene is translocated to a site near the heavy-chain antibody genes. An analogous transloca- tion in the mouse genome is also involved in mouse myelomas. In both cases, the tumor cells arise from antibody-producing cells, which carry out DNA rearrangements during their maturation. The c-myc translocation is a rare aberration of the normal rearrangement events, bringing it from its normal, distant chromosomal location into juxtaposition with the enhancer of the antibody genes. The translocated myc gene, now regulated by the antibody enhancer, is continually expressed, causing the cell to become cancerous. Localized reduplication of a segment of DNA containing the myc gene, which occurs in several human tumors, also causes inappropriately high expression of the otherwise normal Myc protein.Rate this question:
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- 6.
The fascia in the pelvis and perineum consists of three layers that are continuous with abdominal fascial layers. Which of the following types of fascia can all be found in the deep layer of fascia?
- A.
External spermatic fascia & dartos fascia
Explanation
The deep layer of fascia in the pelvis and perineum contains the external spermatic fascia and dartos fascia. These fascial layers are continuous with the abdominal fascial layers. The external spermatic fascia surrounds the spermatic cord and testes, providing support and protection. Dartos fascia is a smooth muscle layer that is responsible for the wrinkling of the scrotum. Both of these fascial layers are found in the deep layer of fascia in the pelvis and perineum.Rate this question:
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- 7.
A 58-year-old woman with a right ovarian tumor undergoes an ovariectomy, which removes the ovary and a portion of the suspensory ligament. What important artery follows the path of the suspensory ligament?
- A.
Ovarian artery
- B.
Uterine artery
- C.
Cervical artery
- D.
Vesical artery
- E.
Umbilical artery
Correct Answer
C. Cervical artery -
- 8.
A 23-year old male is hit by a car while crossing a busy street. Among his many injuries is a torn sacrospinous ligament. Name (i) the muscle that will most likely also be affected and (ii) the nerve that may also be compromised.
- A.
Obturator internus muscle - pudendal nerve
- B.
Levator ani muscle - pudendal nerve
- C.
Coccygeus muscle - pudendal nerve
- D.
Levator ani muscle - perineal nerve
- E.
Coccygeus muscle - perineal nerve
Correct Answer
C. Coccygeus muscle - pudendal nerveExplanation
The torn sacrospinous ligament is located in the pelvis, and it provides support to the pelvic organs. The coccygeus muscle is also located in the pelvis, and it attaches to the sacrospinous ligament. Therefore, if the sacrospinous ligament is torn, it is likely that the coccygeus muscle will also be affected. The pudendal nerve is responsible for innervating the muscles of the pelvic floor, including the coccygeus muscle. Therefore, if the sacrospinous ligament is torn, it is possible that the pudendal nerve may also be compromised.Rate this question:
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- 9.
A boy with Duchenne muscular dystrophy (DMD) was born to parents with no family history of the disease. The most likely explanation for this occurrence is
- A.
A CGG expansion that resulted in the disruption of the promoter of the dystrophin gene
- B.
Infidelity
- C.
A point mutation in the dystrophin gene
- D.
A recombination event in the dystrophin gene that gave rise to a frameshift mutation leading to an untranslatable mRNA
- E.
A translocation that resulted in the disruption of the dystrophin gene
Correct Answer
D. A recombination event in the dystropHin gene that gave rise to a frameshift mutation leading to an untranslatable mRNAExplanation
The most likely explanation for the occurrence of Duchenne muscular dystrophy (DMD) in a boy with no family history of the disease is a recombination event in the dystrophin gene that caused a frameshift mutation. This frameshift mutation would result in an untranslatable mRNA, leading to the absence of functional dystrophin protein. This explanation suggests that the boy inherited the mutation from his parents through a recombination event during gamete formation, rather than through a known familial genetic mutation.Rate this question:
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- 10.
Triplet repeat expansions (CGG) in Fragile X syndrome interferes by?
- A.
Decreasing mRNA synthesis
- B.
Increasing mRNA synthesis
- C.
Creating splicing defect
- D.
Gain of function mutation
- E.
Dominant negative mutation
Correct Answer
A. Decreasing mRNA synthesisExplanation
Prevalence 1 in 4000 in males and 1 in 8000 in females
FRM1 gene encodes for a RNA-binding protein termed FMRP that is expressed in many cells including neurons. Loss of function mutation
99% of the FRM1 mutations are due to expansions of a (CGG)n repeat located at the 5’ end of the gene CGG Repeat expansion
(slide 17- trinuc repts-Blanch)Rate this question:
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- 11.
The pedigree below represents a family with cystic fibrosis (autosomal recessive). What is the risk that individual 11-2 will have an affected child if the prevalence of cystic fibrosis is in 2500 individuals?
- A.
1/50
- B.
1/100
- C.
1/200
- D.
1/300
- E.
1/400
Correct Answer
B. 1/100Explanation
Based on the pedigree, individual 11-2 is a carrier of the cystic fibrosis gene. Since cystic fibrosis is an autosomal recessive disorder, for individual 11-2 to have an affected child, they would need to have a child with another carrier or an individual with cystic fibrosis. The risk of having a child with cystic fibrosis is 1/4 if both parents are carriers. Therefore, the risk that individual 11-2 will have an affected child is 1/4 multiplied by the probability of the other parent being a carrier, which is 1/4 as well. This results in a risk of 1/16. Given a prevalence of 2500 individuals, the risk can be calculated as 1/2500 multiplied by 1/16, which simplifies to 1/40000. This is approximately equal to 1/100, so the answer is 1/100.Rate this question:
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- 12.
As a female enters puberty, which of the following hormones or neurotransmitters will increase its concentration or activity above prepubertal levels to drive neuronal secretion of GnRH from the hypothalamus and thereby initiate follicular development?
- A.
Glutamic acid
- B.
Testosterone
- C.
Gamma-aminobutyric acid
- D.
Neuropeptide Y
- E.
Melatonin
Correct Answer
A. Glutamic acidExplanation
Glutamic acid is not a hormone or neurotransmitter involved in the initiation of follicular development. The correct answer should be GnRH (Gonadotropin-releasing hormone). GnRH is released from the hypothalamus and stimulates the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland, which then initiate follicular development.Rate this question:
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- 13.
The adjacent figure illustrates the time course of plasma estradiol concentration during the ovarian cycle. Pick the correct concept map that depicts the feedback relationship that exists during the phase of estradiol concentration indicated by the dashed box 1.
- A.
![Block 7 Problem Quest - Quiz]()
- B.
![Block 7 Problem Quest - Quiz]()
- C.
![Block 7 Problem Quest - Quiz]()
- D.
![Block 7 Problem Quest - Quiz]()
Correct Answer
B. -
- 14.
A 22-year-old female (5 ft 2 in) experienced her first menstrual cycle at age 14. Until recently, she had normal, regular menstrual cycles with an interval of 30 days. Six months ago she began training for a marathon. She runs roughly 115 miles a week and as a result of her training regimen she has lost 20 pounds (110 pounds before and 90 pounds now). She has not menstruated for the past three (3) months. What is the best explanation for her amenorrhea?
- A.
Absence of GnRH surge
- B.
Prolonged elevation of follicle stimulating hormone
- C.
Increase in plasma leptin
- D.
Absence of a surge in luteinizing hormone
- E.
Abnormally elevated plasma estradiol
Correct Answer
D. Absence of a surge in luteinizing hormoneExplanation
The best explanation for her amenorrhea is the absence of a surge in luteinizing hormone. This is likely due to her intense training regimen for the marathon and the resulting weight loss. Intense exercise and significant weight loss can disrupt the hormonal balance in the body, leading to the suppression of luteinizing hormone, which is necessary for ovulation and the menstrual cycle.Rate this question:
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- 15.
Female reproduction I (ovary) Which of the following statements concerning the ovary is CORRECT?
- A.
The granulosa layer of cells of a secondary follicle is highly vascularized
- B.
The theca externa produces androstenedione
- C.
The basal lamina separates the primary oocyte from the granulosa layer
- D.
The zona pellucida found in the secondary follicle is composed of GAGs and glycoproteins
- E.
The secondary follicle contains a secondary oocyte
Correct Answer
D. The zona pellucida found in the secondary follicle is composed of GAGs and glycoproteinsExplanation
The correct answer is that the zona pellucida found in the secondary follicle is composed of GAGs and glycoproteins. The zona pellucida is a thick layer that surrounds the oocyte and plays a crucial role in fertilization. It helps to protect the oocyte and facilitate sperm binding and penetration. It is primarily composed of glycosaminoglycans (GAGs) and glycoproteins, which provide structural support and aid in the interaction between the oocyte and sperm.Rate this question:
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- 16.
Which of the following statements concerning the hormonal interplay on the ovary is CORRECT?
- A.
FSH stimulates the primordial follicles to develop
- B.
LH stimulates proliferation of the granulosa layer of cells in the multilamina primary follicle
- C.
Activin stimulates proliferation of the follicular layer to form the granulosa layer in the multilaminar primary follicle
- D.
FSH inhibits the production of progesterone in the corpus luteum
- E.
LH inhibits the production of estrogen in the corpus luteum
Correct Answer
C. Activin stimulates proliferation of the follicular layer to form the granulosa layer in the multilaminar primary follicleExplanation
Activin is a hormone that plays a role in the development of ovarian follicles. It stimulates the proliferation of the follicular layer, which leads to the formation of the granulosa layer in the multilaminar primary follicle. This is an important step in the maturation of the follicle and the eventual release of an egg during ovulation. FSH and LH also play important roles in the hormonal interplay on the ovary, but the statement about Activin is the only correct one among the given options.Rate this question:
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- 17.
Some people believe that the socioeconomic status of the family in which a child is raised is a major determinant of the child’s intelligence. This theory implies that individual differences in intelligence are mainly caused by
- A.
Measurement error
- B.
Nonadditive genes
- C.
Nonshared environment
- D.
Assortative mating
- E.
Shared environment
Correct Answer
E. Shared environmentExplanation
The correct answer is shared environment. This is because the theory suggests that the socioeconomic status of the family, which is a part of the shared environment, plays a significant role in determining a child's intelligence. The shared environment refers to the environmental factors that are common to individuals in the same family or household, such as parenting style, education, and socioeconomic conditions.Rate this question:
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- 18.
A female in her early twentes takes an oral contraceptive pill which contains a synthetic progestin. What is the most likely explanation for the contraceptive action of this drug?
- A.
Replacement of the LH surge by an FSH surge.
- B.
Abolition of the LH surge
- C.
Enhanced positive feedback of the hypothalamic-pituitary-gonadal axis.
- D.
Increased conversion of testosterone to estradiol.
- E.
Inadequate decidualization of the uterus.
Correct Answer
E. Inadequate decidualization of the uterus.Explanation
The most likely explanation for the contraceptive action of the oral contraceptive pill containing synthetic progestin is inadequate decidualization of the uterus. This means that the lining of the uterus does not properly develop and thicken, making it less suitable for implantation of a fertilized egg. This prevents pregnancy from occurring.Rate this question:
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- 19.
The dominant follicle is likely selected during the preceding menstrual cycle, and then grows prolifically during the proliferative phase of the next cycle. You want to administer a receptor antagonist designed to block growth of the dominant follicle. Inhibition of which receptor would most likely result in suppressed growth and development of the dominant follicle?
- A.
Gonadotropin releasing hormone receptor
- B.
Luteinizing hormone receptor
- C.
Follicle stimulating hormone receptor
- D.
Estrogen receptor
- E.
Progesterone receptor
Correct Answer
A. Gonadotropin releasing hormone receptorExplanation
Blocking the GnRH receptor will result in decreased production of LH and FSH,
which will subsequently inhibit growth of the dominant follicle. Interestingly, you could also suppress follicle growth and development by administering receptor antagonists designed to inhibit FSH receptor pathway or the LH receptor pathway, but the best answer is a GnRH antagonist that blocks both
LH and FSH activity. Recall the 2‐cell theory of steroidogenesis, and how LH and FSH action on the theca and granulosa cells is a complementary system that results in estradiol production.Rate this question:
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- 20.
Elevated production of estriol is associated with which of the following major events of early pregnancy?
- A.
Blastocyst invasion
- B.
Formation of the placenta
- C.
Spiral artery remodeling
- D.
Luteal‐placental shift
- E.
Syncytiotrophoblast hCG production
Correct Answer
D. Luteal‐placental shiftExplanation
A fully functional placenta begins to secrete increasing concentrations of estriol
at approximately 8 weeks of pregnancy. The rise in estriol indicates that the maternal‐fetal‐placental unit is fully functional. Therefore, the rise in estriol is associated with the luteal‐placental shift, which typically occurs between 7‐9 weeks of gestation. The other four major events occur within the first 2 weeks of pregnancy and are not associated with estriol.Rate this question:
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- 21.
Human chorionic gonadotropin (hCG) rescues the corpus luteum during early pregnancy by acting directly on the granulosa‐lutein cells. Which of the following statements best describes the primary functions of the granulosa‐lutein cells (GLC) and theca‐lutein cells (TLC) during early pregnancy?
- A.
GLC secrete estrogen and progesterone; TLC secrete androgen and estrogen
- B.
GLC secrete progesterone and estrogen; TLC secrete androgen and progesterone
- C.
GLC secrete androgen and estrogen; TLC secrete progesterone and estrogen
- D.
GLC secrete progesterone and androgen; TLC secrete progesterone and androgen
- E.
GLC secrete progesterone and androgen; TLC secrete androgen and estrogen
Correct Answer
B. GLC secrete progesterone and estrogen; TLC secrete androgen and progesteroneExplanation
Granulosa‐lutein cells (GLC) and theca‐lutein cells (TLC) both express
functional LH receptors, and the GLC secrete progesterone and estrogen whereas the TLC secrete androgen
(predominantly androstenedione) and progesterone. The GLC then aromatize the androgen into estrogen. These cells
types can also be distinguished histologically, since the TLC express high levels of CYP17 (the enzyme required to convert
progesterone into androgen) whereas the GLC express CYP19 (aromatase, required to convert androgen into estrogen).
Remember that the primary function of the CL is to secrete progesterone.
Steroidogenesis Summary:
Granulosa cells = estrogen during the follicular phase
Granulosa cells = estrogens and progesterone during the ovulatory window (after they acquire the LH
receptor)
Granulosa-lutein cells = progesterone and estrogen during the luteal phase
Theca cells = androgens
Theca-lutein cells = androgens and subsidiary amounts of progesterone
hCG = binds to the LH receptor and therefore maintains luteal steroidogenesis resulting in continued
progesterone production
The CL predominantly secretes progesterone. Follicles predominantly secrete estrogen.Rate this question:
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- 22.
Acquisition of the LH receptor by the granulosa cells is absolutely necessary for ovulation of the dominant follicle. Which of the following compounds is secreted by the granulosa cells in response to LH stimulation?
- A.
Testosterone
- B.
Progesterone
- C.
Estradiol
- D.
Fibronectin
- E.
Serine proteases
Correct Answer
B. ProgesteroneExplanation
LH stimulation causes the granulosa cells to produce and secrete progesterone. Progesterone plays a crucial role in the ovulation process, including the maturation and release of the dominant follicle. It helps prepare the uterus for potential implantation of a fertilized egg and supports the development of the endometrium. Therefore, the secretion of progesterone by the granulosa cells in response to LH stimulation is necessary for ovulation of the dominant follicle.Rate this question:
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- 23.
Estriol is synthesized in large amounts during pregnancy. What is the most likely physiological activity of this estrogen during pregnancy?
- A.
Stimulates vasodilation and uterine blood flow
- B.
Stimulates endometrial decidualization
- C.
Stimulates the secretion of luteal progesterone
- D.
Stimulates vascular remodeling of the spiral arteries
- E.
Stimulates blastocyst invasion
Correct Answer
A. Stimulates vasodilation and uterine blood flowExplanation
All three estrogens are secreted in large amounts and (estrone, estradiol,
estriol) act as vasodilators to increase blood flow to the uterus and growing placenta. Estriol is synthesized by the fully functional placenta after the luteal‐placental steroidogenic shift, and is considered the estrogen of pregnancy. Additional roles of estrogen during pregnancy are being examined, but to date, remain largely unknown.Rate this question:
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- 24.
A 42 yo married woman in a monogamous relationship has not experienced a menstrual period for 3 months. The woman is concerned that she is entering menopause, and notes that her mother and older sisters all experienced horrible migraine headaches during the hormone withdrawal associated with menopause. The woman also complains of minor nausea for the past week, which she attributes to a "bug going around". Based on this woman's history, which hormones should you assay to determine this woman's current menopausal status?
- A.
Progesterone
- B.
Estradiol
- C.
Human chorionic gonadotropin
- D.
Estriol
- E.
Estrone
Correct Answer
C. Human chorionic gonadotropinExplanation
This woman may be experiencing peri‐menopause, but nausea is not a typical
symptom associated with menopause. The history of no menstrual period for 3 months and onset of nausea is
indicative of pregnancy, likely the end of the first trimester. An hCG test will quickly determine pregnancy status. The
woman is worried about menopause, but as a physician you need to look at the entire picture. Additionally, you are
told in the first sentence that the woman is in a "monogamous relationship", therefore in this instance you should
assume the woman is engaged in sexual activity.
Estrone is considered the estrogen of menopause, but in this case, it would be prudent to evaluate progesterone and
estradiol levels to first determine cyclicity. If estradiol levels are normal, then the woman may have an underlying
pathophysiological disorder, such as PCOS or leiomyoma (uterine fibroids). Reproductive pathophysiological disorders
will be covered in detail in Semester 4.Rate this question:
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- 25.
A 26 yo male visits his primary care physician (PCP). The man complains of lethargy and muscle weakness. He then explains to his PCP that he and his wife have been trying to get pregnant for the past 8 months with no success. The man further explains that sometimes he is unable to maintain an erection, and because he can't match his wife's libido he is feeling depressed. His PCP suspects this man may have decreased levels of testosterone. Which of the following hormone assays should the PCP order to determine if this man has low testosterone as a result of an impaired hypothalamic‐pituitary‐testicular axis?
- A.
Testesterone and dehydrotestosterone
- B.
Dehydrotestosterone and prolactin
- C.
Testosterone and follicle stimulating hormone
- D.
Luteinizing hormone and follicle stimulating hormone
- E.
Testosterone and luteinizing hormone
Correct Answer
E. Testosterone and luteinizing hormoneExplanation
Luteinizing hormone (LH) works directly on the interstitial cells of Leydig (i.e.
Leydig cells) to stimulate the production of testosterone. Low levels of LH can result in decreased levels of testosterone,
which can subsequently lead to decreased sperm production. Remember that LH acts directly on the Leydig cells, and
then the testosterone generated within the Leydig cells acts on the Sertoli cells to regulate spermatogenesis Prolonged
exposure to low levels of testosterone can also lead to systemic effects, such as decreased muscle mass and/or lethargy.
Evaluating the levels of DHT and FSH would also be beneficial, since levels of DHT are directly correlated with levels of
testosterone and FSH is also required by the Sertoli cells during the process of spermatogenesis. Additionally, checking
the levels of prolactin could be informative, since prolactin helps stimulate the expression of the LH receptors.
However, in this particular case the PCP suspects a problem with testosterone production and/or secretion, and
therefore the first step is to directly measure serum levels of testosterone and LH.Rate this question:
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.JPG "The adjacent figure illustrates the time course of plasma estradiol concentration during the ovarian cycle. Pick the correct concept map that depicts the feedback relationship that exists during the phase of estradiol concentration indicated by the dashed box 1.")
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