Welcome to your 7. ♂️ Male Reproductive Disorders, Infertility, Prostatic Disease & Androgen Pharmacology Arena — 40 Integrated MCQs
1.
A prostate biopsy is performed in a man with a suspicious peripheral-zone lesion. Which microscopic finding most strongly supports adenocarcinoma rather than benign prostatic hyperplasia?
2.
Ketoconazole is used in a clinical setting where rapid reduction of androgen production is desired. Which action is responsible for this antiandrogen effect?
3.
A man with a malignant testicular germ-cell tumor has retroperitoneal lymph-node involvement on CT, but no distant metastases are identified. Which clinical stage best describes this disease?
4.
A 30-year-old woman has cyclical pelvic pain, deep dyspareunia and infertility. Which disorder is most likely?
5.
A malignant testicular germ-cell tumor spreads through its normal lymphatic drainage. Which lymph nodes are most likely to be involved first?
6.
An orally active anabolic-androgenic steroid resists rapid hepatic metabolism but is associated with clinically important liver toxicity. Which pharmacokinetic modification best explains these properties?
7.
A woman receiving prolonged GnRH agonist therapy develops hot flushes and vaginal dryness. These effects are mainly due to:
8.
A woman develops fever, lower abdominal pain and uterine tenderness after a uterine procedure. Which pathological process is most likely?
9.
An endometrial biopsy is performed in a woman with persistent abnormal bleeding. Which finding favors chronic endometritis?
10.
A 27-year-old woman has been unable to conceive despite regular unprotected intercourse for one year. Which term best describes this condition?
11.
A patient is given a GnRH agonist continuously for endometriosis. Which effect develops after the initial stimulation phase?
12.
Repeated bleeding from ectopic endometrial tissue eventually produces pelvic adhesions. Which process most directly leads to these adhesions?
13.
Histological examination of a testicular tumor shows large uniform cells with clear cytoplasm separated by fibrous septa containing lymphocytes. Which diagnosis is most likely?
14.
A man taking spironolactone develops reduced libido and gynecomastia. Which additional pharmacological action of this drug best explains these effects?
15.
After adequate follicular development, a woman receives hCG during an ovulation-induction cycle. What is the main purpose of this drug?
16.
A patient with advanced androgen-dependent prostate carcinoma receives continuous treatment with a GnRH agonist. Testosterone initially rises but subsequently falls markedly. Which mechanism produces the later suppression?
17.
A 29-year-old man has infertility with normal libido, normal secondary sexual characteristics and normal-sized testes. Semen analysis shows azoospermia, while gonadotropin levels are normal. Both vasa deferentia are not palpable. Which category of infertility is most likely?
18.
An ovarian cyst removed from a woman with chronic pelvic pain contains thick brown altered blood. Which condition best explains this finding?
19.
A 38-year-old woman with heavy menstrual bleeding has a firm uterine mass. On cut section, the lesion is white-gray with a whorled appearance. Which diagnosis is most likely?
20.
A 26-year-old man undergoes surgery for a testicular mass. The cut surface is poorly circumscribed with prominent hemorrhage and necrosis. Microscopy shows primitive pleomorphic epithelial-like cells forming solid and glandular patterns. Which tumor is most likely?
21.
A woman undergoing infertility treatment receives recombinant FSH. Which effect is expected?
22.
A multiparous woman reports a vaginal bulge and pelvic heaviness that worsen on standing. Which underlying abnormality best explains her symptoms?
23.
A patient with benign prostatic hyperplasia is prescribed finasteride. Which pharmacological action produces its therapeutic effect?
24.
A 50-year-old woman leaks small amounts of urine when coughing and sneezing. Which type of urinary incontinence is most likely?
25.
Two men have prostatic adenocarcinoma. The second patient's biopsy shows markedly greater loss of normal gland formation and more disorganized tumor architecture. What does this higher Gleason grade indicate?
26.
Histological examination of a testicular tumor in a 24-year-old man shows mature cartilage, glandular epithelium and neural tissue. Which interpretation is most appropriate for this lesion in a post-pubertal male?
27.
A 67-year-old man with benign prostatic hyperplasia has troublesome hesitancy and weak urinary flow. Examination shows a smooth enlarged prostate without evidence of renal impairment. Which drug class most directly reduces the dynamic component of his obstruction?
28.
An experimental male contraceptive regimen combines an androgen with a progestin. Peripheral androgen effects are maintained, but sperm production falls markedly. Which physiological change best explains the contraceptive effect?
29.
A 58-year-old man develops a new right-sided varicocele that remains prominent when he lies down. Which underlying process should be considered because of this atypical presentation?
30.
A young boy has a persistent palpable testis in the inguinal canal that has failed to descend into the scrotum. Which management principle best reduces prolonged exposure of the testis to an abnormal environment and facilitates later examination?
31.
A woman with PCOS has infrequent ovulation and infertility. Which process is primarily responsible for her reduced fertility?
32.
A 28-year-old man is evaluated for infertility. Semen analysis shows no spermatozoa in the ejaculate. Which term best describes this finding?
33.
A man presents with a soft left-sided scrotal swelling that becomes more prominent while standing and feels like a bag of worms. Which diagnosis is most likely?
34.
A testicular tumor in a young man is associated with an elevated serum alpha-fetoprotein level. Which tumor is most strongly associated with this marker?
35.
A 25-year-old man has an undescended testis since childhood. Which long-term complication is particularly important?
36.
A 68-year-old man has hesitancy, weak urinary stream and nocturia. Enlargement of which prostatic region most commonly produces these symptoms in benign prostatic hyperplasia?
37.
A woman treated for endometriosis develops acne and increased facial hair. Which drug is the most likely cause?
38.
A man develops fever, dysuria and severe perineal discomfort. The prostate is tender on examination. Which inflammatory cell is expected to predominate in the prostate?
39.
Gossypol was investigated as a non-hormonal male contraceptive. Which effect is most relevant to its contraceptive action?
40.
A man with infertility has low testosterone with low serum LH and FSH levels. Which abnormality is the most likely cause?
41.
A 51-year-old man has recurrent urinary tract infections and intermittent pelvic discomfort for several months. Prostatic tissue shows lymphocytes, plasma cells and stromal fibrosis. Which diagnosis best fits these findings?
42.
Most conventional prostatic adenocarcinomas arise predominantly in which part of the gland?
43.
A man receiving testosterone therapy develops breast enlargement despite adequate androgen replacement. Which biochemical conversion most directly contributes to this adverse effect?
44.
A 55-year-old man develops a new painless hydrocele. Ultrasonography also demonstrates a solid intratesticular lesion on the same side. Which management principle is most appropriate?
45.
A 42-year-old woman presents with abnormal uterine bleeding. Which investigation is most useful as an initial imaging test to assess for uterine fibroids and ovarian pathology?
46.
A man with hypogonadotropic hypogonadism is being treated for infertility. Which drug can stimulate Leydig cells through an LH-like action?
47.
A painless cystic scrotal swelling transilluminates on examination. Which condition is the most likely diagnosis?
48.
A woman experiences sudden urinary urgency followed by involuntary leakage before she can reach the toilet. Which mechanism best explains this problem?
49.
A 22-year-old man has a painless solid mass within the testis. Which tumor belongs to the germ-cell tumor group?
50.
A 72-year-old man has a hard irregular prostate and persistent back pain. Imaging shows sclerotic vertebral lesions. Which diagnosis is most likely?
51.
MRI in a patient with prostate carcinoma shows extension of tumor beyond the prostate into adjacent local tissue. No regional lymph-node or distant metastases are detected. Which description best fits the disease extent?
52.
A patient with benign prostatic hyperplasia develops progressive bladder-outlet obstruction. Which complication may result from prolonged urinary obstruction?
53.
A testicular tumor contains both cytotrophoblasts and syncytiotrophoblasts and is associated with markedly increased β-hCG. Which tumor is most likely?
54.
A drug used for its antiandrogen action blocks androgen receptors and also has progestational activity that suppresses gonadotropin secretion. Which drug has these properties?
55.
A 32-year-old man is evaluated for infertility. Examination shows small testes. Serum testosterone is reduced, while LH and FSH are elevated. Which abnormality best explains this pattern?
56.
A well-circumscribed yellow-brown testicular tumor is composed of cells with abundant eosinophilic cytoplasm. Reinke crystals are identified microscopically, and no invasive features are present. Which diagnosis is most likely?
57.
A man using high doses of anabolic steroids develops reduced sperm production and testicular atrophy. Which mechanism best explains these effects?
58.
A woman with a uterine fibroid has marked heavy menstrual bleeding because the lesion projects toward and distorts the uterine cavity. Which type of fibroid is most likely?
59.
Clomiphene is prescribed to induce ovulation in a woman with anovulatory infertility. Which mechanism best explains its effect?
60.
A 25-year-old woman presents with irregular menstrual cycles, acne, hirsutism and difficulty conceiving. Which underlying disorder is most likely?
