Nandrolone MCQs With Answer

Introduction: Nandrolone MCQs With Answer provides B. Pharm students a focused, keyword-rich review of nandrolone pharmacology, clinical uses, metabolism, adverse effects and forensic detection. This concise set emphasizes nandrolone decanoate, 19‑nortestosterone chemistry, mechanism of action at the androgen receptor, reduced aromatization and 5α‑reduction to dihydronandrolone, pharmacokinetics of esterified formulations, therapeutic indications, risks such as virilization, erythrocytosis and lipid changes, and anti‑doping/analytical considerations (urinary 19‑nor metabolites). Questions are designed to deepen understanding for exams and practical dispensing or counselling. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which structural feature distinguishes nandrolone from testosterone?

• Absence of the 19‑methyl group (19‑nortestosterone)
• Presence of a 17α‑alkyl group
• Additional hydroxyl at C6
• Saturated A‑ring

Correct Answer: Absence of the 19‑methyl group (19‑nortestosterone)

Q2. What is the primary mechanism of action of nandrolone?

• Inhibition of aromatase enzyme
• Agonism at androgen receptors modulating gene transcription
• Antagonism at glucocorticoid receptors
• Stimulating insulin release from pancreatic β‑cells

Correct Answer: Agonism at androgen receptors modulating gene transcription

Q3. Nandrolone decanoate is commonly administered by which route?

• Oral tablets daily
• Intramuscular deep depot injection
• Topical gel application
• Subcutaneous implant

Correct Answer: Intramuscular deep depot injection

Q4. Compared with testosterone, nandrolone generally has which pharmacological profile?

• Higher androgenic and lower anabolic activity
• Higher anabolic and lower androgenic activity
• Equal anabolic and androgenic activity
• No anabolic effects, only androgenic

Correct Answer: Higher anabolic and lower androgenic activity

Q5. Which enzyme converts nandrolone into dihydronandrolone (DHN)?

• Aromatase
• 5α‑reductase
• 17β‑hydroxysteroid dehydrogenase
• CYP3A4

Correct Answer: 5α‑reductase

Q6. How does 5α‑reduction of nandrolone affect its androgenicity?

• Converts it into a more potent androgen
• Produces a less androgenic metabolite than parent drug
• Has no effect on androgenicity
• Makes it a stronger estrogenic compound

Correct Answer: Produces a less androgenic metabolite than parent drug

Q7. Nandrolone is classified chemically as:

• A 17α‑alkylated androgen
• A 19‑nortestosterone derivative
• A corticosteroid analogue
• An estrogen receptor agonist

Correct Answer: A 19‑nortestosterone derivative

Q8. Which therapeutic indication has historically used nandrolone formulations?

• Management of acute bacterial infections
• Osteoporosis and certain anemias
• Type 1 diabetes mellitus
• Epilepsy control

Correct Answer: Osteoporosis and certain anemias

Q9. Why is nandrolone less hepatotoxic than some other anabolic steroids?

• It is not metabolized by the liver
• It lacks 17α‑alkylation that causes cholestatic liver injury
• It is rapidly excreted unchanged in urine
• It increases hepatic glutathione synthesis

Correct Answer: It lacks 17α‑alkylation that causes cholestatic liver injury

Q10. Which urinary metabolites are commonly monitored for nandrolone detection in doping tests?

• Testosterone glucuronide and estrone
• 19‑norandrosterone and 19‑noretiocholanolone
• Androsterone and etiocholanolone only
• Cortisol and cortisone metabolites

Correct Answer: 19‑norandrosterone and 19‑noretiocholanolone

Q11. The decanoate ester of nandrolone primarily affects which pharmacokinetic parameter?

• Oral bioavailability
• Volume of distribution
• Duration of action / elimination half‑life
• Protein binding in plasma

Correct Answer: Duration of action / elimination half‑life

Q12. Which adverse effect is a notable haematologic consequence of nandrolone therapy?

• Thrombocytopenia
• Iron deficiency anemia
• Erythrocytosis (increased RBC mass)
• Neutropenia

Correct Answer: Erythrocytosis (increased RBC mass)

Q13. In female patients, a common androgenic side effect of nandrolone is:

• Hyperpigmentation of palms
• Virilization (hirsutism, voice deepening)
• Alopecia areata
• Galactorrhea

Correct Answer: Virilization (hirsutism, voice deepening)

Q14. Nandrolone’s propensity for aromatization to estrogens is:

• Greater than testosterone
• Absent; it cannot aromatize
• Lower than testosterone, leading to less estrogenic side effects
• Equivalent to estradiol conversion

Correct Answer: Lower than testosterone, leading to less estrogenic side effects

Q15. Use of nandrolone is contraindicated in which condition?

• Benign prostatic hyperplasia with PSA elevation
• Vitamin D deficiency
• Mild osteoarthritis
• Iron deficiency anemia responsive to oral iron

Correct Answer: Benign prostatic hyperplasia with PSA elevation

Q16. Which laboratory change is typical with anabolic steroid misuse including nandrolone?

• Increase in HDL cholesterol and decrease in LDL
• Decrease in HDL cholesterol and increase in LDL cholesterol
• Reduction of serum creatinine to very low levels
• Marked increase in thyroid stimulating hormone (TSH)

Correct Answer: Decrease in HDL cholesterol and increase in LDL cholesterol

Q17. Nandrolone’s effect on bone is mainly due to:

• Direct aromatization to estradiol in bone tissue only
• Promotion of osteoblastic activity and bone formation
• Calcium chelation and excretion
• Inhibition of vitamin D activation

Correct Answer: Promotion of osteoblastic activity and bone formation

Q18. Which statement about nandrolone metabolism is correct?

• It is primarily eliminated unchanged via bile
• It undergoes hepatic metabolism to polar conjugates excreted in urine
• It is converted into active glucocorticoids by 11β‑HSD
• It is exclusively metabolized by renal tubular enzymes

Correct Answer: It undergoes hepatic metabolism to polar conjugates excreted in urine

Q19. When counselling a patient prescribed nandrolone decanoate, which advice is most appropriate?

• Expect immediate oral effects within hours
• Monitor hematocrit and lipid profile during therapy
• There is no need for contraception in women
• It can be stopped abruptly without monitoring

Correct Answer: Monitor hematocrit and lipid profile during therapy

Q20. Which drug interaction concern is relevant with nandrolone?

• Potentiation of anticoagulant effect of warfarin
• Antagonism of insulin causing hypoglycemia
• Decreased plasma levels of lithium
• Inhibition of acetaminophen metabolism causing toxicity

Correct Answer: Potentiation of anticoagulant effect of warfarin

Q21. In anti‑doping analysis, a positive nandrolone result is usually indicated by elevated levels of:

• Testosterone/epitestosterone ratio only
• 19‑norandrosterone in urine
• Serum estradiol concentration
• Plasma SHBG levels

Correct Answer: 19‑norandrosterone in urine

Q22. Compared to orally active 17α‑alkylated anabolic steroids, injectable nandrolone decanoate is associated with:

• Greater hepatotoxic risk
• Lower risk of cholestatic liver injury
• Higher oral bioavailability
• Faster onset of action after oral dosing

Correct Answer: Lower risk of cholestatic liver injury

Q23. The anabolic effects of nandrolone include:

• Reduction of nitrogen retention in muscle
• Enhanced protein synthesis and muscle mass gain
• Inhibition of IGF‑1 production in muscle
• Complete suppression of skeletal growth

Correct Answer: Enhanced protein synthesis and muscle mass gain

Q24. Which population should absolutely avoid exposure to nandrolone due to teratogenic/virilizing risk?

• Postmenopausal women
• Pregnant women
• Elderly men with osteoporosis
• Adolescent males past puberty

Correct Answer: Pregnant women

Q25. Long‑term anabolic steroid abuse can impair fertility primarily by:

• Directly damaging Leydig cell mitochondria only
• Suppressing hypothalamic‑pituitary‑gonadal axis and reducing spermatogenesis
• Increasing FSH and LH secretion permanently
• Enhancing testicular testosterone production excessively

Correct Answer: Suppressing hypothalamic‑pituitary‑gonadal axis and reducing spermatogenesis

Q26. Which monitoring parameter is most important for early detection of erythrocytosis during nandrolone therapy?

• Serum potassium
• Complete blood count (hematocrit/hemoglobin)
• 21‑hydroxylase antibody titers
• Serum amylase

Correct Answer: Complete blood count (hematocrit/hemoglobin)

Q27. In forensic interpretation, distinguishing endogenous from exogenous nandrolone can be challenging because:

• Nandrolone is not metabolized and lacks urinary markers
• Low levels of 19‑nor metabolites can occur endogenously or from contamination
• There are no analytical methods sensitive enough to detect it
• It completely degrades before excretion

Correct Answer: Low levels of 19‑nor metabolites can occur endogenously or from contamination

Q28. A pharmacology student states that nandrolone increases erythropoiesis. Which mechanism best explains this effect?

• Direct stimulation of renal erythropoietin gene expression
• Androgen receptor‑mediated enhancement of erythropoietic pathways and EPO sensitivity
• Blocking iron absorption to stimulate compensatory production
• Inhibition of bone marrow stem cell proliferation

Correct Answer: Androgen receptor‑mediated enhancement of erythropoietic pathways and EPO sensitivity

Q29. Which statement about nandrolone pharmacodynamics is true?

• It acts primarily through G‑protein coupled receptors on muscle cells
• It modulates transcription of target genes after binding intracellular androgen receptors
• It exerts effects solely by conversion to estradiol
• Its actions are independent of nuclear receptor mechanisms

Correct Answer: It modulates transcription of target genes after binding intracellular androgen receptors

Q30. Which regulatory/legal status best describes medically used nandrolone in many countries?

• Available over the counter without restriction
• Controlled substance requiring prescription and subject to anti‑doping regulations
• Completely banned for all clinical use worldwide
• Classified as a food supplement

Correct Answer: Controlled substance requiring prescription and subject to anti‑doping regulations

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

Mail- Sachin@pharmacyfreak.com