Estrogens MCQs With Answer

Estrogens MCQs With Answer

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Estrogens MCQs With Answer provides B. Pharm students a focused, practical review of estrogen pharmacology, physiology, metabolism and clinical applications. This concise guide covers estradiol, estrone, estriol, synthetic estrogens (ethinylestradiol, conjugated estrogens), estrogen receptors (ERα, ERβ, GPER), pharmacokinetics, hepatic metabolism, drug interactions, SERMs, SERDs and aromatase inhibitors. Emphasis is on mechanism of action, therapeutic uses (HRT, contraception, breast cancer), adverse effects (thrombosis, endometrial hyperplasia), and laboratory monitoring. Designed for exam preparation and clinical relevance, these targeted MCQs reinforce critical concepts, drug selection and safety issues essential for B. Pharm practice. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which is the predominant estrogen in premenopausal women?

  • Estradiol
  • Estrone
  • Estriol
  • Estetrol

Correct Answer: Estradiol

Q2. Which are the classical nuclear estrogen receptor subtypes?

  • ERα and ERβ
  • ERγ and ERδ
  • GPCR-A and GPCR-B
  • Androgen receptor and progesterone receptor

Correct Answer: ERα and ERβ

Q3. What is the primary ovarian cell type responsible for estrogen synthesis in the follicular phase?

  • Granulosa cells
  • Theca interna cells
  • Cumulus oophorus
  • Interstitial Leydig cells

Correct Answer: Granulosa cells

Q4. Which metabolic reactions are most important in hepatic estrogen metabolism?

  • Hydroxylation followed by conjugation (glucuronidation/sulfation)
  • Deamination and decarboxylation
  • Direct renal excretion without modification
  • Methylation only

Correct Answer: Hydroxylation followed by conjugation (glucuronidation/sulfation)

Q5. Estrogen effects on target cells are mediated by which mechanisms?

  • Genomic (nuclear receptor) actions only
  • Non-genomic (membrane receptor) actions only
  • Both genomic and non-genomic actions
  • Neither genomic nor non-genomic actions

Correct Answer: Both genomic and non-genomic actions

Q6. Unopposed estrogen therapy (without progestin) increases the risk of which condition?

  • Endometrial carcinoma
  • Osteoporosis
  • Type 1 diabetes
  • Parkinson’s disease

Correct Answer: Endometrial carcinoma

Q7. Which estrogen is most commonly used in combined oral contraceptives?

  • Ethinylestradiol
  • Estriol
  • Conjugated equine estrogens (Premarin)
  • Estetrol

Correct Answer: Ethinylestradiol

Q8. Which SERM acts as an estrogen antagonist in breast and agonist in bone, with minimal uterine agonism?

  • Tamoxifen
  • Raloxifene
  • Fulvestrant
  • Clomiphene

Correct Answer: Raloxifene

Q9. Which drug is a selective estrogen receptor degrader (SERD) used in ER-positive metastatic breast cancer?

  • Tamoxifen
  • Fulvestrant
  • Raloxifene
  • Letrozole

Correct Answer: Fulvestrant

Q10. Which of the following is an aromatase inhibitor commonly used in postmenopausal breast cancer?

  • Anastrozole
  • Medroxyprogesterone
  • Ethinylestradiol
  • Clomiphene

Correct Answer: Anastrozole

Q11. Estrogen therapy has what overall effect on coagulation?

  • Increases synthesis of clotting factors and thrombosis risk
  • Decreases clotting factor synthesis and bleeding risk
  • No significant effect on coagulation
  • Causes disseminated intravascular coagulation (DIC) in all patients

Correct Answer: Increases synthesis of clotting factors and thrombosis risk

Q12. Which of the following is an absolute contraindication to estrogen therapy?

  • History of deep vein thrombosis or pulmonary embolism
  • Controlled hypothyroidism
  • Mild hyperlipidemia
  • Seasonal allergic rhinitis

Correct Answer: History of deep vein thrombosis or pulmonary embolism

Q13. Which estrogen predominates in pregnancy and is used as a marker of fetoplacental function?

  • Estriol
  • Estradiol
  • Estrone
  • Ethinylestradiol

Correct Answer: Estriol

Q14. Estrogen therapy increases hepatic production of which binding protein commonly measured in endocrinology?

  • Sex hormone-binding globulin (SHBG)
  • Thyroxine-binding globulin (TBG)
  • C-reactive protein (CRP)
  • Transferrin

Correct Answer: Sex hormone-binding globulin (SHBG)

Q15. Which marketed product is an example of conjugated estrogens derived from equine sources?

  • Premarin
  • Estrace (estradiol)
  • Vivelle (transdermal estradiol)
  • Ethinyl estradiol tablets

Correct Answer: Premarin

Q16. Which agent is classified as a selective estrogen receptor degrader (SERD) rather than a SERM?

  • Tamoxifen
  • Fulvestrant
  • Raloxifene
  • Clomiphene

Correct Answer: Fulvestrant

Q17. Clomiphene citrate induces ovulation by which primary mechanism?

  • Antagonizing estrogen receptors in the hypothalamus to increase GnRH/LH/FSH release
  • Directly stimulating ovarian follicle growth independent of gonadotropins
  • Inhibiting aromatase in granulosa cells
  • Blocking progesterone receptors in the pituitary

Correct Answer: Antagonizing estrogen receptors in the hypothalamus to increase GnRH/LH/FSH release

Q18. What is the primary effect of estrogens on bone?

  • Decrease bone resorption and help maintain bone mineral density
  • Increase bone resorption leading to osteoporosis
  • No effect on bone remodeling
  • Convert trabecular bone to cortical bone exclusively

Correct Answer: Decrease bone resorption and help maintain bone mineral density

Q19. Oral estrogens exhibit reduced bioavailability primarily due to what pharmacokinetic phenomenon?

  • First-pass hepatic metabolism
  • Poor intestinal absorption due to polarity
  • Immediate renal clearance
  • Extensive distribution into adipose tissue only

Correct Answer: First-pass hepatic metabolism

Q20. Long-term estrogen therapy is associated with an increased risk of which biliary condition?

  • Gallstones (cholelithiasis)
  • Acute pancreatitis only
  • Primary sclerosing cholangitis
  • Hepatorenal syndrome

Correct Answer: Gallstones (cholelithiasis)

Q21. Administration of estrogen therapy has what effect on serum FSH levels via feedback mechanisms?

  • Decrease FSH secretion
  • Increase FSH secretion
  • No change in FSH secretion
  • Causes erratic fluctuations with no predictable trend

Correct Answer: Decrease FSH secretion

Q22. Estetrol (E4), a natural estrogen, is produced primarily by which fetal tissue?

  • Fetal liver
  • Placenta
  • Ovary
  • Adrenal cortex

Correct Answer: Fetal liver

Q23. Concomitant use of which drug class is most likely to reduce oral estrogen levels by inducing hepatic metabolism?

  • Rifampicin and other hepatic enzyme inducers
  • ACE inhibitors
  • Proton pump inhibitors
  • Beta blockers

Correct Answer: Rifampicin and other hepatic enzyme inducers

Q24. Why is a progestin added to estrogen therapy in women with an intact uterus?

  • To prevent endometrial hyperplasia and carcinoma
  • To increase estrogen potency systemically
  • To enhance estrogen absorption from the gut
  • To induce amenorrhea permanently

Correct Answer: To prevent endometrial hyperplasia and carcinoma

Q25. Which estrogen receptor isoform is predominantly expressed in the uterus and liver?

  • ERα
  • ERβ
  • GPER only
  • Progesterone receptor

Correct Answer: ERα

Q26. The interconversion of estradiol and estrone is catalyzed primarily by which enzyme?

  • 17β-hydroxysteroid dehydrogenase (17β-HSD)
  • Aromatase
  • CYP3A4
  • Sulfotransferase

Correct Answer: 17β-hydroxysteroid dehydrogenase (17β-HSD)

Q27. Which modification increases oral estrogen potency and stability, as seen in many contraceptive estrogens?

  • Ethinyl substitution at C17 (as in ethinylestradiol)
  • Removal of the aromatic A-ring
  • Sulfation at C3 only
  • Conversion to ester prodrugs exclusively

Correct Answer: Ethinyl substitution at C17 (as in ethinylestradiol)

Q28. Estrogen therapy can alter anticoagulant therapy; it most commonly has what effect on warfarin anticoagulation?

  • Reduce warfarin anticoagulant effect by enhancing clotting tendency and metabolic interactions
  • Potentiate warfarin leading to severe bleeding in all patients
  • No interaction with warfarin
  • Convert warfarin to an inactive metabolite directly

Correct Answer: Reduce warfarin anticoagulant effect by enhancing clotting tendency and metabolic interactions

Q29. Which clinical condition is considered a significant contraindication to estrogen-containing oral contraceptives due to vascular risk?

  • Migraine with aura
  • Mild acne
  • History of appendectomy
  • Seasonal allergic rhinitis

Correct Answer: Migraine with aura

Q30. Which statement best summarizes the risk–benefit profile of menopausal estrogen therapy?

  • Provides relief of vasomotor symptoms and prevents bone loss but increases risks of thromboembolism and hormone-dependent cancers if unopposed
  • Has no therapeutic benefit and only causes harm
  • Prevents all chronic diseases and has no adverse effects
  • Is only useful for contraception and has no role in menopause

Correct Answer: Provides relief of vasomotor symptoms and prevents bone loss but increases risks of thromboembolism and hormone-dependent cancers if unopposed

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