Anabolic steroids MCQs With Answer provide B. Pharm students with focused, clinically relevant practice on androgenic‑anabolic steroids, covering mechanism of action, pharmacokinetics, metabolism, therapeutic uses, adverse effects, monitoring, and legal/doping issues. These questions emphasize concepts such as androgen receptor signaling, 17α‑alkylation and hepatotoxicity, aromatization to estrogens, effects on lipid profile and haematopoiesis, and strategies for management of complications. This concise, keyword‑rich set reinforces drug classification, examples (testosterone esters, oxandrolone, stanozolol), laboratory monitoring (ALT/AST, hematocrit, semen analysis), and prevention of misuse. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary molecular mechanism by which anabolic steroids exert their effects?
- Activation of intracellular androgen receptors leading to gene transcription
- Direct stimulation of muscle cell membranes without receptor binding
- Inhibition of aromatase enzyme to reduce estrogen levels
- Blockade of glucocorticoid receptors to reduce catabolism
Correct Answer: Activation of intracellular androgen receptors leading to gene transcription
Q2. Why are many oral anabolic steroids modified by 17α‑alkylation?
- To increase oral bioavailability by resisting hepatic first‑pass metabolism
- To enhance conversion to dihydrotestosterone (DHT)
- To prevent aromatization to estrogens
- To target delivery to skeletal muscle tissue
Correct Answer: To increase oral bioavailability by resisting hepatic first‑pass metabolism
Q3. Which of the following is the most characteristic hepatic adverse effect associated with 17α‑alkylated oral anabolic steroids?
- Hepatotoxicity including cholestasis and elevated transaminases
- Acute pancreatitis
- Nephrotic syndrome
- Autoimmune hepatitis mediated by antibodies
Correct Answer: Hepatotoxicity including cholestasis and elevated transaminases
Q4. Which preparation represents a long‑acting injectable testosterone ester commonly used therapeutically?
- Testosterone enanthate
- Stanozolol
- Oxandrolone
- Finasteride
Correct Answer: Testosterone enanthate
Q5. Aromatization of testosterone to estradiol can lead to which clinical adverse effect in males?
- Gynecomastia
- Hypokalemia
- Hyperglycemia
- Renal stones
Correct Answer: Gynecomastia
Q6. Which cellular process best describes the anabolic action of androgenic‑anabolic steroids?
- Increased muscle protein synthesis and positive nitrogen balance
- Enhanced glycogenolysis in muscle cells
- Inhibition of mitochondrial ATP production
- Activation of adipocyte lipogenesis exclusively
Correct Answer: Increased muscle protein synthesis and positive nitrogen balance
Q7. Which drug is used to reduce DHT‑mediated androgenic side effects by inhibiting 5α‑reductase?
- Finasteride
- Tamoxifen
- Anastrozole
- Spironolactone
Correct Answer: Finasteride
Q8. A common hematologic laboratory change caused by anabolic steroid abuse is:
- Rise in hematocrit due to stimulated erythropoiesis
- Marked thrombocytopenia
- Severe neutropenia
- Hemolytic anemia with schistocytes
Correct Answer: Rise in hematocrit due to stimulated erythropoiesis
Q9. Chronic supraphysiologic anabolic steroid use suppresses which axis leading to testicular atrophy?
- Hypothalamic‑pituitary‑gonadal (HPG) axis with decreased LH and FSH
- Renin‑angiotensin‑aldosterone system causing aldosterone deficiency
- Hypothalamic‑pituitary‑adrenal (HPA) axis with decreased ACTH
- Sodium‑potassium pump regulation in Leydig cells
Correct Answer: Hypothalamic‑pituitary‑gonadal (HPG) axis with decreased LH and FSH
Q10. Which anabolic steroid is classically considered non‑aromatizable, reducing estrogen‑related side effects?
- Stanozolol
- Nandrolone
- Testosterone
- Estradiol
Correct Answer: Stanozolol
Q11. Which laboratory tests are most useful to monitor hepatic injury from anabolic steroids?
- Serum ALT and AST
- Serum creatinine and BUN
- Thyroid stimulating hormone and free T4
- Serum troponin I and CK‑MB
Correct Answer: Serum ALT and AST
Q12. Which synthetic anabolic steroid is known for relatively strong anabolic and low androgenic activity, often used therapeutically?
- Oxandrolone
- Flutamide
- Estrone
- Propranolol
Correct Answer: Oxandrolone
Q13. In the United States, many anabolic steroids are classified as which controlled substance schedule?
- Schedule III
- Schedule I
- Schedule V
- Over‑the‑counter product
Correct Answer: Schedule III
Q14. What is a primary legitimate therapeutic indication for testosterone replacement therapy?
- Male hypogonadism with documented low testosterone
- First‑line therapy for prostate cancer
- Treatment of granulocytopenia
- Primary management of hypertension
Correct Answer: Male hypogonadism with documented low testosterone
Q15. Chronic anabolic steroid use commonly causes which change in lipid profile?
- Decreased HDL and increased LDL cholesterol
- Markedly increased HDL with decreased LDL
- No change in lipid profile
- Decreased total cholesterol with increased triglycerides only
Correct Answer: Decreased HDL and increased LDL cholesterol
Q16. Virilization in women using anabolic steroids is primarily due to:
- Androgen receptor activation leading to masculinizing effects
- Excess estrogen production by aromatase
- Direct thyroid hormone stimulation
- Inhibition of cortisol synthesis in the adrenal cortex
Correct Answer: Androgen receptor activation leading to masculinizing effects
Q17. Which agent is commonly employed to treat anabolic steroid‑induced gynecomastia by blocking estrogen receptors?
- Tamoxifen
- Spironolactone
- Finasteride
- Metformin
Correct Answer: Tamoxifen
Q18. Which hepatic syndrome is particularly associated with high‑dose oral 17α‑alkylated anabolic steroids?
- Cholestatic jaundice
- Autoimmune hepatitis
- Primary sclerosing cholangitis
- Fulminant viral hepatitis
Correct Answer: Cholestatic jaundice
Q19. To assess fertility effects in a male patient on long‑term anabolic steroids, which test is most informative?
- Semen analysis
- Fasting blood glucose
- Thyroid function tests
- Serum potassium concentration
Correct Answer: Semen analysis
Q20. Which biological sample is most commonly analyzed for detection of anabolic steroid abuse in sports doping tests?
- Urine
- Hair
- Saliva
- Tears
Correct Answer: Urine
Q21. Nandrolone is distinct from testosterone because it often exhibits which pharmacologic property?
- Higher anabolic:androgenic ratio with notable progestogenic activity
- Complete resistance to hepatic metabolism
- Potent aromatase inhibition
- Selective estrogen receptor modulation
Correct Answer: Higher anabolic:androgenic ratio with notable progestogenic activity
Q22. Where are androgen receptors located and how do they function after ligand binding?
- Located in the cytosol, then translocate to the nucleus to modulate transcription
- Embedded in the cell membrane and activate G‑protein signaling only
- Located exclusively in mitochondria to alter ATP synthesis
- Present in extracellular matrix to bind circulating steroids
Correct Answer: Located in the cytosol, then translocate to the nucleus to modulate transcription
Q23. Which enzyme converts testosterone to the more potent androgen dihydrotestosterone (DHT)?
- 5α‑reductase
- Aromatase
- CYP3A4
- Monoamine oxidase
Correct Answer: 5α‑reductase
Q24. In catabolic states such as severe burns, anabolic steroids can be used clinically to:
- Promote anabolism and improve nitrogen balance
- Suppress wound healing to reduce scarring
- Increase gluconeogenesis to raise blood glucose permanently
- Act as first‑line antimicrobial therapy
Correct Answer: Promote anabolism and improve nitrogen balance
Q25. A potentially serious cardiovascular risk associated with anabolic steroid–induced polycythemia is:
- Thromboembolic events due to increased blood viscosity
- Bradyarrhythmias from vagal overactivity
- Hypotension from vasodilation
- Acute bacterial endocarditis
Correct Answer: Thromboembolic events due to increased blood viscosity
Q26. How do aromatase inhibitors help manage estrogenic effects of anabolic steroid therapy?
- They block aromatase, reducing conversion of androgens to estrogens
- They increase hepatic clearance of estrogens by glucuronidation
- They act as estrogen receptor agonists to counterbalance androgens
- They stimulate LH secretion to restore endogenous testosterone
Correct Answer: They block aromatase, reducing conversion of androgens to estrogens
Q27. Which withdrawal symptom may occur after stopping long‑term supraphysiologic anabolic steroid use?
- Depression and decreased libido due to hypogonadism
- Acute mania with increased activity
- Polydipsia and polyuria from diabetes insipidus
- Immediate normalization of spermatogenesis
Correct Answer: Depression and decreased libido due to hypogonadism
Q28. Which of the following is an example of a selective androgen receptor modulator (SARM) under investigation for anabolic effects with fewer androgenic side effects?
- Ostarine (enobosarm)
- Testosterone enanthate
- Stanozolol
- Nandrolone decanoate
Correct Answer: Ostarine (enobosarm)
Q29. Combining anabolic steroids with erythropoiesis‑stimulating agents (ESAs) increases the risk of:
- Thrombosis due to excessive rise in hematocrit
- Hypocoagulability and bleeding
- Severe hypokalemia requiring urgent replacement
- Acute renal tubular necrosis within hours
Correct Answer: Thrombosis due to excessive rise in hematocrit
Q30. Which clinical laboratory parameter best reflects liver synthetic function to monitor serious hepatic compromise from anabolic steroids?
- Prothrombin time/international normalized ratio (PT/INR)
- Serum creatine kinase (CK)
- Serum triglycerides
- Urine specific gravity
Correct Answer: Prothrombin time/international normalized ratio (PT/INR)
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