Male reproductive system MCQs With Answer provides B.Pharm students a focused review of male reproductive anatomy, physiology, endocrinology and relevant pharmacology. This resource covers spermatogenesis, roles of Sertoli and Leydig cells, hormonal regulation by GnRH, LH and FSH, testosterone biosynthesis, prostate and accessory gland function, semen analysis parameters, common pathologies (BPH, prostatitis, varicocele), and drug classes like PDE5 inhibitors, 5α-reductase inhibitors and alpha-blockers. Emphasis on mechanism of action, adverse effects and drug interactions ensures clinical relevance for pharmacy practice. Clear, exam-oriented MCQs with explanations help reinforce concepts and improve retention. Now let’s test your knowledge with 50 MCQs on this topic.
Q1. Which cell type in the testis is primarily responsible for testosterone production?
- Sertoli cell
- Leydig cell
- Germ cell
- Peritubular myoid cell
Correct Answer: Leydig cell
Q2. Which hormone directly stimulates Leydig cells to synthesize testosterone?
- Prolactin
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Thyroid-stimulating hormone (TSH)
Correct Answer: Luteinizing hormone (LH)
Q3. What is the main function of Sertoli cells?
- Secrete testosterone into circulation
- Provide nourishment and support for developing sperm
- Produce seminal fluid components
- Contract to propel sperm through epididymis
Correct Answer: Provide nourishment and support for developing sperm
Q4. Spermatogenesis occurs primarily in which structure?
- Epididymis
- Vas deferens
- Seminiferous tubules
- Prostate gland
Correct Answer: Seminiferous tubules
Q5. Which barrier protects developing germ cells from immune attack?
- Blood–brain barrier
- Blood–testis barrier
- Placental barrier
- Hemato-epididymal barrier
Correct Answer: Blood–testis barrier
Q6. Which enzyme converts testosterone to dihydrotestosterone (DHT)?
- Aromatase
- 5α-reductase
- CYP11A1
- Steroid sulfatase
Correct Answer: 5α-reductase
Q7. Dihydrotestosterone (DHT) is most associated with which clinical condition?
- Testicular torsion
- Benign prostatic hyperplasia (BPH) and androgenic alopecia
- Varicocele
- Epididymitis
Correct Answer: Benign prostatic hyperplasia (BPH) and androgenic alopecia
Q8. Which drug class inhibits 5α-reductase and reduces prostate size?
- Alpha-1 blockers
- 5α-reductase inhibitors
- Phosphodiesterase-5 inhibitors
- Selective estrogen receptor modulators
Correct Answer: 5α-reductase inhibitors
Q9. Which medication is a 5α-reductase inhibitor commonly used for BPH?
- Tamsulosin
- Finasteride
- Sildenafil
- Terazosin
Correct Answer: Finasteride
Q10. Which mechanism mediates penile erection physiologically?
- Increased sympathetic tone causing smooth muscle contraction
- NO-mediated cGMP increase causing smooth muscle relaxation
- Direct androgen binding to corpus cavernosum receptors
- Decreased blood flow due to vasoconstriction
Correct Answer: NO-mediated cGMP increase causing smooth muscle relaxation
Q11. Which drug class potentiates the NO–cGMP pathway to treat erectile dysfunction?
- Alpha-1 blockers
- Phosphodiesterase-5 (PDE5) inhibitors
- 5α-reductase inhibitors
- Beta-blockers
Correct Answer: Phosphodiesterase-5 (PDE5) inhibitors
Q12. A contraindication to PDE5 inhibitors is concomitant use of which drug type?
- Nitrates
- ACE inhibitors
- Statins
- Proton pump inhibitors
Correct Answer: Nitrates
Q13. Which part of sperm contains the enzymes that help penetrate the ovum?
- Midpiece
- Tail (flagellum)
- Acrosome
- Principal piece
Correct Answer: Acrosome
Q14. Semen volume and fructose are primarily secreted by which organ?
- Prostate gland
- Seminal vesicles
- Bulbourethral glands
- Testes
Correct Answer: Seminal vesicles
Q15. Which gland contributes prostatic-specific antigen (PSA) to semen?
- Seminal vesicles
- Prostate gland
- Bulbourethral glands
- Epididymis
Correct Answer: Prostate gland
Q16. Normal sperm concentration in semen is typically above which threshold (WHO)?
- 1 million/mL
- 15 million/mL
- 50 million/mL
- 100 million/mL
Correct Answer: 15 million/mL
Q17. Oligospermia refers to which abnormal semen finding?
- Low sperm motility
- Low sperm concentration
- Absence of sperm
- High white blood cells in semen
Correct Answer: Low sperm concentration
Q18. Azoospermia means:
- Low semen volume
- Complete absence of sperm in ejaculate
- Decreased sperm motility
- High percentage of abnormal sperm
Correct Answer: Complete absence of sperm in ejaculate
Q19. Which condition is most commonly associated with infertility due to increased scrotal temperature?
- Hydrocele
- Varicocele
- Orchitis
- Testicular cancer
Correct Answer: Varicocele
Q20. Which infectious agent is a common cause of acute epididymo-orchitis in sexually active young men?
- Staphylococcus aureus
- Chlamydia trachomatis
- Mycobacterium tuberculosis
- Escherichia coli (only in neonates)
Correct Answer: Chlamydia trachomatis
Q21. Prostate-specific antigen (PSA) is useful clinically for:
- Diagnosing testicular torsion
- Screening and monitoring prostate disease including cancer
- Evaluating epididymal function
- Assessing sperm motility
Correct Answer: Screening and monitoring prostate disease including cancer
Q22. Which receptor mediates most intracellular effects of androgens?
- Estrogen receptor
- Androgen receptor (nuclear receptor)
- GABA receptor
- β-adrenergic receptor
Correct Answer: Androgen receptor (nuclear receptor)
Q23. Long-term testosterone therapy in males can cause which adverse effect on fertility?
- Increase in spermatogenesis
- Suppression of spermatogenesis and reduced sperm count
- Improved sperm motility
- Hyperplasia of seminiferous tubules
Correct Answer: Suppression of spermatogenesis and reduced sperm count
Q24. Which hormone is produced by the hypothalamus to initiate the HPG axis?
- Gonadotropin-releasing hormone (GnRH)
- Luteinizing hormone (LH)
- Testosterone
- Inhibin B
Correct Answer: Gonadotropin-releasing hormone (GnRH)
Q25. In males, FSH primarily acts on which cells to support spermatogenesis?
- Leydig cells
- Sertoli cells
- Germ cells directly
- Interstitial macrophages
Correct Answer: Sertoli cells
Q26. Which protein secreted by Sertoli cells provides negative feedback to inhibit FSH?
- Inhibin B
- Activin
- Prolactin
- Transferrin
Correct Answer: Inhibin B
Q27. Aromatase converts testosterone into which hormone?
- Dihydrotestosterone (DHT)
- Estradiol (estrogen)
- Cortisol
- Aldosterone
Correct Answer: Estradiol (estrogen)
Q28. Which drug is commonly used to relax prostate smooth muscle and improve urinary flow quickly in BPH?
- Finasteride
- Tamsulosin
- Metformin
- Sildenafil
Correct Answer: Tamsulosin
Q29. Alpha-1 blockers used for BPH act primarily by:
- Inhibiting DHT production
- Relaxing smooth muscle in the prostate and bladder neck
- Increasing testosterone synthesis
- Blocking PDE5 enzyme
Correct Answer: Relaxing smooth muscle in the prostate and bladder neck
Q30. Which laboratory value would increase with primary hypogonadism?
- Testosterone (high)
- Luteinizing hormone (LH) (high)
- FSH (low)
- GnRH (high)
Correct Answer: Luteinizing hormone (LH) (high)
Q31. Testicular torsion is best characterized by which clinical sign?
- Gradual onset scrotal pain relieved by elevation
- Acute severe testicular pain with absent cremasteric reflex
- Painless testicular swelling with fever
- Chronic intermittent scrotal ache improved by rest
Correct Answer: Acute severe testicular pain with absent cremasteric reflex
Q32. Which diagnostic test is first-line for evaluating varicocele?
- Scrotal ultrasound with Doppler
- PSA measurement
- Semen culture
- Testicular biopsy
Correct Answer: Scrotal ultrasound with Doppler
Q33. Which cell organelle is abundant in the sperm midpiece to support motility?
- Ribosomes
- Mitochondria
- Golgi apparatus
- Lysosomes
Correct Answer: Mitochondria
Q34. Which of the following medications can cause gynecomastia in males?
- Spironolactone
- Metformin
- Amoxicillin
- Levothyroxine
Correct Answer: Spironolactone
Q35. The vas deferens functions primarily to:
- Produce sperm
- Store testosterone
- Transport sperm from epididymis to ejaculatory ducts
- Secrete alkaline mucus into semen
Correct Answer: Transport sperm from epididymis to ejaculatory ducts
Q36. Which surgical procedure blocks sperm transport for male contraception?
- Vasectomy
- Circumcision
- Orchiectomy
- Prostatectomy
Correct Answer: Vasectomy
Q37. Bulbourethral (Cowper’s) glands primarily secrete:
- Fructose-rich fluid
- A pre-ejaculate alkaline mucus
- Prostatic fluid high in PSA
- Lipids for sperm membrane synthesis
Correct Answer: A pre-ejaculate alkaline mucus
Q38. Which tumor marker is most specific for seminomatous testicular cancer?
- AFP (alpha-fetoprotein)
- β-hCG (beta-human chorionic gonadotropin) and placental alkaline phosphatase
- PSA
- CA-125
Correct Answer: β-hCG (beta-human chorionic gonadotropin) and placental alkaline phosphatase
Q39. Anabolic steroid abuse commonly leads to which endocrine change?
- Increased LH and FSH
- Suppression of LH and FSH, causing testicular atrophy
- Increased GnRH secretion
- Permanent increase in sperm count
Correct Answer: Suppression of LH and FSH, causing testicular atrophy
Q40. Which substance in semen helps neutralize acidic vaginal secretions?
- Fructose
- Alkaline prostatic secretions
- Testosterone
- Inhibin B
Correct Answer: Alkaline prostatic secretions
Q41. Which imaging modality is preferred to evaluate prostate size and guide biopsy?
- Transrectal ultrasound (TRUS)
- Abdominal X-ray
- Scrotal MRI
- Chest CT
Correct Answer: Transrectal ultrasound (TRUS)
Q42. Which drug is used to pharmacologically reduce androgen action by blocking androgen receptors?
- Spironolactone
- Flutamide
- Finasteride
- Leuprolide
Correct Answer: Flutamide
Q43. GnRH agonists used in prostate cancer initially cause which effect before suppression?
- Immediate suppression of LH/FSH
- Initial surge (flare) of LH/FSH and testosterone
- No change in hormone levels
- Permanent decrease in GnRH production
Correct Answer: Initial surge (flare) of LH/FSH and testosterone
Q44. Which physiological change occurs during the ejaculatory phase?
- Storage of sperm in epididymis
- Rhythmic contractions propelling semen through urethra
- Relaxation of pelvic floor muscles
- Decreased sympathetic outflow
Correct Answer: Rhythmic contractions propelling semen through urethra
Q45. Testicular descent into the scrotum is primarily mediated by which structure in fetal development?
- Sertoli cells
- Gubernaculum
- Prostate gland
- Seminal vesicles
Correct Answer: Gubernaculum
Q46. Which lab finding suggests primary testicular failure rather than hypothalamic-pituitary dysfunction?
- Low LH and low testosterone
- High LH with low testosterone
- High GnRH with high testosterone
- Low FSH with high testosterone
Correct Answer: High LH with low testosterone
Q47. Which antibiotic is commonly used to treat bacterial prostatitis with good prostatic penetration?
- Aminoglycosides
- Fluoroquinolones (e.g., ciprofloxacin)
- Penicillin V
- First-generation cephalosporins only
Correct Answer: Fluoroquinolones (e.g., ciprofloxacin)
Q48. A high proportion of morphologically abnormal sperm in semen analysis is termed:
- Asthenozoospermia
- Teratozoospermia
- Leukocytospermia
- Necrozoospermia
Correct Answer: Teratozoospermia
Q49. Which laboratory assay is most specific for evaluating Leydig cell function?
- Serum estradiol
- Serum testosterone level
- Serum PSA
- Serum prolactin only
Correct Answer: Serum testosterone level
Q50. Which preventive measure reduces risk of testicular cancer and is recommended in newborn males with undescended testes?
- Immediate testosterone therapy
- Orchidopexy (surgical descent) in early childhood
- Routine vasectomy
- Prostatectomy
Correct Answer: Orchidopexy (surgical descent) in early childhood
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