Androgens, with testosterone as the principal hormone, are critical regulators of male development and physiological function. Their pharmacology and medicinal chemistry, topics covered in the Patient Care 5 and foundational science curricula, are essential for understanding both replacement therapies for deficiency and anti-androgen therapies used in conditions like benign prostatic hyperplasia and prostate cancer. This quiz will test your knowledge on the structure, function,and pharmacotherapy of this vital class of steroid hormones.
1. The principal and most abundant circulating androgen in males is:
- a. Dihydrotestosterone (DHT)
- b. Androstenedione
- c. Dehydroepiandrosterone (DHEA)
- d. Testosterone
Answer: d. Testosterone
2. Testosterone is synthesized primarily in which cells within the testes?
- a. Sertoli cells
- b. Germ cells
- c. Leydig cells
- d. Epithelial cells
Answer: c. Leydig cells
3. Testosterone is converted to the more potent androgen, dihydrotestosterone (DHT), by which enzyme?
- a. Aromatase
- b. 5-alpha reductase
- c. CYP3A4
- d. 11-beta hydroxylase
Answer: b. 5-alpha reductase
4. Finasteride and dutasteride exert their therapeutic effect in benign prostatic hyperplasia (BPH) by:
- a. Blocking the androgen receptor directly.
- b. Inhibiting the 5-alpha reductase enzyme.
- c. Increasing the clearance of testosterone.
- d. Acting as a selective alpha-1 blocker.
Answer: b. Inhibiting the 5-alpha reductase enzyme.
5. Androgens belong to which chemical class of hormones?
- a. Peptides
- b. Glycoproteins
- c. Catecholamines
- d. Steroids
Answer: d. Steroids
6. The “Management of Testosterone Deficiency” is a specific lecture in which course?
- a. PHA5787C Patient Care 5
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5787C Patient Care 5
7. A key counseling point for a patient using a topical testosterone gel is to:
- a. Apply it to the scrotum for best effect.
- b. Cover the application site with clothing to prevent transference to women or children.
- c. Apply it twice daily.
- d. Expect immediate results within one day.
Answer: b. Cover the application site with clothing to prevent transference to women or children.
8. What is the primary mechanism of action of androgens?
- a. They bind to cell surface receptors to activate a G-protein cascade.
- b. They bind to intracellular androgen receptors, which then act as transcription factors to regulate gene expression.
- c. They block calcium channels.
- d. They inhibit the sodium-potassium pump.
Answer: b. They bind to intracellular androgen receptors, which then act as transcription factors to regulate gene expression.
9. A potential adverse effect of testosterone replacement therapy (TRT) that requires monitoring of the CBC is:
- a. Anemia
- b. Leukopenia
- c. Polycythemia
- d. Thrombocytopenia
Answer: c. Polycythemia
10. Which of the following is an absolute contraindication to initiating testosterone replacement therapy?
- a. Type 2 diabetes
- b. A history of prostate cancer
- c. Benign prostatic hyperplasia
- d. Age over 65
Answer: b. A history of prostate cancer
11. The management of men’s health disorders is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
12. The purpose of creating testosterone esters (e.g., cypionate, enanthate) for administration is to:
- a. Increase the potency of the hormone.
- b. Decrease the side effects.
- c. Create a more lipophilic prodrug that is slowly released from an oily vehicle after IM injection.
- d. Allow for oral administration.
Answer: c. Create a more lipophilic prodrug that is slowly released from an oily vehicle after IM injection.
13. A patient on TRT should have which lab parameter monitored to assess for potential effects on the prostate?
- a. Serum testosterone
- b. Hematocrit
- c. Prostate-Specific Antigen (PSA)
- d. Alanine aminotransferase (ALT)
Answer: c. Prostate-Specific Antigen (PSA)
14. Anabolic-androgenic steroids (AAS) are abused by athletes to:
- a. Improve cardiovascular endurance.
- b. Increase muscle mass and strength.
- c. Enhance mental focus.
- d. Decrease appetite.
Answer: b. Increase muscle mass and strength.
15. Counseling patients on the appropriate use of medications and devices is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
16. Which of the following is a primary physiological effect of androgens?
- a. Stimulation of erythropoiesis.
- b. Development and maintenance of male secondary sexual characteristics.
- c. Regulation of libido.
- d. All of the above.
Answer: d. All of the above.
17. The “Introduction to Urological Disorders” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
18. Bicalutamide is an anti-androgen used for prostate cancer that works by:
- a. Inhibiting 5-alpha reductase.
- b. Inhibiting GnRH release.
- c. Competitively blocking the androgen receptor.
- d. Inhibiting testosterone synthesis.
Answer: c. Competitively blocking the androgen receptor.
19. Why were older oral androgens like methyltestosterone largely abandoned?
- a. Due to a high risk of hepatotoxicity.
- b. They were not effective.
- c. They were too expensive.
- d. They had to be taken every hour.
Answer: a. Due to a high risk of hepatotoxicity.
20. An active learning session on urological disorders is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. A patient with symptomatic hypogonadism is started on TRT. A realistic expectation for improvement in libido is:
- a. Within 24 hours.
- b. Within 3-6 weeks.
- c. After 6 months.
- d. It will not improve libido.
Answer: b. Within 3-6 weeks.
22. A patient using an Androderm® (testosterone) patch should be counseled to:
- a. Apply it to the scrotum.
- b. Apply it daily to a new site on the back, abdomen, upper arms, or thighs.
- c. Wear the same patch for one week.
- d. Apply it right after showering to wet skin.
Answer: b. Apply it daily to a new site on the back, abdomen, upper arms, or thighs.
23. The principles of hormonal agents in cancer are covered in the Patient Care 2 curriculum.
- a. True
- b. False
Answer: a. True
24. An active learning session on men’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
25. A major concern with the abuse of supraphysiologic doses of anabolic steroids is:
- a. An improved lipid profile.
- b. Adverse cardiovascular effects, including cardiomyopathy and dyslipidemia.
- c. Increased fertility.
- d. Decreased aggression.
Answer: b. Adverse cardiovascular effects, including cardiomyopathy and dyslipidemia.
26. Which of the following is NOT a therapeutic use for androgens or androgen derivatives?
- a. Treatment of hypogonadism.
- b. Management of certain types of anemia.
- c. First-line treatment for benign prostatic hyperplasia.
- d. Palliative treatment for some breast cancers.
Answer: c. First-line treatment for benign prostatic hyperplasia.
27. Dihydrotestosterone (DHT) is primarily responsible for the development of:
- a. Male secondary sexual characteristics during puberty.
- b. The external male genitalia during fetal development.
- c. Muscle mass.
- d. Red blood cell production.
Answer: b. The external male genitalia during fetal development.
28. An active learning session on urological disorders is part of which course module?
- a. Module 8: Urological Disorders
- b. Module 1: Diabetes Mellitus
- c. Module 3: Women’s Health
- d. Module 6: Geriatrics
Answer: a. Module 8: Urological Disorders
29. The use of exogenous androgens causes negative feedback on the HPG axis, leading to:
- a. Increased GnRH, LH, and FSH.
- b. Decreased GnRH, LH, and FSH.
- c. No change in pituitary hormones.
- d. Increased testicular size.
Answer: b. Decreased GnRH, LH, and FSH.
30. The “Management of Testosterone Deficiency” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
31. The term “andropause” is sometimes used to refer to:
- a. The onset of puberty in males.
- b. A sudden and complete cessation of testosterone production in middle age.
- c. The gradual decline in testosterone levels seen in aging men.
- d. A type of prostate cancer.
Answer: c. The gradual decline in testosterone levels seen in aging men.
32. A pharmacist’s role in androgen therapy is to:
- a. Ensure appropriate indication and monitoring.
- b. Counsel on proper administration and risk of transference.
- c. Identify potential contraindications.
- d. All of the above.
Answer: d. All of the above.
33. The principles of steroid hormone structure are covered in which foundational course?
- a. PHA5439 Principles of Medicinal Chemistry and Pharmacology I
- b. PHA5161L Professional Practice Skills Lab I
- c. PHA5007 Population Health
- d. PHA5103 Principles of Patient-Centered Care
Answer: a. PHA5439 Principles of Medicinal Chemistry and Pharmacology I
34. Finasteride is more selective for inhibiting which isoenzyme of 5-alpha reductase?
- a. Type 1
- b. Type 2
- c. Type 3
- d. It is non-selective.
Answer: b. Type 2
35. Dutasteride inhibits which isoenzyme(s) of 5-alpha reductase?
- a. Type 1 only
- b. Type 2 only
- c. Both Type 1 and Type 2
- d. It does not inhibit 5-alpha reductase.
Answer: c. Both Type 1 and Type 2
36. From a medicinal chemistry perspective, all steroid hormones share a common:
- a. Four-ring nucleus structure (cyclopentanoperhydrophenanthrene).
- b. Peptide backbone.
- c. Catecholamine structure.
- d. Indole ring structure.
Answer: a. Four-ring nucleus structure (cyclopentanoperhydrophenanthrene).
37. Which of the following is a symptom of hypogonadism?
- a. Increased body hair
- b. Decreased bone density
- c. Increased sperm count
- d. Deepening of the voice
Answer: b. Decreased bone density
38. The lecture “Men’s Health Disorders” is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
39. Testosterone therapy can worsen which of the following conditions?
- a. Obstructive sleep apnea
- b. Benign prostatic hyperplasia
- c. Both a and b
- d. Neither a nor b
Answer: c. Both a and b
40. An active learning session covering men’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
41. The goal of testosterone replacement therapy is to restore serum levels to:
- a. Supraphysiologic ranges.
- b. The low-normal range for young, healthy men.
- c. The high-normal range for young, healthy men.
- d. The mid-normal range for young, healthy men.
Answer: d. The mid-normal range for young, healthy men.
42. Which of the following is NOT a dosage form for testosterone replacement?
- a. Intramuscular injection
- b. Transdermal gel
- c. Intravenous infusion
- d. Transdermal patch
Answer: c. Intravenous infusion
43. A patient using testosterone gel should be advised that the application site should NOT be:
- a. The upper arms
- b. The shoulders
- c. The abdomen
- d. The scrotum
Answer: d. The scrotum
44. What is the primary reason for monitoring hematocrit in patients on TRT?
- a. To screen for anemia.
- b. To screen for polycythemia, which can increase blood viscosity and the risk of thromboembolic events.
- c. To check for infection.
- d. To assess liver function.
Answer: b. To screen for polycythemia, which can increase blood viscosity and the risk of thromboembolic events.
45. Which of the following is a potential psychological side effect of anabolic steroid abuse?
- a. Calmness and relaxation
- b. Apathy
- c. Increased aggression and irritability (“roid rage”)
- d. Improved mood stability
Answer: c. Increased aggression and irritability (“roid rage”)
46. The use of a 5-alpha reductase inhibitor like finasteride will lead to:
- a. Increased levels of DHT.
- b. Decreased levels of testosterone.
- c. Decreased levels of DHT and a slight increase in testosterone.
- d. Increased levels of estrogen.
Answer: c. Decreased levels of DHT and a slight increase in testosterone.
47. A “gel-blot” or transference of testosterone from a patient to his female partner can cause:
- a. Virilization (development of male characteristics) in the partner.
- b. No effects in the partner.
- c. A decrease in the patient’s testosterone level.
- d. A skin rash only.
Answer: a. Virilization (development of male characteristics) in the partner.
48. An active learning session on men’s health is part of which course module?
- a. Module 8: Urological Disorders
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 6: Geriatrics
Answer: a. Module 8: Urological Disorders
49. The overall management of a patient on TRT requires:
- a. A one-time dose adjustment.
- b. A careful balancing of benefits and risks with regular laboratory monitoring.
- c. The use of the highest dose possible.
- d. No follow-up after initiation.
Answer: b. A careful balancing of benefits and risks with regular laboratory monitoring.
50. The ultimate goal of learning about androgens is to:
- a. Be able to recommend their use for bodybuilding.
- b. Safely manage their use and the use of anti-androgens for appropriate medical indications.
- c. Pass the endocrinology exam.
- d. Memorize the chemical structure of testosterone.
Answer: b. Safely manage their use and the use of anti-androgens for appropriate medical indications.