The hormonal regulation of male reproduction is a complex interplay governed by the hypothalamic-pituitary-gonadal (HPG) axis. Disruptions in this system can lead to testosterone deficiency (hypogonadism), a key topic within the “Men’s Health Disorders” module of the Patient Care 5 curriculum. This quiz will test your knowledge on the physiology of testosterone and the principles of managing testosterone deficiency with various replacement therapies, focusing on their risks, benefits, and key counseling points.
1. Which hormone is released from the hypothalamus to initiate the male reproductive axis?
- a. Luteinizing Hormone (LH)
- b. Follicle-stimulating Hormone (FSH)
- c. Gonadotropin-releasing Hormone (GnRH)
- d. Testosterone
Answer: c. Gonadotropin-releasing Hormone (GnRH)
2. In response to GnRH, the pituitary gland releases LH and FSH. What is the primary function of LH in males?
- a. To stimulate Sertoli cells for spermatogenesis.
- b. To stimulate Leydig cells in the testes to produce testosterone.
- c. To provide negative feedback to the hypothalamus.
- d. To convert testosterone to DHT.
Answer: b. To stimulate Leydig cells in the testes to produce testosterone.
3. The majority of circulating testosterone is:
- a. Free and biologically active.
- b. Bound to proteins like sex hormone-binding globulin (SHBG) and albumin.
- c. Converted to estrogen in the testes.
- d. Stored in adipose tissue.
Answer: b. Bound to proteins like sex hormone-binding globulin (SHBG) and albumin.
4. 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
5. A patient with primary hypogonadism (testicular failure) would be expected to have which pattern of lab results?
- a. Low Testosterone, Low LH/FSH
- b. High Testosterone, High LH/FSH
- c. Low Testosterone, High LH/FSH
- d. High Testosterone, Low LH/FSH
Answer: c. Low Testosterone, High LH/FSH
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 patient with secondary hypogonadism (pituitary/hypothalamic failure) would be expected to have which pattern of lab results?
- a. Low Testosterone, Low LH/FSH
- b. High Testosterone, High LH/FSH
- c. Low Testosterone, High LH/FSH
- d. High Testosterone, Low LH/FSH
Answer: a. Low Testosterone, Low LH/FSH
8. Which of the following is a classic symptom of testosterone deficiency?
- a. Increased energy
- b. Increased muscle mass
- c. Decreased libido
- d. Thickening of the skin
Answer: c. Decreased libido
9. The diagnosis of hypogonadism requires low testosterone levels and:
- a. A high PSA.
- b. The presence of clinical signs and symptoms.
- c. A history of BPH.
- d. A low hematocrit.
Answer: b. The presence of clinical signs and symptoms.
10. When should a patient’s testosterone level be drawn for an accurate diagnosis?
- a. In the evening, after a meal.
- b. In the early morning, as levels are highest at this time.
- c. At any time of day.
- d. Immediately after vigorous exercise.
Answer: b. In the early morning, as levels are highest at this time.
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. What is a key counseling point for a patient using a topical testosterone gel?
- a. Apply the gel to the scrotum for best absorption.
- b. It is okay for children and female partners to touch the application site.
- c. Wash hands thoroughly after application and cover the site with clothing to prevent transference.
- d. Apply a thick layer all over the body.
Answer: c. Wash hands thoroughly after application and cover the site with clothing to prevent transference.
13. A patient on testosterone replacement therapy (TRT) should have which of the following lab values monitored regularly?
- a. Hematocrit and PSA
- b. Serum electrolytes
- c. Liver function tests
- d. A1c
Answer: a. Hematocrit and PSA
14. A potential adverse effect of TRT is polycythemia, which is a(n):
- a. Decrease in red blood cells.
- b. Increase in white blood cells.
- c. Increase in red blood cells (hematocrit).
- d. Decrease in platelets.
Answer: c. Increase in red blood cells (hematocrit).
15. Testosterone replacement therapy is contraindicated in patients with:
- a. A history of benign prostatic hyperplasia (BPH).
- b. A history of prostate or breast cancer.
- c. Type 2 diabetes.
- d. Hypothyroidism.
Answer: b. A history of prostate or breast cancer.
16. The “Introduction to Urological Disorders” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
17. How does exogenous testosterone administration affect spermatogenesis?
- a. It enhances spermatogenesis by increasing FSH and LH.
- b. It impairs or stops spermatogenesis by suppressing the release of GnRH, LH, and FSH.
- c. It has no effect on spermatogenesis.
- d. It only affects sperm motility.
Answer: b. It impairs or stops spermatogenesis by suppressing the release of GnRH, LH, and FSH.
18. Which of the following is NOT a primary role of testosterone?
- a. Maintenance of bone density.
- b. Development of secondary sexual characteristics.
- c. Regulation of libido.
- d. Stimulation of the thyroid gland.
Answer: d. Stimulation of the thyroid gland.
19. A patient wants to start TRT to improve his athletic performance. The pharmacist should:
- a. Recommend the highest dose possible.
- b. Counsel the patient that this is an inappropriate use and TRT is only for confirmed medical conditions.
- c. Sell him an over-the-counter testosterone booster.
- d. Agree that this is a good idea.
Answer: b. Counsel the patient that this is an inappropriate use and TRT is only for confirmed medical conditions.
20. An active learning session on urological disorders is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. Testosterone cypionate and enanthate are what type of formulations?
- a. Short-acting oral tablets
- b. Long-acting intramuscular injections
- c. Transdermal patches
- d. Topical gels
Answer: b. Long-acting intramuscular injections
22. A patient with BPH who is on TRT may experience:
- a. An improvement in urinary symptoms.
- b. A worsening of urinary symptoms.
- c. No change in urinary symptoms.
- d. A cure for their BPH.
Answer: b. A worsening of urinary symptoms.
23. The role of the pharmacist in managing TRT includes:
- a. Counseling on proper administration of different dosage forms.
- b. Educating on potential side effects and the need for monitoring.
- c. Both a and b.
- d. Neither a nor b.
Answer: c. Both a and b.
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 patient on TRT should have their Prostate Specific Antigen (PSA) monitored because:
- a. Testosterone can stimulate the growth of an existing, undiagnosed prostate cancer.
- b. Testosterone causes prostate cancer.
- c. It is a marker for hypogonadism.
- d. It measures the effectiveness of therapy.
Answer: a. Testosterone can stimulate the growth of an existing, undiagnosed prostate cancer.
26. The primary benefit of using a transdermal gel or patch for TRT compared to injections is:
- a. It is less expensive.
- b. It provides more stable, physiologic serum testosterone levels.
- c. It has a lower risk of transference.
- d. It is more effective at building muscle mass.
Answer: b. It provides more stable, physiologic serum testosterone levels.
27. What is the role of FSH in male reproduction?
- a. It stimulates testosterone production.
- b. It acts on Sertoli cells to support spermatogenesis.
- c. It inhibits GnRH release.
- d. It has no role in males.
Answer: b. It acts on Sertoli cells to support spermatogenesis.
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. A patient is prescribed testosterone cypionate 200 mg IM every 2 weeks. The “cypionate” portion is a(n):
- a. Active ingredient.
- b. Ester added to the testosterone molecule to prolong its absorption and duration of action.
- c. Preservative.
- d. Solvent.
Answer: b. Ester added to the testosterone molecule to prolong its absorption and duration of action.
30. The “Management of Testosterone Deficiency” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
31. A common side effect of testosterone gel is:
- a. Skin irritation at the application site.
- b. Hypertension.
- c. Polycythemia.
- d. Decreased libido.
Answer: a. Skin irritation at the application site.
32. Klinefelter syndrome is a genetic condition that is a cause of:
- a. Secondary hypogonadism
- b. Primary hypogonadism
- c. Hypergonadism
- d. Normal testosterone function
Answer: b. Primary hypogonadism
33. The HPG axis operates on a negative feedback loop where high levels of testosterone inhibit the release of:
- a. Only LH
- b. Only FSH
- c. Only GnRH
- d. Both GnRH and LH/FSH
Answer: d. Both GnRH and LH/FSH
34. Which of the following is NOT a potential benefit of TRT in a truly hypogonadal man?
- a. Improved libido and erectile function.
- b. Increased muscle mass and bone density.
- c. Improved mood and energy levels.
- d. Preservation of fertility.
Answer: d. Preservation of fertility.
35. A man using exogenous testosterone for bodybuilding will likely experience:
- a. Increased testicular size.
- b. Testicular atrophy and infertility.
- c. Increased natural testosterone production.
- d. No change in testicular function.
Answer: b. Testicular atrophy and infertility.
36. Testosterone is what type of chemical molecule?
- a. A peptide
- b. A carbohydrate
- c. A steroid
- d. An alkaloid
Answer: c. A steroid
37. Before initiating TRT, a physician should perform a:
- a. Digital rectal exam and obtain a baseline PSA level.
- b. Colonoscopy.
- c. Chest x-ray.
- d. Electrocardiogram.
Answer: a. Digital rectal exam and obtain a baseline PSA level.
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 sleep disorders?
- a. Insomnia
- b. Restless leg syndrome
- c. Obstructive sleep apnea
- d. Narcolepsy
Answer: c. Obstructive sleep apnea
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 primary goal of TRT is to:
- a. Build muscle mass for athletic competition.
- b. Restore testosterone levels to the normal physiologic range to alleviate symptoms of hypogonadism.
- c. Increase the patient’s hematocrit.
- d. Shrink the prostate.
Answer: b. Restore testosterone levels to the normal physiologic range to alleviate symptoms of hypogonadism.
42. Which of the following is NOT a symptom of low testosterone?
- a. Fatigue
- b. Increased facial hair growth
- c. Depressed mood
- d. Loss of muscle mass
Answer: b. Increased facial hair growth
43. A pharmacist’s role includes counseling patients that TRT:
- a. Is a cure for hypogonadism.
- b. Is often a lifelong therapy.
- c. Has no risks or side effects.
- d. Will improve their athletic ability.
Answer: b. Is often a lifelong therapy.
44. What is the role of sex hormone-binding globulin (SHBG)?
- a. It transports testosterone in the blood, and only unbound testosterone is active.
- b. It is the receptor for testosterone.
- c. It breaks down testosterone.
- d. It stimulates testosterone production.
Answer: a. It transports testosterone in the blood, and only unbound testosterone is active.
45. Which of the following is a potential cause of secondary hypogonadism?
- a. A pituitary tumor
- b. Chronic opioid use
- c. Anabolic steroid abuse
- d. All of the above
Answer: d. All of the above
46. The use of finasteride for BPH can interfere with the diagnosis of prostate cancer by:
- a. Falsely elevating the PSA level.
- b. Falsely lowering the PSA level by about 50%.
- c. Masking the symptoms of BPH.
- d. It does not interfere.
Answer: b. Falsely lowering the PSA level by about 50%.
47. A key part of the “Introduction to Urological Disorders” lecture would be the physiology of the male reproductive system.
- a. True
- b. False
Answer: a. True
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 testosterone deficiency requires:
- a. A “one-size-fits-all” approach.
- b. A careful diagnosis, individualized treatment plan, and regular monitoring.
- c. The use of over-the-counter supplements only.
- d. A focus on diet and exercise alone.
Answer: b. A careful diagnosis, individualized treatment plan, and regular monitoring.
50. The ultimate goal of learning about male reproduction and its disorders is to:
- a. Safely and effectively manage pharmacotherapy to improve a patient’s health and quality of life.
- b. Be able to recommend illegal anabolic steroids.
- c. Pass the final exam.
- d. Memorize all the different testosterone formulations.
Answer: a. Safely and effectively manage pharmacotherapy to improve a patient’s health and quality of life.