Progesterone MCQs With Answer offer B. Pharm students a focused review of progesterone’s pharmacology, clinical applications, formulations, and safety profile. This set covers biochemical synthesis, receptor pharmacodynamics, progestin analogues, pharmacokinetics, therapeutic uses in contraception and hormone replacement, adverse effects, drug interactions, and monitoring parameters. Emphasis is placed on mechanisms of action, differences between natural progesterone and synthetic progestins, dosage forms (oral, injectable, intrauterine), and relevant clinical scenarios like luteal support and emergency contraception. These MCQs are crafted to deepen understanding, improve exam readiness, and reinforce critical points in reproductive pharmacotherapy. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which receptor mediates the genomic effects of progesterone in target tissues?
- Estrogen receptor alpha
- Progesterone receptor (PR)
- Androgen receptor
- Glucocorticoid receptor
Correct Answer: Progesterone receptor (PR)
Q2. Progesterone is primarily synthesized in which ovarian structure during the luteal phase?
- Granulosa cells of the follicle
- Theca interna
- Corpus luteum
- Cumulus oophorus
Correct Answer: Corpus luteum
Q3. Which of the following is a major hepatic metabolic pathway for progesterone?
- Glucuronidation and sulfation
- Renal conjugation
- Direct excretion unchanged
- Decarboxylation
Correct Answer: Glucuronidation and sulfation
Q4. Which synthetic progestin is commonly used in depot injection formulations for contraception?
- Levonorgestrel
- Medroxyprogesterone acetate (MPA)
- Norethindrone acetate
- Drospirenone
Correct Answer: Medroxyprogesterone acetate (MPA)
Q5. Progesterone’s effect on the endometrium during the luteal phase is to:
- Proliferate endometrial glands
- Differentiate and secretory transformation
- Cause immediate shedding
- Stimulate heavy bleeding
Correct Answer: Differentiate and secretory transformation
Q6. Which formulation of progesterone has improved bioavailability by bypassing first-pass hepatic metabolism?
- Oral micronized progesterone
- Intramuscular oil-based progesterone
- Transdermal progesterone
- Rectal suppository
Correct Answer: Intramuscular oil-based progesterone
Q7. Mifepristone acts clinically as a:
- Progesterone receptor agonist
- Progesterone receptor antagonist
- Estrogen receptor antagonist
- Aromatase inhibitor
Correct Answer: Progesterone receptor antagonist
Q8. Which progestin is noted for anti-androgenic activity and is used in combined oral contraceptives?
- Levonorgestrel
- Norethisterone
- Drospirenone
- Desogestrel
Correct Answer: Drospirenone
Q9. A principal contraceptive action of progestins is mediated by:
- Enhancing ovulation
- Inhibiting ovulation and thickening cervical mucus
- Increasing endometrial receptivity
- Stimulating follicular growth
Correct Answer: Inhibiting ovulation and thickening cervical mucus
Q10. Which enzyme family is primarily responsible for hepatic metabolism of many synthetic progestins?
- Cyclooxygenases (COX)
- Cytochrome P450 (CYP) enzymes
- Monoamine oxidases (MAO)
- Acetylcholinesterases
Correct Answer: Cytochrome P450 (CYP) enzymes
Q11. Progesterone increases body temperature slightly during the luteal phase by acting on:
- Hypothalamic thermoregulatory center
- Medullary respiratory center
- Spinal motor neurons
- Peripheral vasculature only
Correct Answer: Hypothalamic thermoregulatory center
Q12. Which adverse effect is most classically associated with progestin-only contraceptives?
- Hypertension in all users
- Irregular bleeding or spotting
- Severe hyperglycemia
- Immediate infertility
Correct Answer: Irregular bleeding or spotting
Q13. Progesterone plays a critical role in pregnancy maintenance by:
- Stimulating uterine contractions
- Suppressing maternal immune response and supporting endometrium
- Blocking placental development
- Reducing maternal blood volume
Correct Answer: Suppressing maternal immune response and supporting endometrium
Q14. Which laboratory assay is commonly used to measure circulating progesterone levels?
- Thyroid-stimulating hormone (TSH) assay
- Radioimmunoassay or immunoassay for progesterone
- Complete blood count (CBC)
- Liver function test (LFT)
Correct Answer: Radioimmunoassay or immunoassay for progesterone
Q15. The structural class of natural progesterone is:
- Peptide hormone
- Steroid (pregnane) hormone
- Polypeptide
- Amino acid derivative
Correct Answer: Steroid (pregnane) hormone
Q16. Which progestin is commonly used in intrauterine systems (IUS) for long-term local progestogenic effect?
- Levonorgestrel
- Medroxyprogesterone acetate
- Drospirenone
- Norethindrone
Correct Answer: Levonorgestrel
Q17. Progesterone antagonists used for medical termination of pregnancy act primarily by:
- Enhancing progesterone synthesis
- Blocking progesterone receptors and causing decidual breakdown
- Stimulating estrogen receptors
- Inhibiting prostaglandin synthesis exclusively
Correct Answer: Blocking progesterone receptors and causing decidual breakdown
Q18. Which pharmacokinetic property of oral micronized progesterone improves its clinical performance?
- Increased water solubility eliminates first-pass metabolism
- Micronization enhances absorption and bioavailability
- It converts to an inactive metabolite rapidly
- It is immune to hepatic enzymes
Correct Answer: Micronization enhances absorption and bioavailability
Q19. Progestins with androgenic activity can cause which unwanted effect?
- Breast atrophy only
- Acne and hirsutism
- Hypotension
- Improved insulin sensitivity
Correct Answer: Acne and hirsutism
Q20. Which of the following is a key difference between natural progesterone and many synthetic progestins?
- Natural progesterone has no receptor-mediated effects
- Synthetic progestins often have variable androgenic, estrogenic, or glucocorticoid activities
- Natural progesterone is a peptide, synthetics are steroids
- Synthetic progestins are not orally active
Correct Answer: Synthetic progestins often have variable androgenic, estrogenic, or glucocorticoid activities
Q21. In luteal phase support during assisted reproductive techniques, progesterone is used to:
- Promote implantation and maintain early pregnancy
- Induce ovulation
- Suppress endometrial growth entirely
- Cause selective fetal membrane rupture
Correct Answer: Promote implantation and maintain early pregnancy
Q22. Which side effect is more associated with drospirenone-containing contraceptives compared to older progestins?
- Hypokalemia
- Hyperkalemia due to antimineralocorticoid activity
- High androgenic stimulation
- Severe hepatic necrosis
Correct Answer: Hyperkalemia due to antimineralocorticoid activity
Q23. The primary clinical indication for progesterone in hormone replacement therapy (HRT) is to:
- Prevent estrogen-induced endometrial hyperplasia in women with an intact uterus
- Stimulate ovarian follicle growth
- Induce permanent amenorrhea
- Enhance testosterone levels
Correct Answer: Prevent estrogen-induced endometrial hyperplasia in women with an intact uterus
Q24. Which factor most significantly reduces the oral bioavailability of natural progesterone?
- High renal clearance
- Extensive first-pass hepatic metabolism
- Poor binding to plasma proteins
- Immediate degradation in the stomach acid
Correct Answer: Extensive first-pass hepatic metabolism
Q25. Which monitoring parameter is most relevant when prescribing long-term injectable medroxyprogesterone acetate?
- Bone mineral density
- Frequent liver biopsies
- Daily blood glucose checks
- Continuous ECG monitoring
Correct Answer: Bone mineral density
Q26. Which statement about levonorgestrel emergency contraception is true?
- It is effective by preventing implantation after fertilization only
- It primarily works by inhibiting or delaying ovulation
- It must be taken within 72 days
- It acts as a progesterone receptor antagonist
Correct Answer: It primarily works by inhibiting or delaying ovulation
Q27. Progestin-only pills primarily rely on which mechanism to prevent pregnancy?
- Consistent ovulation induction
- Thickening cervical mucus and altering endometrium
- Permanent tubal occlusion
- Increasing sperm motility
Correct Answer: Thickening cervical mucus and altering endometrium
Q28. Which metabolite class is produced from progesterone metabolism and can be measured in urine as a marker of progesterone exposure?
- Pregnanediol glucuronide
- Estrone sulfate
- Testosterone glucuronide
- Cortisol
Correct Answer: Pregnanediol glucuronide
Q29. Which of the following progestins has relatively high androgenic activity and is often associated with adverse lipid profile changes?
- Desogestrel
- Cyproterone acetate
- Levonorgestrel
- Drospirenone
Correct Answer: Levonorgestrel
Q30. Which clinical scenario is a contraindication for estrogen-containing combined contraceptives but where progestin-only methods may be preferred?
- Young healthy non-smoking woman with no history
- Woman with history of thromboembolism or high risk of VTE
- Woman desiring immediate fertility restoration
- Woman with uncontrolled hyperkalemia
Correct Answer: Woman with history of thromboembolism or high risk of VTE

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