Master sex hormones with targeted Sex hormones MCQs With Answer designed for B. Pharm students. This concise, exam-oriented collection covers steroid and peptide hormone biosynthesis, endocrine regulation, receptor pharmacology, metabolism, clinical uses, adverse effects, assays, and therapeutic analogs such as estrogens, progestins, androgens, gonadotropins, and steroidogenesis inhibitors. Each question emphasizes mechanisms, drug actions, interactions, and implications in contraception, infertility, hormone replacement, cancers, and metabolic disorders to enhance pharmacology understanding and clinical reasoning. Ideal for revision, class tests, and competitive exams, these MCQs strengthen both basic concepts and applied therapeutic knowledge. Now let’s test your knowledge with 50 MCQs on this topic.
Q1. Which enzyme catalyzes the conversion of cholesterol to pregnenolone, the first step in steroid hormone biosynthesis?
- 17β-Hydroxysteroid dehydrogenase
- Aromatase
- Cholesterol side-chain cleavage enzyme (CYP11A1)
- 5α-Reductase
Correct Answer: Cholesterol side-chain cleavage enzyme (CYP11A1)
Q2. Aromatase inhibitors are primarily used in hormone receptor–positive breast cancer because they block conversion of:
- Pregnenolone to progesterone
- Androgens to estrogens
- Testosterone to dihydrotestosterone (DHT)
- Cortisol to cortisone
Correct Answer: Androgens to estrogens
Q3. Which sex hormone binds primarily to sex hormone-binding globulin (SHBG) in plasma?
- Cortisol
- Estradiol and testosterone
- Aldosterone
- Insulin
Correct Answer: Estradiol and testosterone
Q4. The major biologically active estrogen during reproductive years is:
- Estrone (E1)
- Estriol (E3)
- Estradiol (E2)
- Estetrol (E4)
Correct Answer: Estradiol (E2)
Q5. 5α-Reductase inhibitors such as finasteride reduce levels of which potent androgen?
- Testosterone
- Dihydrotestosterone (DHT)
- Androstenedione
- DHEA
Correct Answer: Dihydrotestosterone (DHT)
Q6. Progesterone exerts its genomic effects primarily via which receptor type?
- G-protein coupled receptor
- Nuclear progesterone receptor (ligand-activated transcription factor)
- Tyrosine kinase receptor
- Ion channel receptor
Correct Answer: Nuclear progesterone receptor (ligand-activated transcription factor)
Q7. Combined oral contraceptives prevent ovulation mainly by suppressing which hormonal event?
- GnRH pulsatility
- FSH secretion only
- Luteinizing hormone (LH) surge
- Progesterone production by corpus luteum
Correct Answer: Luteinizing hormone (LH) surge
Q8. Which selective estrogen receptor modulator (SERM) acts as an estrogen antagonist in breast tissue but an agonist in bone?
- Tamoxifen
Correct Answer: Raloxifene
Q9. Clomiphene citrate induces ovulation by blocking estrogen feedback at the hypothalamus, thereby increasing secretion of:
- Prolactin
- GnRH → LH and FSH
- ACTH
- TSH
Correct Answer: GnRH → LH and FSH
Q10. The primary site of aromatase activity responsible for peripheral estrogen production in postmenopausal women is:
- Ovarian granulosa cells
- Adipose tissue
- Testes
- Anterior pituitary
Correct Answer: Adipose tissue
Q11. Testosterone’s anabolic effects are largely mediated through conversion to which hormone in target tissues?
- Cortisol
- Estradiol
- Dihydrotestosterone (DHT)
- Progesterone
Correct Answer: Dihydrotestosterone (DHT)
Q12. Which laboratory method is considered the gold standard for quantifying steroid hormones due to specificity and accuracy?
- Radioimmunoassay
- Enzyme-linked immunosorbent assay (ELISA)
- Liquid chromatography–tandem mass spectrometry (LC-MS/MS)
- Colorimetric assay
Correct Answer: Liquid chromatography–tandem mass spectrometry (LC-MS/MS)
Q13. Gonadotropin-releasing hormone (GnRH) agonists initially stimulate then downregulate gonadotropin release; this biphasic effect is used therapeutically in:
- Acute adrenal insufficiency
- Infertility induction only
- Prostate cancer and endometriosis
- Hypothyroidism
Correct Answer: Prostate cancer and endometriosis
Q14. Aromatase is a member of which enzyme family?
- CYP450 (cytochrome P450)
- Hydrolases
- Transferases
- Oxidoreductases unrelated to CYP
Correct Answer: CYP450 (cytochrome P450)
Q15. Androgen insensitivity syndrome is due to mutations in the gene encoding:
- 5α-Reductase
- Androgen receptor
- Aromatase
- Luteinizing hormone β-subunit
Correct Answer: Androgen receptor
Q16. Which progestin has significant androgenic activity and can worsen acne or hirsutism?
- Norethindrone
- Medroxyprogesterone acetate (MPA)
- Drospirenone
- Levonorgestrel
Correct Answer: Levonorgestrel
Q17. Selective progesterone receptor modulators (SPRMs) like mifepristone act primarily as:
- Pure progesterone agonists
- Progesterone receptor antagonists/modulators
- Estrogen receptor agonists
- Gonadotropin secretagogues
Correct Answer: Progesterone receptor antagonists/modulators
Q18. Which steroidogenic enzyme deficiency leads to congenital adrenal hyperplasia with virilization due to androgen excess?
- 11β-Hydroxylase deficiency
- 21-Hydroxylase deficiency
- Aromatase excess
- 17β-Hydroxysteroid dehydrogenase deficiency
Correct Answer: 21-Hydroxylase deficiency
Q19. Estradiol replacement therapy increases risk of venous thromboembolism primarily because of:
- Direct platelet activation
- Hepatic induction of clotting factors (first-pass effect)
- Increase in fibrinolysis
- Renal sodium retention
Correct Answer: Hepatic induction of clotting factors (first-pass effect)
Q20. In male contraception development, which approach targets spermatogenesis by hormonal suppression?
- 5α-Reductase enhancement
- Exogenous combined estrogen-progestin to suppress gonadotropins
- Aromatase inhibition
- GnRH antagonists to increase LH/FSH
Correct Answer: Exogenous combined estrogen-progestin to suppress gonadotropins
Q21. Estriol (E3) is the predominant estrogen measured during pregnancy and is mainly produced by:
- The maternal adrenal cortex
- The placenta from fetal and maternal precursors
- The maternal ovary
- The pituitary gland
Correct Answer: The placenta from fetal and maternal precursors
Q22. Which drug is a nonsteroidal aromatase inhibitor commonly used in postmenopausal breast cancer?
- Anastrozole
- Letrozole
- Exemestane
- Both Anastrozole and Letrozole
Correct Answer: Both Anastrozole and Letrozole
Q23. Which hormone is secreted by Leydig cells and stimulated by LH?
- Inhibin B
- Testosterone
- Estrogen
- Progesterone
Correct Answer: Testosterone
Q24. The mechanism of action of tamoxifen in breast cancer involves binding to estrogen receptors and:
- Acting as a full estrogen agonist in breast tissue
- Acting as an estrogen antagonist in breast tissue
- Inhibiting aromatase enzyme
- Blocking progesterone receptors
Correct Answer: Acting as an estrogen antagonist in breast tissue
Q25. Which hormone assay is most affected by high concentrations of SHBG, leading to lower free fraction readings?
- Free cortisol
- Total testosterone
- Free testosterone
- Insulin
Correct Answer: Free testosterone
Q26. Androgen receptor antagonists such as flutamide are used in prostate cancer to:
- Increase testosterone synthesis
- Block androgen binding to receptor and inhibit tumor growth
- Stimulate LH secretion
- Enhance aromatization to estrogen
Correct Answer: Block androgen binding to receptor and inhibit tumor growth
Q27. Which contraceptive method primarily relies on progestin-induced thickening of cervical mucus and endometrial changes rather than consistent ovulation suppression?
- Combined oral contraceptive pill
- Progestin-only pill (mini‑pill)
- Copper IUD
- Condom
Correct Answer: Progestin-only pill (mini‑pill)
Q28. The placental enzyme that prevents fetal masculinization in pregnant women carrying male fetuses by converting androgens to estrogens is:
- 5α-Reductase
- Aromatase
- 17α-Hydroxylase
- 3β-HSD
Correct Answer: Aromatase
Q29. Synthetic anabolic-androgenic steroids exert their effects primarily through:
- Non-genomic membrane receptors only
- Activation of nuclear androgen receptors and modulation of gene transcription
- Conversion to estrogen and acting via estrogen receptors
- Direct activation of LH receptors
Correct Answer: Activation of nuclear androgen receptors and modulation of gene transcription
Q30. Which condition is characterized by hyperandrogenism, oligo/anovulation, and polycystic ovaries and is relevant to pharmacologic management of sex hormones?
- Turner syndrome
- Polycystic ovary syndrome (PCOS)
- Androgen insensitivity syndrome
- Sheehan syndrome
Correct Answer: Polycystic ovary syndrome (PCOS)
Q31. Which enzyme converts androstenedione to testosterone in peripheral tissues?
- Aromatase
- 17β-Hydroxysteroid dehydrogenase (17β-HSD)
- 21-Hydroxylase
- 11β-Hydroxylase
Correct Answer: 17β-Hydroxysteroid dehydrogenase (17β-HSD)
Q32. Which therapeutic agent is used as emergency contraception and is a progesterone receptor agonist/antagonist depending on dose and timing?
- Levonorgestrel
- Clomiphene
- Methotrexate
- Finasteride
Correct Answer: Levonorgestrel
Q33. Long-term estrogen therapy without progestin in women with an intact uterus increases the risk of:
- Ovarian torsion
- Endometrial hyperplasia and carcinoma
- Breast atrophy
- Hypogonadism
Correct Answer: Endometrial hyperplasia and carcinoma
Q34. Which hormone is primarily responsible for maturation of ovarian follicle and estradiol production under FSH stimulation?
- LH
- FSH
- Prolactin
- Oxytocin
Correct Answer: FSH
Q35. In men, administration of exogenous testosterone can cause decreased spermatogenesis due to suppression of:
- Prolactin
- Growth hormone
- GnRH → LH and FSH
- Thyroid hormones
Correct Answer: GnRH → LH and FSH
Q36. Which antiandrogen acts by inhibiting androgen production via blockade of CYP17A1 and is used in castration-resistant prostate cancer?
- Finasteride
- Abiraterone
- Flutamide
- Spironolactone
Correct Answer: Abiraterone
Q37. Which metabolic pathway commonly inactivates steroid hormones making them water-soluble for renal excretion?
- Phosphorylation
- Glycosylation
- Conjugation (glucuronidation/sulfation)
- Peptide cleavage
Correct Answer: Conjugation (glucuronidation/sulfation)
Q38. Tamoxifen therapy carries an increased risk of which adverse effect due to its partial estrogen agonist activity in the uterus?
- Endometrial cancer
- Osteoporosis
- Hypoglycemia
- Hyperkalemia
Correct Answer: Endometrial cancer
Q39. Which hormone is secreted by granulosa cells and increases in response to FSH to promote follicular growth?
- Inhibin
- Testosterone
- Aldosterone
- Cortisol
Correct Answer: Inhibin
Q40. Which contraceptive implant or injection delivers progestin systemically and can cause amenorrhea or irregular bleeding?
- Copper IUD
- Levonorgestrel-releasing intrauterine system (LNG-IUS)
- Depot medroxyprogesterone acetate (DMPA) injection
- Condom
Correct Answer: Depot medroxyprogesterone acetate (DMPA) injection
Q41. Hypogonadotropic hypogonadism is characterized by low sex steroids due to deficiency in:
- Gonadotropins (LH/FSH) from pituitary or GnRH from hypothalamus
- Gonadal receptor function only
- Peripheral conversion of androgens to estrogens
- Renal clearance of sex steroids
Correct Answer: Gonadotropins (LH/FSH) from pituitary or GnRH from hypothalamus
Q42. Which drug is used to treat endometriosis by suppressing ovarian estrogen production through prolonged suppression of gonadotropins?
- GnRH agonists (e.g., leuprolide)
- Estrogen patches
- Oral testosterone
- HMG injections
Correct Answer: GnRH agonists (e.g., leuprolide)
Q43. Estrogen receptor (ER) α and β differ in tissue distribution; ERβ is relatively abundant in:
- Uterine endometrium only
- Prostate, ovary, and vascular endothelium
- Adrenal medulla exclusively
- Pancreatic β-cells only
Correct Answer: Prostate, ovary, and vascular endothelium
Q44. Which lipid-soluble property of steroid hormones explains their intracellular receptor mechanism and slow onset of genomic effects?
- They are hydrophilic and circulate free
- They readily cross cell membranes to bind intracellular receptors
- They require membrane transporters to enter cells
- They act only through membrane-bound ion channels
Correct Answer: They readily cross cell membranes to bind intracellular receptors
Q45. In polycystic ovary syndrome (PCOS), which pharmacologic agent is commonly used to improve insulin resistance and restore ovulation?
- Metformin
- Finasteride
- Leuprolide
- Tamoxifen
Correct Answer: Metformin
Q46. Which of the following is a steroidal irreversible aromatase inactivator used in breast cancer?
- Anastrozole
- Letrozole
- Exemestane
- Tamoxifen
Correct Answer: Exemestane
Q47. Which physiologic change in aging men may be due to increased SHBG levels?
- Increased free testosterone
- Decreased free testosterone despite normal total testosterone
- Increased spermatogenesis
- Decreased cortisol levels
Correct Answer: Decreased free testosterone despite normal total testosterone
Q48. Which drug used for infertility acts as an estrogen receptor partial agonist at the hypothalamus, increasing gonadotropin release?
- Clomiphene citrate
- Levonorgestrel
- Medroxyprogesterone
- Finasteride
Correct Answer: Clomiphene citrate
Q49. The major hepatic effect of oral estrogens that is dose-dependent and clinically significant is induction of:
- Phase II conjugation only
- Synthesis of clotting factors and triglycerides
- Urea cycle enzymes
- Renal excretion pathways
Correct Answer: Synthesis of clotting factors and triglycerides
Q50. Which therapeutic approach treats estrogen receptor–positive breast cancer by blocking estrogen binding to the receptor in breast tissue?
- Aromatase inhibitors only
- Selective estrogen receptor modulators (SERMs) like tamoxifen
- 5α-Reductase inhibitors
- GnRH agonists exclusively
Correct Answer: Selective estrogen receptor modulators (SERMs) like tamoxifen
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