Sex hormones – Testosterone MCQs With Answer
This concise, exam-focused introduction reviews testosterone biology, pharmacology, clinical uses and adverse effects tailored for B. Pharm students. Key concepts include steroid biosynthesis from cholesterol, regulation by LH/FSH, conversion to dihydrotestosterone (DHT) by 5α-reductase, aromatization to estradiol, plasma binding by SHBG, pharmacokinetics of esters and 17α‑alkylated derivatives, receptor-mediated genomic actions, therapeutic indications, monitoring parameters, and common drug interactions and toxicities. Emphasis is on mechanisms, formulations, clinical applications and safety considerations to support rational dispensing and patient counseling. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary circulating endogenous androgen in adult males?
- Testosterone
- Dihydrotestosterone (DHT)
- Androstenedione
- Dehydroepiandrosterone (DHEA)
Correct Answer: Testosterone
Q2. Which cells in the testes are primarily responsible for testosterone synthesis?
- Sertoli cells
- Leydig cells
- Germ cells
- Interstitial fibroblasts
Correct Answer: Leydig cells
Q3. Which enzyme converts testosterone to the more potent androgen dihydrotestosterone (DHT)?
- Aromatase
- 5α‑Reductase
- 17β‑Hydroxysteroid dehydrogenase
- CYP3A4
Correct Answer: 5α‑Reductase
Q4. Aromatase catalyzes the conversion of testosterone into which estrogen?
- Estrone
- Estriol
- Estradiol
- Progesterone
Correct Answer: Estradiol
Q5. Which plasma protein binds the majority of circulating testosterone with high affinity?
- Albumin
- Sex hormone‑binding globulin (SHBG)
- Corticosteroid‑binding globulin (CBG)
- Transferrin
Correct Answer: Sex hormone‑binding globulin (SHBG)
Q6. Which chemical modification is commonly used to produce orally active anabolic-androgenic steroids?
- 17β‑Esterification
- 17α‑Alkylation
- 3β‑Hydroxylation
- Sulfation at C‑17
Correct Answer: 17α‑Alkylation
Q7. Which of the following is NOT a testosterone ester used for intramuscular depot administration?
- Testosterone enanthate
- Testosterone cypionate
- Testosterone propionate
- Methyltestosterone
Correct Answer: Methyltestosterone
Q8. Testosterone exerts most of its genomic effects by binding to which type of receptor?
- G‑protein coupled receptor (GPCR)
- Tyrosine kinase receptor
- Nuclear (intracellular) androgen receptor
- Ligand‑gated ion channel
Correct Answer: Nuclear (intracellular) androgen receptor
Q9. What is the primary FDA‑approved therapeutic indication for testosterone replacement?
- Contraception for men
- Male hypogonadism with low testosterone
- Asthma management
- Acute bacterial infection
Correct Answer: Male hypogonadism with low testosterone
Q10. Which lipid change is classically associated with anabolic steroid therapy and linked to cardiovascular risk?
- Increase in HDL cholesterol
- Decrease in HDL cholesterol
- Decrease in LDL cholesterol
- Increase in apolipoprotein A1 only
Correct Answer: Decrease in HDL cholesterol
Q11. Chronic supraphysiologic androgen use commonly causes which reproductive adverse effect in men?
- Increased spermatogenesis
- Infertility due to suppressed spermatogenesis
- Hypergonadotropic hypogonadism
- Enhanced testicular size
Correct Answer: Infertility due to suppressed spermatogenesis
Q12. Which drug is a selective 5α‑reductase inhibitor used to treat benign prostatic hyperplasia and male pattern baldness?
- Finasteride
- Flutamide
- Spironolactone
- Ketoconazole
Correct Answer: Finasteride
Q13. Which agent is an androgen receptor antagonist commonly used in prostate cancer therapy?
- Finasteride
- Flutamide
- Anastrozole
- Nandrolone
Correct Answer: Flutamide
Q14. Which laboratory measurement most accurately reflects the biologically active fraction of circulating testosterone?
- Total testosterone
- Free testosterone
- SHBG‑bound testosterone
- Albumin‑bound testosterone
Correct Answer: Free testosterone
Q15. Which parameter is most important to monitor during testosterone therapy to detect erythrocytosis?
- Platelet count
- White blood cell count
- Hematocrit
- Serum ferritin
Correct Answer: Hematocrit
Q16. What is the initial biochemical precursor for steroidogenesis leading to testosterone synthesis?
- Amino acids
- Cholesterol
- Glucose
- Fatty acids
Correct Answer: Cholesterol
Q17. Which pituitary hormone primarily stimulates Leydig cells to synthesize testosterone?
- Luteinizing hormone (LH)
- Follicle‑stimulating hormone (FSH)
- Adrenocorticotropic hormone (ACTH)
- Thyroid‑stimulating hormone (TSH)
Correct Answer: Luteinizing hormone (LH)
Q18. A mutation causing a nonfunctional androgen receptor leads to which clinical condition?
- Klinefelter syndrome
- Androgen insensitivity syndrome
- Turner syndrome
- 5α‑Reductase deficiency
Correct Answer: Androgen insensitivity syndrome
Q19. Deficiency of 5α‑reductase in a genetic male most commonly results in:
- Excessive virilization at birth
- Ambiguous external genitalia with virilization at puberty
- Complete female phenotype with no virilization at puberty
- Primary hypogonadism with high LH and FSH
Correct Answer: Ambiguous external genitalia with virilization at puberty
Q20. Compared with testosterone, dihydrotestosterone (DHT) has:
- Lower affinity for the androgen receptor
- Higher affinity for the androgen receptor
- No affinity for the androgen receptor
- Only non‑genomic effects
Correct Answer: Higher affinity for the androgen receptor
Q21. Which synthetic anabolic steroid is noted for a relatively high anabolic:androgenic ratio and lower virilizing effects?
- Oxandrolone
- Testosterone enanthate
- Methyltestosterone
- Testosterone propionate
Correct Answer: Oxandrolone
Q22. Nandrolone decanoate is primarily used clinically to:
- Treat bacterial infections
- Promote anabolic effects in wasting and cachexia
- Lower testosterone levels in prostate cancer
- Treat hypothyroidism
Correct Answer: Promote anabolic effects in wasting and cachexia
Q23. Which route of testosterone administration typically avoids first‑pass hepatic metabolism and can provide a sustained depot release?
- Oral immediate‑release tablets
- Sublingual tablets
- Intramuscular depot injection of testosterone ester
- Inhalation spray
Correct Answer: Intramuscular depot injection of testosterone ester
Q24. The primary hepatic metabolic pathway for testosterone conjugation and excretion is:
- Sulfation
- Glucuronidation
- Transamination
- Direct renal filtration without conjugation
Correct Answer: Glucuronidation
Q25. Which antifungal agent can suppress testosterone synthesis by inhibiting steroidogenic enzymes and is used in advanced prostate cancer?
- Fluconazole
- Ketoconazole
- Amphotericin B
- Nystatin
Correct Answer: Ketoconazole
Q26. Aromatase inhibitors (e.g., anastrozole) reduce conversion of testosterone to estradiol. Their primary oncologic use is in:
- Pre‑menopausal estrogen receptor‑positive breast cancer
- Post‑menopausal estrogen receptor‑positive breast cancer
- Prostate cancer therapy as first‑line monotherapy
- Testicular cancer
Correct Answer: Post‑menopausal estrogen receptor‑positive breast cancer
Q27. Esterification of testosterone at the 17β‑hydroxyl group primarily results in which pharmacokinetic change?
- Decreased lipophilicity and faster renal excretion
- Increased lipophilicity and prolonged depot release after IM injection
- Enhanced oral bioavailability without hepatotoxicity
- Complete resistance to aromatization
Correct Answer: Increased lipophilicity and prolonged depot release after IM injection
Q28. When collecting a blood sample for basal testosterone measurement, the optimal timing is:
- Late evening (after 10 PM)
- Morning (between 7–10 AM)
- Any random time of day
- Immediately after intense exercise
Correct Answer: Morning (between 7–10 AM)
Q29. The intracellular androgen receptor is primarily located in the cytosol before ligand binding and then:
- Is degraded in the lysosome
- Translocates to the nucleus to modulate gene transcription
- Migrates to the mitochondria to alter ATP production
- Remains permanently cytosolic without DNA interaction
Correct Answer: Translocates to the nucleus to modulate gene transcription
Q30. Which combination strategy has been investigated as a hormonal male contraceptive by suppressing spermatogenesis?
- Exogenous testosterone alone at replacement doses
- GnRH agonist monotherapy
- Exogenous testosterone combined with a progestin
- 5α‑Reductase inhibition alone
Correct Answer: Exogenous testosterone combined with a progestin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
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