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SECTION 1: Male Reproductive Anatomy & Physiology (Q1-Q10)
Q1: Testosterone is primarily produced by which cells in the testes?
A. Sertoli cells
B. Seminiferous tubules
C. Leydig cells [CORRECT]
D. Epididymal epithelium
Correct Answer: C
Rationale: Testosterone is primarily produced by Leydig cells in the interstitium of the
testes under LH stimulation. Sertoli cells support spermatogenesis and produce inhibin,
while seminiferous tubules contain germ cells but do not produce testosterone.
Q2: Which hormone directly stimulates Leydig cells to produce testosterone?
A. FSH
B. GnRH
C. LH [CORRECT]
D. Prolactin
Correct Answer: C
Rationale: Luteinizing hormone (LH) directly stimulates Leydig cells to produce
testosterone. FSH stimulates Sertoli cells for spermatogenesis, and GnRH from the
hypothalamus stimulates LH and FSH release from the pituitary.
Q3: A 28-year-old male has a vasectomy. Which structure is responsible for transporting
sperm from the epididymis to the ejaculatory duct?
A. Vas deferens [CORRECT]
B. Seminiferous tubules
C. Urethra
D. Ejaculatory duct
Correct Answer: A
,Rationale: The vas deferens transports sperm from the epididymis to the ejaculatory
duct during ejaculation. A vasectomy interrupts this tube to achieve contraception. The
epididymis stores sperm but does not transport it to the urethra.
Q4: Which hormone is primarily responsible for stimulating spermatogenesis in Sertoli
cells?
A. LH
B. FSH [CORRECT]
C. Testosterone
D. GnRH
Correct Answer: B
Rationale: FSH stimulates Sertoli cells to support spermatogenesis and produce inhibin.
LH stimulates testosterone production from Leydig cells, and testosterone further
supports germ cell development. GnRH acts on the pituitary, not directly on Sertoli cells.
Q5: Which gland contributes fructose to semen, providing energy for sperm motility?
A. Seminal vesicles [CORRECT]
B. Prostate gland
C. Bulbourethral glands
D. Cowper's glands
Correct Answer: A
Rationale: Seminal vesicles produce fructose-rich fluid comprising approximately 60%
of semen volume. The prostate contributes milky fluid, and bulbourethral glands
produce pre-ejaculate. Fructose provides the primary energy source for sperm motility.
Q6: A 35-year-old male has Kallmann syndrome. Which hormone pattern would be
expected?
A. High GnRH, high LH, high FSH, high testosterone
B. Low GnRH, high LH, high FSH, low testosterone
C. High GnRH, low LH, low FSH, low testosterone
D. Low GnRH, low LH, low FSH, low testosterone [CORRECT]
Correct Answer: D
Rationale: Kallmann syndrome involves defective GnRH neuronal migration, resulting in
isolated hypogonadotropic hypogonadism. This produces low GnRH, low LH, low FSH,
and low testosterone. Primary testicular failure would show elevated LH and FSH.
, Q7: A 45-year-old male has low testosterone, low LH, and low FSH. MRI shows a
pituitary mass. Which condition best explains this finding?
A. Primary hypogonadism
B. Secondary hypogonadism [CORRECT]
C. Tertiary hypogonadism
D. Testicular failure
Correct Answer: B
Rationale: A pituitary mass causes secondary hypogonadism by impairing LH and FSH
secretion. Primary hypogonadism and testicular failure would show elevated LH and
FSH. Tertiary hypogonadism (hypothalamic) is less common and would show low
GnRH.
Q8: A patient with hemochromatosis presents with hypogonadism. Which mechanism is
most likely responsible?
A. Testicular iron deposition causing primary failure
B. Pituitary iron deposition causing secondary failure [CORRECT]
C. Liver dysfunction causing hormonal imbalance
D. Adrenal iron deposition
Correct Answer: B
Rationale: Hemochromatosis causes iron deposition in pituitary gonadotrophs, leading
to secondary hypogonadism with low LH, FSH, and testosterone. While testicular iron
deposition can occur, hypothalamic-pituitary dysfunction is the predominant
mechanism.
Q9: A 60-year-old male has elevated SHBG and normal total testosterone. Which clinical
finding is most likely?
A. Increased free testosterone
B. Normal free testosterone
C. Increased estrogen
D. Decreased free testosterone [CORRECT]
Correct Answer: D
Rationale: SHBG binds testosterone in circulation; elevated SHBG increases binding
capacity and reduces free testosterone levels. Free testosterone is the biologically
active form. Aging, liver disease, and hyperthyroidism can increase SHBG.