USMLE Step 1 First Aid: Reproductive
Pharmacology Test Questions with
Correct Answers 2025-2026 Updated.
Leuprolide -- MOA - Answer GnRH analog --
Agonist with pulsatile fashion
Antagonist with continuous use (downregulates GnRH receptor in pituitary --> Decrease FSH
and LH)
Leuprolide -- Use - Answer Infertility (pulsatile)
Prostate cancer (continous with flutamide)
Uterine fibroids (continuous)
Precocious puberty (continuous)
*FIRST LINE* for women w/ severe or refractory endometriosis-related pain (continuous)
(inhibits GnrH --> decrease FSH/LH --> decrease estrogen. the endometrium needs estrogen to
grow (proliferate), so decrease in estrogen --> shrinking of abnormal endometrial tissue)
Leuprolide -- Toxicity - Answer Nausea
Vomiting
Osteoporosis
Pseudomenopause (night sweats, hot flashes)
Estrogens-- Names - Answer Ethinyl estradiol, DES, Mestranol
,3) Menstrual abnormalities
4) Hormone replacement therapy (post menopausal women)
5) Androgen dependent prostate cancer (men)
Estrogens-- AE - Answer 1) Endometrial cancer (when given w/o progesterone)
2) Bleeding in postmenopausal women
3) Clear cell adenocarcinoma of vagina (DES in utero)
4) Thrombi
5) Pancreatitis
6) Cholestatic jaundice
7) Ischemic colitis
8) Invasive breast and ovarian cancer
Contraindication for estrogen therapy - Answer ER+ breast cancer
DVT history
Name the SERMs - Answer Clomiphene
Tamoxifen
Raloxifene
Selective Estrogen Receptor Modulators-- SERMs: Clomiphene-- MOA - Answer Antagonist at
estrogen receptors in hypothalamus
Prevent normal feedback inhibition--> increases AP release of LH and FSH--> ovulation
Selective Estrogen Receptor Modulators-- SERMs: Clomiphene-- Use - Answer Treats
anovulation in PCOS
Selective Estrogen Receptor Modulators-- SERMs: Clomiphene-- Toxicity - Answer Hot flashes
Ovarian enlargement
Multiple simultaneous pregnancies
Visual disturbances
, Selective Estrogen Receptor Modulators-- SERMs: Tamoxifen-- Use - Answer Treat and
prevent recurrence of ER/PR+ breast cancer
Selective Estrogen Receptor Modulators-- SERMs: Tamoxifen-- Toxicity - Answer Endometrial
cancer, thromboembolism
Selective Estrogen Receptor Modulators-- SERMs: Raloxifene-- MOA - Answer Antagonist at
breast/uterus
Agonist on bone-- decrease resorption
Selective Estrogen Receptor Modulators-- SERMs: Raloxifene-- Use - Answer Osteoporosis
Selective Estrogen Receptor Modulators-- SERMs: Raloxifene-- Toxicity - Answer
Thromboembolism
(no increase in endometrial cancer, unlike tamoxifen)
Name the aromatase inhibitors - Answer Anastrozole
Letrozole
Exemestane
Anastrozole/Letrozole/Exemestane-- MOA/CU/AE - Answer Aromatase inhibitor -- inhibit
peripheral conversion of androgens to estrogen
postmenopausal women with ER+ breast cancer
AE =
1) stevens-johnson syndrome
2) cataracts
3) increased risk of endometrial cancer
4) thrombosis
5) leukopenia
6) osteoporosis
Pharmacology Test Questions with
Correct Answers 2025-2026 Updated.
Leuprolide -- MOA - Answer GnRH analog --
Agonist with pulsatile fashion
Antagonist with continuous use (downregulates GnRH receptor in pituitary --> Decrease FSH
and LH)
Leuprolide -- Use - Answer Infertility (pulsatile)
Prostate cancer (continous with flutamide)
Uterine fibroids (continuous)
Precocious puberty (continuous)
*FIRST LINE* for women w/ severe or refractory endometriosis-related pain (continuous)
(inhibits GnrH --> decrease FSH/LH --> decrease estrogen. the endometrium needs estrogen to
grow (proliferate), so decrease in estrogen --> shrinking of abnormal endometrial tissue)
Leuprolide -- Toxicity - Answer Nausea
Vomiting
Osteoporosis
Pseudomenopause (night sweats, hot flashes)
Estrogens-- Names - Answer Ethinyl estradiol, DES, Mestranol
,3) Menstrual abnormalities
4) Hormone replacement therapy (post menopausal women)
5) Androgen dependent prostate cancer (men)
Estrogens-- AE - Answer 1) Endometrial cancer (when given w/o progesterone)
2) Bleeding in postmenopausal women
3) Clear cell adenocarcinoma of vagina (DES in utero)
4) Thrombi
5) Pancreatitis
6) Cholestatic jaundice
7) Ischemic colitis
8) Invasive breast and ovarian cancer
Contraindication for estrogen therapy - Answer ER+ breast cancer
DVT history
Name the SERMs - Answer Clomiphene
Tamoxifen
Raloxifene
Selective Estrogen Receptor Modulators-- SERMs: Clomiphene-- MOA - Answer Antagonist at
estrogen receptors in hypothalamus
Prevent normal feedback inhibition--> increases AP release of LH and FSH--> ovulation
Selective Estrogen Receptor Modulators-- SERMs: Clomiphene-- Use - Answer Treats
anovulation in PCOS
Selective Estrogen Receptor Modulators-- SERMs: Clomiphene-- Toxicity - Answer Hot flashes
Ovarian enlargement
Multiple simultaneous pregnancies
Visual disturbances
, Selective Estrogen Receptor Modulators-- SERMs: Tamoxifen-- Use - Answer Treat and
prevent recurrence of ER/PR+ breast cancer
Selective Estrogen Receptor Modulators-- SERMs: Tamoxifen-- Toxicity - Answer Endometrial
cancer, thromboembolism
Selective Estrogen Receptor Modulators-- SERMs: Raloxifene-- MOA - Answer Antagonist at
breast/uterus
Agonist on bone-- decrease resorption
Selective Estrogen Receptor Modulators-- SERMs: Raloxifene-- Use - Answer Osteoporosis
Selective Estrogen Receptor Modulators-- SERMs: Raloxifene-- Toxicity - Answer
Thromboembolism
(no increase in endometrial cancer, unlike tamoxifen)
Name the aromatase inhibitors - Answer Anastrozole
Letrozole
Exemestane
Anastrozole/Letrozole/Exemestane-- MOA/CU/AE - Answer Aromatase inhibitor -- inhibit
peripheral conversion of androgens to estrogen
postmenopausal women with ER+ breast cancer
AE =
1) stevens-johnson syndrome
2) cataracts
3) increased risk of endometrial cancer
4) thrombosis
5) leukopenia
6) osteoporosis
