This set of Molecular Endocrinology Multiple Choice Questions & Answers (MCQs) focuses on “Disorders of the Female Reproductive System – Set 2”.
1. Which among the following is the most common androgen blocker used for the treatment of hirsutism in the United States?
a) Spironolactone
b) Cyproterone Acetate
c) Finasteride
d) Flutamide
View Answer
Explanation: Spironolactone, an aldosterone antagonist structurally similar to progestins, is the most common androgen blocker used to treat hirsutism in the United States. Spironolactone is useful for PCOS or idiopathic hirsutism-related irregular hair growth.
2. Which among the following treatment options of hirsutism has the strong progestagenic properties?
a) Spironolactone
b) Cyproterone Acetate
c) Finasteride
d) Flutamide
View Answer
Explanation: Cyproterone acetate has strong progestagenic properties and is a 17-hydroxyprogesterone acetate derivative. By fighting with DHT and testosterone for attachment to the androgen receptor, cyproterone acetate serves as an antiandrogen.
3. Which among the following treatment options of hirsutism inhibits 5α-reductase activity?
a) Spironolactone
b) Cyproterone Acetate
c) Finasteride
d) Flutamide
View Answer
Explanation: 5 α-reductase activity is inhibited by Finasteride. A substantial change in hirsutism after 6 months of therapy without significant side effects has been observed at a dosage of 5 mg/day. The reduction in circulating DHT levels in hirsute females is minimal and cannot be used to track therapy.
4. Finasteride has been used mainly for prostatic hyperplasia therapy.
a) True
b) False
View Answer
Explanation: Finasteride has been used primarily to treat prostatic hyperplasia. It can also be used to treat hirsutism. Finasteride inhibits type 2 of 5 α-reductase activity. By blocking the body’s development of a male hormone that causes the prostate to swell, Finasteride treats BPH.
5. Finasteride primarily inhibits 5α-reductase type 1.
a) True
b) False
View Answer
Explanation: Finasteride mainly inhibits type 2 of 5-α-reductase. Since hirsutism results from type 1 and type 2 combined effects, this agent is only partially successful. While prolonged experience with finasteride is lacking, its benign side effect profile is one of the potential advantages of this agent.
6. Which among the following treatment options of hirsutism is a potent antiandrogen used in the treatment of prostate cancer?
a) Spironolactone
b) Cyproterone Acetate
c) Finasteride
d) Flutamide
View Answer
Explanation: Flutamide is a potent antiandrogen used in prostate cancer treatment. In the treatment of hirsutism, it has been shown to be effective. The average Ferriman-Gallwey score of this is reduced by 41.3%.
7. Which among the following treatment options of hirsutism significantly reduces hirsutism as assessed by the Ferriman-Gallwey scoring system?
a) Metformin
b) Thiazolidinediones
c) Finasteride
d) Cyproterone Acetate
View Answer
Explanation: As measured by the Ferriman-Gallwey rating system, metformin (1500 to 2700 mg/day) for 6 months substantially decreases hirsutism. Many studies have shown small decreases in hirsutism ratings (average, 19.1 percent).
8. Which among the following treatment options of hirsutism specifically reduced Ferriman-Gallwey scores significantly?
a) Metformin
b) Thiazolidinediones
c) Finasteride
d) Cyproterone Acetate
View Answer
Explanation: Thiazolidinediones (4 mg/day of pioglitazone or 30 mg/day of pioglitazone) significantly decreased Ferriman-Gallwey levels. These studies indicated that insulin sensitizing agents, especially in women who do not wish to use other oral agents, could be used in the treatment of hirsutism.
9. What was the older name of Polycystic Ovary Syndrome?
a) Stein-Leventhal syndrome
b) Gilbert Syndrome
c) Lesh Nyhan’s Syndrome
d) Klein’s Syndrome
View Answer
Explanation: Polycystic Ovary Syndrome was primarily known as Stein-Leventhal syndrome. A primary ovarian deficiency was inferred on the basis of Stein and Leventhal’s work, and the condition was generally referred to as polycystic ovarian disease. After ovarian wedge resection, most of their patients resumed menstruation and achieved pregnancy.
10. Which among the following hormones, is a potential regulator of LH secretion in PCOS?
a) Glucagon
b) Insulin
c) Ghrelin
d) Thyrotropin
View Answer
Explanation: As a potential regulator of LH secretion in PCOS, insulin has been found to be involved. Insulin improves the LH-β gene transcription (LHB). An in vivo human study showing that insulin infusion suppresses pituitary response to GnRH in normal women and in women with PCOS supported this laboratory observation.
11. Which among the following act as a precursor that must be converted to estradiol to exert full estrogenic action?
a) Estrone
b) Estradiol
c) Androstenedione
d) Progesterone
View Answer
Explanation: Estrone is not a potent estrogen, but in order to exert complete estrogenic action, it can be used as a precursor that must be converted to estradiol. In peripheral (extraovarian) tissues, the presence of a number of reductive 17β-HSD isoenzymes with overlapping activities that catalyze the conversion of estrone to estradiol is partly responsible for maintaining the development of estradiol in women with PCOS.
12. Which is the most strikingly elevated steroid in PCOS in the ovary?
a) Androstenedione
b) Progesterone
c) Estradiol
d) Estrogen
View Answer
Explanation: The most remarkably elevated steroid in PCOS is Androstenedione of ovarian origin. Androstenedione is not biologically active but acts as a dual precursor for androgen (i.e., testosterone that is further converted to the biologically much stronger androgen DHT) and estrogen (i.e., estrone that is further converted to biologically active estradiol in target tissues).
13. Which among the following disease is the severe variant of Polycystic Ovarian Syndrome?
a) Ovarian hyperthecosis
b) Endometriosis
c) Ovarian Polynema
d) Ovarian craningoma
View Answer
Explanation: A extreme variant of PCOS is ovarian hyperthecosis. The term refers to substantially increased stromal tissue spread throughout large sheets of fibroblast-like cells with luteinized theca-like cells. Another PCOS-related condition that most often occurs in the perimenopausal period is ovarian hyperthecosis.
14. What is an exaggerated version of the process that gives rise to chronic anovulation in PCOS?
a) Hyperthecosis
b) Chroniconemia
c) Hypocognatorea
d) Leptonuria
View Answer
Explanation: Hyperthecosis appears to be an exaggerated version of the same process, giving rise to PCOS chronic anovulation. The intensity of hyperthecosis correlates with the degree of resistance to insulin. Hyperthecosis happens when, along with stromal hyperplasia, an area of luteinization occurs.
15. Which among the following is an example of a genomic loci that have been proposed to account for the PCOS phenotype?
a) CYP11A1
b) Bcl2
c) SNF3
d) Rhoder gene
View Answer
Explanation: In order to account for the PCOS phenotype, multiple genomic loci have been suggested. These include CYP11A1, the insulin gene, and the Follistatin gene, but no convincing evidence has been reported for any of these loci.
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