Androgens come in oral, injectable, implantable, and topical preparations. Because of the toxicity of the oral preparations and the inconvenience of the injectable forms, the transdermal gels have been a major clinical advance for treatment of hypogonadal males.

^ Study Questions

1. The serum level of testosterone in males from adolescence through the fifth decade of life is a primarily a consequence of

(A) A relatively constant level of testicular testosterone production

(B) A significant decline in testosterone production

(C) A decline in the metabolic clearance rate of testosterone

(D) An increase in the metabolic clearance rate of testosterone

(E) A sharp drop in urinary 17-ketosteroid levels 2. Which of the following is mostly likely to be found in a male who lacks functional 5a-reductase?

(A) Depressed serum levels of testosterone

(B) Elevated serum levels of dihydrotestosterone

(C) Highly depressed protein anabolic activity in skeletal muscle, bone, and kidney

(D) Elevated serum levels of testosterone with subnormal prostatic function

(E) Decreased binding of testosterone to sex hormone-binding globulin in the serum

3. The formation of what as a principal precursor of testosterone is considered the biosynthetic rate-limiting step?

(A) Pregnenolone

(B) Cholesterol

(C) Androstenediol

(D) Estrogen

(E) Progesterone

4. Normal skeletal muscle cells

(A) Typically lack androgen receptors and thus are not affected by high concentrations of testosterone

(B) Respond more readily to dihydrotestosterone than to testosterone

(C) Have higher levels of 5a-reductase than do prostatic tissue cells

(D) Use the androgen receptor to enhance protein anabolic activity

(E) Produce testosterone in response to FSH stimuli

5. Upon examination, a 68-year-old married man was found to have a greatly enlarged prostate. Which one of the following drugs is most likely to suppress prostatic growth without affecting libido?

(A) Spironolactone

(B) Finasteride

(C) Ketoconazole

(D) Flutamide

(E) Stanozolol

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