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NBME 17 Answers

nbme17/Block 4/Question#16 (reveal difficulty score)
A 32-year-old man comes to the physician ...
Tissue: Testicle; Effect: Estradiol production ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—breis(56)
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HCG injections down regulate the pituitary release of GnRH.

however HCG alpha subunit can stimulate cells influenced by LH, FSH, TSH.

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cassdawg  (FA2020 p633) - Basically HCG acts like FSH which stimulates estradiol production by the sertoli cells (see http://www.ansci.wisc.edu/jjp1/equine/male_endo/estrpath.html). There is no feedback inhibition since it is injected so there are elevated levels of estradiol causing gynecomastia. +15
j44n  also FSH upregs aromatase so you increase test (LH) and increase aromatase (FSH) that then converts that test to estradiol +1



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