Substance use: anabolic steroid misuse: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: anabolic steroid misuse

Sample item

A 26-year-old bodybuilder has become irritable and aggressive. Examination shows severe acne, small testes, gynaecomastia and a low sperm count. Which substance is he most likely misusing?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Anabolic androgenic steroids

Misuse of anabolic androgenic steroids causes mood lability, aggression ('roid rage'), mania or depression on withdrawal, and suppression of the hypothalamic-pituitary-gonadal axis with testicular atrophy, oligospermia, gynaecomastia and acne.

Option by option

  • A. Cannabis

    Cannabis intoxication causes red eyes, tachycardia and increased appetite, and does not explain the acne and testicular atrophy.

  • B. Cocaine

    Cocaine causes sympathetic overactivity and cardiac effects and does not cause hypogonadism.

  • C. Anabolic androgenic steroids (correct)

    Correct. Testicular atrophy, gynaecomastia and aggression point to anabolic steroids.

  • D. Amphetamine

    Amphetamine causes weight loss, insomnia and psychosis but not testicular atrophy or gynaecomastia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Anabolic androgenic steroids. Misuse of anabolic androgenic steroids causes mood lability, aggression ('roid rage'), mania or depression on withdrawal, and suppression of the hypothalamic-pituitary-gonadal axis with testicular atrophy, oligospermia, gynaecomastia and acne.

Why is "Cannabis" not the answer?

Cannabis intoxication causes red eyes, tachycardia and increased appetite, and does not explain the acne and testicular atrophy.

Why is "Cocaine" not the answer?

Cocaine causes sympathetic overactivity and cardiac effects and does not cause hypogonadism.

Why is "Amphetamine" not the answer?

Amphetamine causes weight loss, insomnia and psychosis but not testicular atrophy or gynaecomastia.

What concept does this question test?

It tests Substance use: anabolic steroid misuse in Psychiatry. The correct option holds because: Correct. Testicular atrophy, gynaecomastia and aggression point to anabolic steroids.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: anabolic steroid misuse?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.