Reproduction: oestrogen-androgen balance in men: practice question

A Physiology 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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Physiology · Reproduction: oestrogen-androgen balance in men

Sample item

A 55-year-old man with alcoholic cirrhosis develops gynaecomastia, testicular atrophy and loss of body hair. Which hormonal mechanism contributes?

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

The answer and the reasoning

A. Reduced hepatic oestrogen clearance with more peripheral aromatisation of androgens

In cirrhosis the liver clears oestrogens poorly and more androgen is aromatised to oestrogen in peripheral tissue, raising the oestrogen to androgen ratio. This causes breast tissue growth, while testicular function and body hair decline.

Option by option

  • A. Reduced hepatic oestrogen clearance with more peripheral aromatisation of androgens (correct)

    Correct. Poor hepatic clearance and more aromatisation shift the balance towards oestrogen.

  • B. Increased conversion of oestrogen to androgens in the liver

    The liver does not convert oestrogen to androgens, so this would not occur.

  • C. Failure of oestrogen production by adipose tissue

    Adipose tissue is a source of oestrogen through aromatase and this is not lost.

  • D. Increased testosterone secretion by Leydig cells

    Testicular failure lowers testosterone, so Leydig cell output does not rise.

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 Physiology question

What is the answer to this Physiology question?

The best answer is A, Reduced hepatic oestrogen clearance with more peripheral aromatisation of androgens. In cirrhosis the liver clears oestrogens poorly and more androgen is aromatised to oestrogen in peripheral tissue, raising the oestrogen to androgen ratio.

Why is "Increased conversion of oestrogen to androgens in the liver" not the answer?

The liver does not convert oestrogen to androgens, so this would not occur.

Why is "Failure of oestrogen production by adipose tissue" not the answer?

Adipose tissue is a source of oestrogen through aromatase and this is not lost.

Why is "Increased testosterone secretion by Leydig cells" not the answer?

Testicular failure lowers testosterone, so Leydig cell output does not rise.

What concept does this question test?

It tests Reproduction: oestrogen-androgen balance in men in Physiology. This causes breast tissue growth, while testicular function and body hair decline.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Reproduction: oestrogen-androgen balance in men?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.