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|SubCategory=Reproductive
|SubCategory=Reproductive
|Prompt=A 61-year-old male comes to the clinic due to hair loss.  He has a progressive history of baldness.  He has tried many topical ointments and different products seen on TV, which have not been very helpful.  He would like to look younger and to prevent losing further hair.  The family doctor considers using Finasteride to treat his condition.  Which of the following is true about the mechanism of action of this drug?
|Prompt=A 61-year-old male comes to the clinic due to hair loss.  He has a progressive history of baldness.  He has tried many topical ointments and different products seen on TV, which have not been very helpful.  He would like to look younger and to prevent losing further hair.  The family doctor considers using Finasteride to treat his condition.  Which of the following is true about the mechanism of action of this drug?
|Explanation=Finasteride is used for BPH (benigh prostatic hyperplasia) and to treat male-pattern baldness,because it promotes hair growth. It is an 5 alfa-reductase inhibitor (normally converts testosterone to DHT), decreasing the conversion of testosterone to DHT (dihydrotestosterone).
|Explanation=Finasteride is used for [[BPH]] (benigh prostatic hyperplasia) and to treat male-pattern baldness,because it promotes hair growth. It is an 5 alfa-reductase inhibitor (normally converts [[testosterone]] to [[DHT]]), decreasing the conversion of testosterone to DHT (dihydrotestosterone).
|AnswerA=It is a non-steroidal competitive inhibitor of androgens at the testosterone receptor
|AnswerA=It is a non-steroidal competitive inhibitor of androgens at the testosterone receptor
|AnswerAExp=<font color="red">'''Incorrect.'''</font> It is incorrect because
|AnswerAExp=<font color="red">'''Incorrect.'''</font>This refers to the mechanism of action of [[flutamide]] which is used in [[prostatic carcinoma]].
|AnswerB=Inhibits the synthesis of steroid
|AnswerB=Inhibits the synthesis of steroid
|AnswerBExp=<font color="red">'''Incorrect.'''</font> It is incorrect because
|AnswerBExp=<font color="red">'''Incorrect.'''</font> [[Ketoconazole]] inhibits steroid synthesis by inhibiting desmolase (normally converts cholesterol to [[pregnenolone]]). ACTH stimulates the activity of desmolase.
|AnswerC=Inhibits the conversion of testosterone to DHT
|AnswerC=Inhibits the conversion of testosterone to DHT
|AnswerCExp=<font color="Green">'''Correct.'''</font> It is incorrect because
|AnswerCExp=<font color="Green">'''Correct.'''</font> It is incorrect because
|AnswerD=Inhibits steroid binding
|AnswerD=Inhibits steroid binding
|AnswerDExp=<font color="red">'''Incorrect.'''</font>  This patient is presenting with:
|AnswerDExp=<font color="red">'''Incorrect.'''</font> [[ Spironolactone]] inhibits the androgen binding to its receptors. It is a potasium sparing diuretic. [[Flutamide]] and cyproterone also inhibit the androgen-receptor interaction.
|AnswerE=Binds to estrogen receptors
|AnswerE=Binds to estrogen receptors
|AnswerEExp=<font color="red">'''Incorrect.'''</font>  It is incorrect because
|AnswerEExp=<font color="red">'''Incorrect.'''</font>  [[Estrogens]] such as ethinyl estradiol, DES, mestranol bind to estrogen receptors, acting as agonists. Estrogen receptor antagonists include [[tamoxifen]], [[raloxifene]] and [[fulvestrant]].
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=Testosterone agonist, testosterone antagonist
|WBRKeyword=Testosterone agonist, testosterone antagonist
|Approved=No
|Approved=No
}}
}}

Revision as of 15:32, 25 September 2013

 
Author [[PageAuthor::Gonzalo A. Romero, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pharmacology
Sub Category SubCategory::Reproductive
Prompt [[Prompt::A 61-year-old male comes to the clinic due to hair loss. He has a progressive history of baldness. He has tried many topical ointments and different products seen on TV, which have not been very helpful. He would like to look younger and to prevent losing further hair. The family doctor considers using Finasteride to treat his condition. Which of the following is true about the mechanism of action of this drug?]]
Answer A AnswerA::It is a non-steroidal competitive inhibitor of androgens at the testosterone receptor
Answer A Explanation [[AnswerAExp::Incorrect.This refers to the mechanism of action of flutamide which is used in prostatic carcinoma.]]
Answer B AnswerB::Inhibits the synthesis of steroid
Answer B Explanation [[AnswerBExp::Incorrect. Ketoconazole inhibits steroid synthesis by inhibiting desmolase (normally converts cholesterol to pregnenolone). ACTH stimulates the activity of desmolase.]]
Answer C AnswerC::Inhibits the conversion of testosterone to DHT
Answer C Explanation [[AnswerCExp::Correct. It is incorrect because]]
Answer D AnswerD::Inhibits steroid binding
Answer D Explanation [[AnswerDExp::Incorrect. Spironolactone inhibits the androgen binding to its receptors. It is a potasium sparing diuretic. Flutamide and cyproterone also inhibit the androgen-receptor interaction.]]
Answer E AnswerE::Binds to estrogen receptors
Answer E Explanation [[AnswerEExp::Incorrect. Estrogens such as ethinyl estradiol, DES, mestranol bind to estrogen receptors, acting as agonists. Estrogen receptor antagonists include tamoxifen, raloxifene and fulvestrant.]]
Right Answer RightAnswer::C
Explanation [[Explanation::Finasteride is used for BPH (benigh prostatic hyperplasia) and to treat male-pattern baldness,because it promotes hair growth. It is an 5 alfa-reductase inhibitor (normally converts testosterone to DHT), decreasing the conversion of testosterone to DHT (dihydrotestosterone).

Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Testosterone agonist, WBRKeyword::testosterone antagonist
Linked Question Linked::
Order in Linked Questions LinkedOrder::