USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

Which condition may lead to hypogonadotropic hypogonadism in males?

1. Mullerian Duct Abnormalities

2. Primary hypogonadism due to Leydig cell dysfunction

3. Primary hypogonadism due to Leydig cell + seminiferous tubule dysfunction

4. Secondary hypogonadism

The correct answer is: Secondary hypogonadism

Hypogonadotropic hypogonadism in males is characterized by low levels of testosterone due to insufficient stimulation from gonadotropins (FSH and LH), which are produced by the pituitary gland. This condition represents a failure of the hypothalamus or pituitary gland rather than a problem with the testes themselves. The correct choice is associated with secondary hypogonadism, which directly implies that the issue lies within the hypothalamus or pituitary gland. Conditions that can lead to secondary hypogonadism include pituitary tumors, hypothalamic disorders, stress, obesity, and other health issues that impair the normal function of gonadotropin-releasing hormone (GnRH) or pituitary hormone production. As a result, the testes are not adequately stimulated to produce testosterone, leading to hypogonadotropic hypogonadism. The other conditions mentioned primarily involve direct testicular dysfunction or anatomical abnormalities. For example, Mullerian duct abnormalities typically pertain to developmental issues affecting the reproductive tract but do not directly alter pituitary function or lead to hypogonadotropic conditions. Primary hypogonadism conditions, whether due to Leydig cell dysfunction or combined with seminiferous tubule dysfunction, indicate that the testes are the source of the