A 49-yr-old man who has type 2 diabetes, high blood pressure, hyperlipidemia, and gastroesophageal reflux tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction (ED)?

Correct Answer: C

Rationale: The correct answer is C: Propranolol (Inderal). Propranolol is a beta-blocker commonly used to treat high blood pressure, which can lead to erectile dysfunction (ED) as a side effect by affecting blood flow. The other choices, A: Ranitidine (Zantac) is an H2 blocker used for GERD; B: Atorvastatin (Lipitor) is a statin used to lower cholesterol; and D: Metformin (Glucophage) is an oral antidiabetic agent. These medications are not typically associated with causing ED.

Correct Answer: B

Rationale: The correct answer is B because FSH, or Follicle-Stimulating Hormone, stimulates spermatogenesis in males and oocyte maturation in females. In males, FSH acts on the Sertoli cells in the testes to promote the development of sperm cells. In females, FSH stimulates the growth and maturation of ovarian follicles, leading to the release of mature eggs. Choice A is incorrect because FSH is not primarily responsible for the development of gonads during early development. Choice C is incorrect because FSH does not directly increase the secretion of testosterone by the testes; that is the role of LH (Luteinizing Hormone). Choice D is incorrect because FSH does not regulate the secretion of the bulbourethral gland; that is controlled by other hormones.

Correct Answer: C

Rationale: The correct answer is C: gastrula. During the gastrula stage of embryonic development, the blastula undergoes a process called gastrulation, where the three primary germ layers - ectoderm, mesoderm, and endoderm - are formed. The ectoderm gives rise to the nervous system and skin, the mesoderm forms muscles and organs, and the endoderm develops into the lining of the digestive tract and respiratory system. Morula (A) is an earlier stage where the zygote divides into multiple cells. Blastula (B) is the stage before gastrula where a hollow ball of cells is formed. Neurula (D) is a stage specific to vertebrate embryos where the neural tube begins to form.

Correct Answer: C

Rationale: The correct answer is C: Epithelial hyperplasia. Fibrocytic disease involves nonproliferative and proliferative fibrocystic changes in the breast tissue. Epithelial hyperplasia is a common proliferative change seen in fibrocystic disease, characterized by increased number of epithelial cells in the ducts and lobules. Apocrine metaplasia, choice A, is another common change in fibrocystic disease but is not specific to morphology. Proliferation of ductules, choice B, is not a characteristic feature of fibrocystic disease. Giant cells, choice D, are not typically associated with fibrocystic changes.

Correct Answer: B

Rationale: The correct answer is B: Increased size of the uterus. In a 72-year-old woman, an increased size of the uterus can indicate potential issues such as fibroids or endometrial hyperplasia, which may require further investigation. Thinning of pubic hair (A) is a common age-related change. Decreased size of the clitoris (C) and loss of tone of the pelvic ligaments (D) can also occur with aging but are not typically concerning findings during a routine physical exam in this age group.