Your 20 year old male patient is c/o growths on his penile shaft. He noticed them first about 6 weeks ago, and he thinks there are more now. Denies pain with intercourse or urination. He has had 3 former partners and has been with his current girlfriend for 6 months. She is on the pill so they do not use condoms. Denies fever, weight loss, night sweats. His PMH is unremarkable. He is in college part time and works in construction and is engaged to be married and has no children. On exam, you see several moist papules along all sides of the penile shaft and two on the corona. He has been circumcised. On palpation of his inguinal region there is no inguinal lymphadenopathy. Which abnormality of the penis does this patient most likely have?

Correct Answer: A

Rationale: The correct answer is A: Condylomata acuminata (genital warts) based on the patient's presentation of painless moist papules on the penile shaft and corona, multiple sexual partners, lack of other systemic symptoms, and absence of inguinal lymphadenopathy. This is consistent with HPV infection, the most likely cause of genital warts. Genital herpes (B) typically presents as painful vesicles or ulcers, syphilitic chancre (C) presents as a painless ulcer, and penile carcinoma (D) usually presents as a solitary, indurated, ulcerated lesion with associated lymphadenopathy.

Correct Answer: B

Rationale: The correct answer is B because a surge of luteinizing hormone (LH) is necessary for ovulation to occur, typically happening 24-36 hours before ovulation. This surge triggers the release of the mature egg from the ovarian follicle. Choices A, C, and D are incorrect as estrogen levels peak just before ovulation, the corpus luteum forms after ovulation, and progesterone levels rise after ovulation, not fall immediately after the LH surge.

Correct Answer: A

Rationale: The correct answer is A: Fetal hypoxia during the birth process. Fetal hypoxia, which is a lack of oxygen to the fetus during birth, can lead to delayed breathing in newborn infants. This lack of oxygen can result from various factors such as umbilical cord compression or placental insufficiency. Maternal hypoxia (choice B) and hypercapnia (choices C and D) may affect the fetus indirectly but are not direct causes of delayed breathing in newborns. Therefore, the correct choice is A, as it directly addresses the specific cause of delayed breathing in newborn infants.

Correct Answer: C

Rationale: The correct answer is C because high levels of androgen compounds inhibit the secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus. GnRH is responsible for stimulating the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the anterior pituitary gland. LH and FSH are crucial for proper testicular function, including sperm production. When the secretion of GnRH is inhibited by high levels of androgens, it leads to a decrease in LH and FSH levels, ultimately disrupting the normal feedback loop of the hypothalamic-pituitary-gonadal axis. This disruption results in impaired sperm production and fertility. Choice A is incorrect because overstimulation of inhibin formation does not directly lead to sterility. Choice B is incorrect because overstimulation of sperm cell production would not result in the formation of defective sperm cells leading to sterility. Choice D is incorrect because hypert

Correct Answer: A

Rationale: Step 1: Testosterone plays a crucial role in maintaining bone density. Step 2: Estrogen helps regulate bone turnover and calcium balance. Step 3: Women experience a significant drop in estrogen levels after menopause. Step 4: Decreased estrogen production leads to increased bone resorption. Step 5: Men, on the other hand, continue to produce testosterone throughout their lifetime, which helps maintain bone density. Summary: A is correct because men maintain testosterone production, while women cease estrogen production after menopause, leading to a higher risk of osteoporosis in elderly women. B, C, and D are incorrect as they do not address the hormonal changes that contribute to osteoporosis gender disparity.