Endocrine pharmacology
Practice questions with explanations

A. It stimulates erythropoiesis and can cause polycythaemia, increasing thrombotic risk

Polycythaemia is one of the commonest reasons to reduce or interrupt testosterone therapy, and it is more frequent with injectable than transdermal preparations. Prostate assessment, lipids, blood pressure and symptom response are also monitored, and testosterone is contraindicated in prostate and male breast cancer.

B. Insulin glargine or degludec

Long-acting analogues form microprecipitates or multihexamers at the injection site that release slowly, giving a peakless profile that mimics basal secretion with less nocturnal hypoglycaemia than isophane. Rapid analogues cover meals, neutral insulin has a slower onset requiring administration before eating, and isophane has a definite peak.

D. Suppression of the LH surge and ovulation through negative feedback, with additional effects on cervical mucus and endometrium

Ethinylestradiol with a progestogen suppresses gonadotrophin release, preventing follicular development and the LH surge, while the progestogen thickens cervical mucus and thins the endometrium. Progestogen-only methods rely more on the mucus effect, which is why their timing window matters so much for the traditional preparations.