Breast and endocrine surgery: aromatase inhibitors in premenopausal women: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Breast and endocrine surgery: aromatase inhibitors in premenopausal women

Sample item

Why are aromatase inhibitors alone ineffective as adjuvant endocrine therapy in a woman with intact ovarian function?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Loss of oestrogen feedback raises gonadotrophins and ovarian oestrogen output

In premenopausal women, aromatase inhibitors reduce oestrogen, which removes negative feedback on the pituitary. Rising FSH and LH then stimulate the ovaries to make more oestrogen, overcoming the block. They are used only after menopause or with ovarian suppression.

Option by option

  • A. They block progesterone receptors only

    Aromatase inhibitors block oestrogen synthesis, not progesterone receptors.

  • B. Loss of oestrogen feedback raises gonadotrophins and ovarian oestrogen output (correct)

    Correct. The feedback loop restores ovarian oestrogen production.

  • C. Ovarian tissue does not express aromatase

    Ovarian granulosa cells do express aromatase, which is why suppression is needed.

  • D. They are inactivated by hepatic enzymes in young women

    Hepatic inactivation does not explain the poor response.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Loss of oestrogen feedback raises gonadotrophins and ovarian oestrogen output. In premenopausal women, aromatase inhibitors reduce oestrogen, which removes negative feedback on the pituitary.

Why is "They block progesterone receptors only" not the answer?

Aromatase inhibitors block oestrogen synthesis, not progesterone receptors.

Why is "Ovarian tissue does not express aromatase" not the answer?

Ovarian granulosa cells do express aromatase, which is why suppression is needed.

Why is "They are inactivated by hepatic enzymes in young women" not the answer?

Hepatic inactivation does not explain the poor response.

What concept does this question test?

It tests Breast and endocrine surgery: aromatase inhibitors in premenopausal women in General Surgery. Rising FSH and LH then stimulate the ovaries to make more oestrogen, overcoming the block. They are used only after menopause or with ovarian suppression.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Breast and endocrine surgery: aromatase inhibitors in premenopausal women?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.