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A 24-Year-Old Man Is Brought to the Emergency Department by His

question 50

Multiple Choice

A 24-year-old man is brought to the emergency department by his wife after he began threatening her at home. She reports that he has been increasingly irritable and abusive over the last several months and becomes angry for no clear reason. He was recently involved in a fist fight at work. His wife also adds that they have been unsuccessful in their attempts to conceive over the past 2 years. The husband states that there is nothing wrong. He is otherwise healthy and exercises frequently. The patient reports occasional alcohol use and past marijuana use. On examination, blood pressure is 148/92 mm Hg and pulse is 102/min; he has a receding hairline. There is palpable tissue underneath his nipples bilaterally. Heart and lung examinations are normal. Which of the following substances most likely explains the patient's symptoms and findings?

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