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Disorders of Sex development
combined male and female problems in phys that mess up gender (end of male and female packets)
58
Physiology
Undergraduate 4
05/17/2011

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Term
atypical
Definition
is development of chromosomal, gonadal, or anatomical sex typical, or atypical?
Term
1/100 live births
Definition
how many people develop some type of gonadal dysgenesis, ambiguous genetalia, genital malformations, or sex reversal?
Term
Kallman's syndrome (type of hypogonadism)
Definition
what disorder is characterized by an armspan exceeding their height, a straight hairline, and high pitched voice?
Term
1 in 500 males, clinical presentation is 1 in 1000 males
Definition
what is the incidence of Klinefelter's syndrome?
Term
Klinefelter's syndrome
Definition
what disorder is characterized by 47 XXY?
Term
Klinefelter's syndrome, caused by a meiotic non-disjunction event
Definition
what is the most common sex chromosome disorder? what even causes this?
Term
Klinefelter's syndrome
Definition
this disorder results in a male phenotype 100% of the time, small testes 100% of the time, and normal/tall stature with eunuchoidal proportions(reduced muscle development) 100% of the time?
Term
reduced virilization and gynecomastia
Definition
what do people with Klinefelter's get at puberty 70% of the time?
Term
Testosterone replacement therapy
Definition
what is prescribed for Klinefelter's patients at puberty?
Term
reduced fertility
Definition
does Klinefelters result in reduced or no fertility?
Term
hypogonadism
Definition
what class of disorders results when there is non-functional fetal testes or absence of androgen receptors in the target cells?
Term
pre: androgenous or infantile sex char (eunuchism) = tall, skinny, straight hair line

post pubertal: regression of organs and voice, lost of secondary body hair, decreased muscle and bone mass, decreased erection and sexual desire (regress slower post pubertal)
Definition
what happens if you lose your testes prior to puberty vs post pubertal?
Term
Androgen insensitivity Syndrome (AIS)
Definition
what disorder is also known as testicular feminization?
Term
AIS
Definition
what sex disorder has a 46 XY karyotype?
Term
female
Definition
in CAIS, what kind of genitalia is typical?
Term
male or female predominantly, or ambiguous genetalia
Definition
in PAIS, what kind of genitalia is typical?
Term
male genetalia
Definition
in MAIS, what kind of genitalia is typical?
Term
gonadectomy of testes, followed by estrogen replacement
Definition
how is CAIS treated?
Term
female: treat same as CAIS (gonadectomy + estrogen therapy)

male/ambiguous: sex assignment surgery
Definition
how is PAIS treated?
Term
mammoplasty for gynecomastia, testosterone
Definition
hose is MAIS treated?
Term
5 alpha reductase deficiency
Definition
what disease only affects genetic males, and often causes males to identify as females?
Term
yes, they can produce viable sperm
Definition
are people with 5 alpha reductase deficiency fertile?
Term
yes
Definition
are AIS patients infertile?
Term
juevodoces = 5 alpha reductase deficiency
Definition
what disease happens commonly in the Domincan republic that causes females to turn male?
Term
autosomal recessive (NOT carried on sex chromosome)
Definition
is 5 alpha reductase deficiency dominant or recessive?
Term
DHT
Definition
what causes prostatic hypertrophy?
Term
age 50
Definition
after what age is BPH and adenomatous hyperplasia common?
Term
age 80
Definition
by what age do almost all men have cancer cells in their prostate?
Term
adenoma, adenocarcinoma
Definition
what are tumors of the prostate that sometimes develop and frequently metastasize
Term
castration, radiation therapy, or chemical castration

(can give estrogen to decrease androgens)
Definition
how do you treat prostate cancer?
Term
1/2500 live births, 98% miscarry
Definition
how common is Turner's syndrome?
Term
Turner's syndrome
Definition
what disorder is associated with 45 XO genotype?
Term
Turner's syndrome
Definition
short stature, webbed neck, and delayed puberty are associated with what sex development disorder?
Term
Turner's syndrome
Definition
what causes a dysmorphic streak ovaries(non-functional), amenorrhea, and infertility?
Term
estrogen replacement therapy to induce puberty, and then estrogen plus progesterone
Definition
what is done to treat Turner's syndrome?
Term
1) broad chest, wide spaced nipples, short, webbed neck
2) low set ears and micrognathia
3) coartation of the aorta and aortic stenosis
4) renal abnormalities such as horseshoe kidney
5) edema
6) musculoskeletal issues such as cubitus valagas(deformed, divergent elbows), short 4th metacarpal, genu valgas(knock knees)
7) sensorineural deafness, recurrent otitis media
8) increased incident of grave's disease(hyperthyroidism)
Definition
list some of the dismorphic features of turner's syndrome
Term
female
Definition
what sex do turner's syndrome patients appear as?
Term
CAH
Definition
what is the most common cause of ambiguous genitalia?
Term
Congenital Adrenal Hyperplasia
Definition
aka adrenal steroid 21-hydroxylase deficiency
Term
they are given glucocorticoids to help balance out the body and prevent the overproduction of ACTH trying to correct this
Definition
what is the treatment of CAH?
Term
both boys and girls, girls more severe
boys: early puberty and small testes
girls: normal ovaries, uterus, and oviducts, ambiguous genitalia
Definition
what sexes are affected by CAH? how?
Term
CAH
Definition
what disorder is an acute life threatening crisis in neonates?
Term
Polycystic Ovary syndrome (PCOS)
Definition
associated with obesitity and anovulation (increased virilization) follicles grow and produces a lot of androgens (androgen excess disorder)
Term
PCOS
Definition
most common endocrine cause of anovulatory infertility
Term
PCOS
Definition
characterized by variable combinations of menstrual irrecularity, chronic anovulation, hirsutism or acne, and obesity
Term
hyper-insulinemia (many have diabetes mellitus), which stimulates androgen production in the ovaries and adrenal glands.
Definition
what drives PCOS?
Term
PCOS is associated with elevated LH and normal or low FSH
Definition
how does FSH and LH vary in PCOS?
Term
1)clomiphene citrate-for infertility, competitive antagonist of estrogen leading to rises in GnRH, FSH, and LH

2) ISDs (insulin sensitizing drugs)

3) Ovarian drilling - removal of androgen producing ovarian tissue by diathermy or laser
Definition
what is used to treat PCOS?
Term
leiomyomata
Definition
what is the med term for uterine fibroids?
Term
uterine fibroids
Definition
benign smooth muscle tumors of the myometrium, the most common pelvic solid tumor
Term
40%, it is the most frequently reported indication for surgery in women
Definition
of the 600,000 hysterectomies in the US, what percent are due to fibroids?
Term
abnormal bleeding & pain
Definition
what is a symptom of uterine fibroids?
Term
supress estrogen to decrease FSH and LH (disrupt cycle, shrink fibroids, restart cycle)

also continuous GnRH (instead of cyclic) to shut down FSH and LH
Definition
how are uterine fibroids treated besides surgery?
Term
endometriosis
Definition
presence of endometrial tissue outside the uterus dependent on estrogen (65% in the ovary)
Term
infertility, pain, recurrent bleeding from ectopic sites
Definition
what are the symptoms of endometriosis?
Term
just 1
Definition
how many smooth muscle cells are needed to cause a fibroid?
Term
GnRH continuous therapy & oral contraceptives to resolve the growths
Definition
how is endometriosis treated?
Term
not usually
Definition
are patients with endometriosis fertile?
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