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Details Title: Male Gonad Pathophysiology Description: 4.18.07 Total Flash Cards: 32 Created: 04/18/2007 17:33:02	To study from this set of flash cards, or to create your own your own study flash cards, register HERE. If you are already a registered user, CLICK HERE.
Cards Term what is hypogonadism? Definition Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). The gonads have two functions: to produce hormones (testosterone, estradiol, antimullerian hormone, progesterone, inhibin B), activin and to produce gametes (eggs or sperm). Deficiency of sex hormones can result in defective primary or secondary sexual development, or withdrawal effects (e.g., premature menopause) in adults. Defective egg or sperm development results in infertility. The term hypogonadism is usually applied to permanent rather than transient or reversible defects, and usually implies deficiency of reproductive hormones, with or without fertility defects. The term is less commonly used for infertility without hormone deficiency. Term What's the difference btw primary and secondary hypogonadism? Definition primary affects the testes, and secondary affects the hypothal and pituitary. Term what do all secondary causes of hypogonadism have in common? Definition They all cause a decrease/impairment of FSH and/or LH which causes a decreased sperm count. Term What is primary hypogonadism? Definition testicular hypogonadism, where normally damage to seminiferous tubules is greater than that to the Leydig cells. The only exception to this is a congenital deficiency of an enzyme necessary for testosterone biosynthesis. Term What is end-organ restistance? Definition androgen receptor abnormality (testicular feminization syndrome); a genetic abnormality due to deletions and point mutations Term what aer the primary causes of congenital hypogonadism? Definition chromosomal abnormalities (47XXY), cryptorchidism, myotonic dystrophy, mutation of FSH and LH receptors Term Why do you get Klinefelter syndrome? Definition an extra X chromosome (47XXY, 47XXXY, 47XXY/46XY). THe degree of abnormality is proportional to the number of extra Xs Term What are KlinS's associated gonadal abnormalities? Definition damage to seminif tubules is invariable, and damage to leydig cells are variable (so testes secretion could be normal or abnormal) Term What are KlinS's associated extragonadal abnormalities? Definition long legs, behavioral abnormalities, bronchiectasis, varicose veins, diabetes mellitus. Term What are 2 causes of damages associated with unilateral undescended testes? Definition original damage that caused 1 testes not to descend, and the testes that does not descend is subjected to the heat of the abdomen, which damages the seminif tubules. Term how does cryptorchidism affect sperm count? Definition decreased in 1/3 if unilateral, but INVARIABLE if bilateral Term How does cryptorchidism affect testosterone production? Definition normal if unilateral, but low if bilateral Term What is cryptorchidism? Definition undescended testes Term Is it bilateral or unilateral? Definition it can be both, but abnormalities are greater if bilateral. All in all, an increased risk of testicular cancer Term what are the primary causes of acquired hypogonadism? Definition infections (mumps), radiation therapy, medications (antineoplastic, suramin, ketoconazole), trauma, testicular torsion, testicular torsion, autoimmune diseases, chronic systemic failure (renal failure, AIDS), idiopathic (50%) Term Causes of secondary (congenital) hypogonadism? Definition isolated idiopathic hypogonadotrophic hypogonadism (IHH), Kallmann's syndrome, IHH associated with other hypothalamic hormonal deficiencies, IHH associated with MR (prader willi) Term Causes of secondary (acquired) hypogonadism? Definition benign tumors and cysts (pituitary, adenoma, craniopharyngioma), malig tumors (primary or metastatic), infiltrative diseases (sarcoidosis, LCH (Langerhans' cell histiocytocis), hemochromatosis), infections (TB, menigitis), pituitary apoplexy, pituitary infarction (sheehan's syndrome), trauma to skull base, critical illness, meds (high dose of glucocorticoids, chronic narcotics) Term Is there a genetic mutation in Kallmann's syndrome? Definition yes, in the KALL gene Term With IHH, do you get LH or FSH PULSES? Definition NO. However, it does respond to exogenous GbRH Tx (ie, this tx will create pulsating LH) Term What is end organ resistance to test? Definition 1. androgen receptor abnor (a. complete form: female external genetalia) (b. incomplete forL spetrum from minimal to almost normal virilization). 2. 5-alpha reductase deficiency: ambigous external genitalia, male internal gen, virilation at puberty Term What are 3 different horomoes T can act as? Definition T, DHT (dihydrotest), and E2 (estrodiol) Term How do you get T to E2? Definition use aromatase Term How do you get from T to DHT? Definition use 5 alpha reductase Term what are target organs of T? Definition skin (hair growth, balding, sebum production), brain (libido), male sex organs (penile growth, spermatogenesis, prostate growth and function), muscle (increase mass and strength), bone marrow (stimu or erythropoiesis), bone (accelerated linear growth, closure of epiphyses, increased bone mineral density) Term What are signs and symptoms of male hypogonadism? Definition damage to, or decrease stim of, the seminif tubules--decreased spermatogenesis and size of testes. Damage to, or decreased stim, of Leydig Cells: decreased T production. The effects depend upon the time that defic. occurs. If in UTERO: first Trimester: incomplete male sex diff. If in utero, Third Trimester: microphallus, crytorchidism; prepuberty: incomplete puberty, eunuchoid proportions; postpuberty: partial regression of pubertal changes. Term What are the consequences of hypogonad in men (acquired in adulthood)? Definition SYMPTOMS; decreased energy, libido, and hot flashes, and mood changes. PHYSICAL FINDINGS: decreased muscle mass, small testes. OTHER: decreased muscle strength, bone mineral density, hemoglobin and hermatocrit Term What can T do? Definition increase fat-free muscle mass, increase erythrocytosis, increases BMD and lumbar spine, sexual interest, sences of energy. Term How do you diagnose HG? Definition for Testicular fuction: do a semen analysis or serum test concentratino. For gonadotroph function: basal and stimulated levels. For chromosomal analysis: karyotype. Term Is Male Hypogonadism similar to normal aging? Definition yes Term What are these consequences of hg in males? Definition decreased libido, energy, sexual hair, muscle mass, bone mass Term Describe beneficial aspects of castration: Definition prostate cancer is T dependent. So if you castrate a male, improve cancer outlook. Term In this procedure, is medical or surgical castration better? Definition no diff