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Male Reproduction
Downstate > MS2 Endocrine > Male Reproduction
33
Medical
Graduate
03/03/2011

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Cards

Term
What do Sertoli cells do? What activates them?
Definition
Produce inhibit, induce spermatogenesis, activated by FSH
Term
What do Leydig cells produce? What activates them?
Definition
Produces testosterone, activated by LH
Term
Causes of hypothalamic defects that result in reduced GnRH secretion
Definition
Kallman's, trauma, infection, TB, sarcoidosis, hemachromatosis, tumor, radiation, weight loss, severe ilness
Term
Causes of pituitary defects that decrease GnRH secretion
Definition
Compression, prolactinoma, infection, TB, sarcoidosis, hemachromatosis, radiation, opiates
Term
Causes of primary hypogonadism
Definition
Klinefelter, mumps orchitis, radiation, autoimmune, trauma, testicular torsion, drugs
Term
47 XXY male
Definition
Klinefelter
Term
Drugs that cause hypogonadism
Definition
Ketoconazole, dexamethasone, weed, finasteride, cimetidine, spironolactone
Term
How does Klinefelter present?
Definition
Small firm testes, infertility, gynecomastia, high LH and FSH, low testosterone
Term
Is fertility possible in Klinefelter? Why or why not?
Definition
No. Testes are hyalinized.
Term
Differential for gynecomastia
Definition
Hypogonadism, testicular or adrenal tumors secreting HCG or estrogen, chronic liver disease, drugs
Term
Most common cause of erectile dysfunction
Definition
Cardiovascular disease
Term
What neural control is responsible for erections? Emission? Ejaculation?
Definition
Erection is parasympathetic. Emission is sympathetic. Ejaculation is somatic motor.
Term
Tx for erectile dysfunction
Definition
Sildenafil if vascular etiology. Testosterone replacement if hypogonadism etiology.
Term
Sildenafil contraindications? AE?
Definition
Contraindicated for pts on nitrates. AE: vision problems.
Term
Pt with hx of thalassemia presents with infertility. Dx?
Definition
Underandrogenization due to hemochromatosis of hypothalamus-pituitary
Term
Brett farve presents with infertility. Dx suspicion?
Definition
Exogenous androgen use
Term
Testicular causes of infertility in underandrogenized pts?
Definition
Infection, radiation, autoimmune, drugs, liver disease, renal disease, sickle cell anemia, HIV, myotonic dystrophy, androgen resistance
Term
Testicular causes of infertility in androgenized pts?
Definition
PCD, Kartegener's, varicocoele, cryptorchidism, tubal obstruction
Term
Pt presents with infertility, low testosterone, high FSH/LH. CT shows bilateral intra abdominal masses. Dx? Tx?
Definition
Cryptorchidism. Surgery to descend testes.
Term
Role of MIH, HCG, and LH in gonadal development
Definition
Sertoli cells secrete MIH to cause Mullerian duct to degenerate. HCG causes testes to produce testosterone. LH stimulates testes to develop.
Term
What stimulates male external genitalia to form?
Definition
DHT
Term
Internal genitalia begin differentiation at week...
External genitalia begin differentiation at week...
Definition
Internal at week 7
External at week 8
Term
What is the most common cause of ambiguous genitalia in a female infant?
Definition
CAH
Term
2 clinical presentations of neonates with CAH
Definition
1. Ambiguous genitalia, salt wasting, seizures, dehydration, low cortisol, low aldosterone
2. Ambiguous genitalia, no salt wasting, low cortisol
Term
Differential for undevirilized XY male (3)
Definition
Testosterone biosynthesis defect, androgen resistance, 5-alpha reductase deficiency
Term
High testosterone, high estrogen, little body hair, self reported female; dx? What would you find on a pelvic exam?
Definition
Androgen insensitivity. Female external genitalia but no cervix, no uterus. CT would show testes in abdomen.
Term
Presentation of pt with 5-alpha reductase deficiency
Definition
Female pre pubery but male post puberty. Internal male genitalia are normal. External genitalia appear female.
Term
Pt with precocious puberty does not respond to GnRH; dx?
Definition
Exogenous androgens
Term
Pt with precocious pubery responds to GnRH stimulation. Dx?
Definition
Central defect. Early activation of HP axis
Term
Differential for peripheral precocious puberty (4)
Definition
CAH, HCG, McCune Albright syndrome, testotoxicosis
Term
Testotoxicosis
Definition
LH receptor mutation
Term
McCune Albright syndrome presentation
Definition
Cafe au lait spots, polyostotic fibrous dysplasia of bone, precocious puberty
Term
Flutamide: MOA, indication, AE, coadministrations
Definition
Androgen receptor blocker, prostate cancer, increases LH and FSH, coadminister with GnRH blocker
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