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
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
Definition
|
|
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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