128; Gonadal Endicrine Flashcards
What is male hypogonadism?
Androgen deficiency and impaired sperm production
or
Isolated impaired sperm production
What are the causes of Primary Hypogonadism?
- Low testosterone
- Elevated FSH & LH
What are the causes of Secondary Hypogonadism?
- Low testosterone
- Normal/low FSH & LH
What is the role of a Leydig Cell?
- Stimulated by LH
- Produces Testosterine from Cholesterol
What is the role of a Sertoli cell?
- Affected by FSH
- Spermatogenesis
- Produce Inhibin and Activin
What is the role of Gonadotrophin Releasing Hormone?
GnRH
Stimulate release of FSH & LH from the anterior pituitary
Where is GnRH secreated and what regulates its secretion?
Secreted from the hypothalamus
- Inhibited by Inhibin & testosterone
- Induced by Activin
What are the clinical manifestations of androgen deficinecy; hypogonadism in the adult?
- Small / abent testes
- Gynaecomastia
- Infertility, sexual dysfunction
- Small prostate
- Reduced hair growth, skin
- wrinkling, flushes, non specific symptoms
- Osteoporosis
What are the clinical manifestations of hypogonadism in pubertal and Foetal development?
Pubertal: Eunuchoid
Foetal: Almost normal female
What are the symptoms of adult androgen insufficiency?
- Diminished libido
- erectile dysfunction
- gynaecomastia
- infertility
What investigations would be made in to androgen insufficiency?
Morning testosterone level 2x greater than normal
What investigations are indicated if adrenal deficiency suspected?
Morning testosterone levels (repeat x2)
FSH, LH, and seminal analysis
What are the causes of Primary Hypogonadism?
- Kleinfelter’s syndrome
- Castration or trauma
- Infection- orchitis
- Drugs, alcohol, chemo-, radiotherapy
- Chronic liver and kidney disease
- Ageing
- Androgen resistance
What are the causes of Secondary Hypogonadism?
Constitutional delay
Cushing’s syndrome
Drugs, opiates, anabolic steroids
Chronic liver, kidney disease, HIV diabetes
Ageing
Obesity
Hypopituitarism
Hyperprolactinaemia
What is Kleinfelter’s syndrome?
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