18. Male Hypogonadism Flashcards
What are the two lab studies that you should use to lok for testosterone administration safety
PSA and hematocrit
What is the effect of testosterone on RBC mass
Testosterone increases RBC mass
Klinefelter’s Syndrome
Leydig cell failure causes LH, FSH levels to inc. Low testosterone levels
Hypergonadotropin hypogonadism
Presenation: gynecomastia, inability to shave, reduced secondary male characteristics
Kallmann’s Syndrome
hypo-pituitary condition Impaired smell (anomsia) Hypogonadal hypogonadism (LH, FSH, testosterone are all low)
What is the protein that binds testosterone in the blood?
Sex Hormone Binding Globulin (SHBG)
What causes decreases in SHBG
Obesity
What determines if testerone level is low or if the testosterone level is low due to decreases amounts of SHBG
Free testosterone level test
Which drugs can decrease gonadotroins (LH, FSH) ( drugs total)
Narcotics Opiates (heroin) Alcohol Tranquilizers Sedatives Antihypertensives
When should testosterone be drawn?
in the morning when the levels are the highest
What is the normal testosterone range?
300-1100
What happens if you have XY but don’t have testosterone secretion in utero?
Hermaphrodites or testosterone resistant
Is gynecomastia from high or low testosterone?
Both high and low testosterone levels can cause gynecomastia
What percent of testosterone should be free?
2% is free testosterone
Differentiate between primary gonadal failure and secondary gonadal failure
Primary: high level of LH and FSH, low testosterone
Secondary: Low levels of LH and FSH, high testosterone
What is the most common cause of impotence?
DM
What is the consequence of having low testosterone and diabetes on metabolism?
Insulin resistance
Inc testosterone can increase insulin sensitivity
Klinefelter’s syndrome
Hypergonadotropic
Seminiferous tubule dysgenesis
46 XXY
azoospermia, gynecomastia, mental abnormalities, elevated FSH and LH
Tx for prolactinoma
Bromocriptine
Prolacin inhibits which hormone?
GnRH
Can cause hypogonadism
What is the best route of administration for testosterone replacement therapy
Transdermal admin is more common route (patch, gel, pump)
Newest way is through subcutaneous pellets (provided by surgeon every 2-6weeks)
