7 - Disorders of Male Reproduction

Question 1

hormones produced by sertoli cells

Answer 1

anti mullerian hormone
inhibin and activin - regulate FSH secretion
estradiol - direct spermatogenesis

Question 2

when does testosterone spike throughout lifetime?

Answer 2

fetal, neonatal, and puberty (long plateau after this one)

Question 3

bioavailable testosterone includes both ___ & ___, but not ___

Answer 3

free and albumin bound

not SHBG bound

Question 4

results of androgen def during 1st TM and 3rd TM

Answer 4

1st - genital ambiguity

3 - micropenis

Question 5

results of androgen def before puberty

Answer 5

lack of male hair distribution
dec muscle mass / strength
diminished endurance
dec libido
infantile genitalia + prostate
eunuchoid skeleton (long legs and arms relative to body)
osteoporosis
high pitch voice

Question 6

causes of primary testicular failure

Answer 6

Klinefelter's
orchitis
trauma
autoimmune damage
chemo / drugs (ketoconazole, spironolactone, alcohol)
cryptorchidism
LH receptor mutations
organ failure (liver, kidney)

Question 7

genetic cause of tertiary testicular def

Answer 7

Kallman’s syndrome - w/ assoc anosmia

Question 8

hormone findings in androgen resistance syndromes

Answer 8

elevated gonadotropin and elevated testosterone (neg feedback on pituitary doesnt work b/c of mutation in receptor)

Question 9

genetic disorder that makes genetic males have sort of a mixed / variable phenotype between normal male and female

Answer 9

5 alpha reductase def

Question 10

drugs that can cause erectile dysfunction

Answer 10

CNS acting agents (anti depressants, methadone, cocaine, nicotine, etc)
anticholinergic
antiadrenergic
diuretics (thiazides)
antiandrogen
antihypertensive

Question 11

peyronie’s disease

Answer 11

chronic inflammation of tunica albuginea

causes pain, ED, and deformity

Question 12

causes of non-physiologic gynecomastia

Answer 12

neoplasm - steroid or hCG producing, male breast CA
drugs - anti androgens, anti ulcer drugs, chemo, spironolactone, drugs of abuse, hormones, haloperidol
congenital - Klinefelter’s, cryptorchidism, any dec testosterone state
testicular damage
systemic disorders - renal failure, liver failure, thyrotoxicosis

Question 13

physiologic times for gynecomastia

Answer 13

neonate - circulating maternal hormones
puberty - while establishing balance between sex hormones
sensecence