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RDS Test 1 > B8-006 Male Endocrinology > Flashcards

B8-006 Male Endocrinology Flashcards

1
Q

stimulates leydig cells

A

LH

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2
Q

stimulates sertoli cells

A

FSH

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3
Q

testosterone inhibits […] and […] release from the pituitary gland

A

GnRH
LH

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4
Q

inhibin B inhibits […] release from the pituitary gland

A

FSH

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5
Q

[…] cells produce testosterone

A

Leydig

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6
Q

leydig cells express […] receptors

A

LH

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7
Q

sertoli cells express […] receptors [2]

A

FSH
androgen

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8
Q

[…] cells produce anti-mullerian hormone, androgen binding protein, and inhibin B

A

sertoli

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9
Q

[…] inhibits LH secretion in males

A

nicotine

(lowers testosterone levels)

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10
Q

factors that stimulate GnRH release [3]

A

NE
neuropeptide Y
leptin

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11
Q

factors that inhibit GnRH release [4]

A

IL-1
GABA
dopamine
prolactin

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12
Q

does LH or FSH have a longer half life?

A

FSH

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13
Q

[LH/FSH] higher amplitude pulses in plasma

A

LH

(FSH pulses are more stable due to longer half life)

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14
Q

both LH and […] bind to the same LH receptors on Leydig cells

A

hCG

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15
Q

[…] is secreted episodically in response to LH with about a 40 min lag

A

testosterone

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16
Q

what time of day does testosterone peak?

A

early morning

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17
Q

[…] levels of LH is expected with precocious puberty, primary testicular failure, and castration

A

high

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18
Q

[…] levels of LH is expected with Kallman syndrome, hyperprolactinemia, and primary pituitary failure

A

low

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19
Q

key rate limiting step in steroid hormone biosynthesis

A

steroidogenic acute regulatory protein (StAR)

(in mitochondria)

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20
Q

3 key symptoms of low testosterone

A

decreased morning erections
erectile dysfunction
decreased frequency of sexual thoughts

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21
Q

main function is to suppress the secretion of FSH from pituitary

A

inhibin B

(secreted from sertoli cells)

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22
Q

[…] cells secrete inhibin B

A

sertoli

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23
Q

[…] serums levels are a direct marker of sertoli cell function and correlate with both testicular volume and sperm production

A

inhibin B

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24
Q

normally inhibin B levels in males rise during puberty, however in […] syndrome they fail to rise due to testicular dysgenesis

A

Klinefelter

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25
Q

how do anabolic steroids cause infertility and shrinkage of testicles?

A

reduces LH secretion –> less testosterone produced

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26
Q

is testosterone bound to SHBG biologically active?

A

no

only free testosterone and albumin-bound are biologically available

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27
Q

describe SHBG levels throughout early life

A

fetal: low
childhood: high
puberty: low
adulthood: slowly rises over time

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28
Q

conditions that increase the amount of SHBG

A

hyperthyroidism
low GH
cirrhosis
stress
smoking
anti-seizure medications

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29
Q

essential for maintaining function of epididymis

A

androgen binding protein (sertoli cells)

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30
Q

the majority of estradiol in males is produced in […] tissue

A

adipose

(via aromatization of testosterone)

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31
Q

generates 3 times as much DHT and is critical for differentiation of male external genitalia

A

type II 5-a-reductase

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32
Q

5-a-reductase inhibitor used in treatment of BPH

A

finasteride

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33
Q

finasteride is sold under the brand name […] for BPH and […] for androgenic alopecia

A

proscar

propecia

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34
Q

controls sexual differentiation via development of the mesonephric duct structures

A

testosterone

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35
Q

defects of 5-a-reductase typically result in defects of

A

external genitalia

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36
Q

enzyme responsible for epiphyseal plate closure

A

aromatase

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37
Q

[…] virus replicates in Leydig cells and causes a decrease in testosterone production, can lead to infertility

A

mumps

LH and FSH will be high trying to stimulate T

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38
Q

FSH and LH concentrations remain significantly increased for […] months after acute phase of mumps

A

10-12

(testosterone lowers in acute phase but returns to baseline relatively quickly)

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39
Q

when are the 3 peaks on testosterone levels through the male lifetime?

A

fetal 12-18 weeks
neonatal 1 month
30 years old

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40
Q

[…] seems to be essential for the increased GnRH pulse secretions leading to puberty

A

leptin

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41
Q

precocious puberty is defined as the appearance of secondary sex characteristics before age […]

A

9

(rare in males)

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42
Q

[…]gonadotropic hypogonadism results from dysfunction at the level of the hypothalamus

A

hypo

(kallman)

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43
Q

[…]gonadotropic hypogonadism results from dysfunction at the level of the testis

A

hyper

(klinefelters)

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44
Q

[…] syndrome is characterized by delayed/absent puberty and impaired sense of smell

A

Kallmann

due to impaired migration of GnRH neurons from olfactory bulb to AVPV

45
Q

inheritance pattern of Kallman’s syndrome

A

X linked recessive

46
Q

high levels of prolactin inhibit […] release

A

GnRH

47
Q

describe testosterone, LH, and FSH levels in Kallmanns

A

all low

48
Q

describe testosterone, LH, and FSH levels in Klinefelters

A

testosterone: low
LH: high
FSH: high

testicular dysgenesis due to 47XXY

49
Q

defect in androgen receptor resulting in female-appearing genetic male

A

complete androgen insensitivity syndrome

50
Q

female external genitalia present
functioning testis present
no internal male/female genitalia

A

complete androgen insensitivity syndrome

51
Q

genetic condition in which male has extra Y chromosome

A

jacob’s syndrome

double Y syndrome

52
Q

risks of testosterone replacement therapy [4]

A

prostate disease (BPH or cancer)
polycythemia
sleep apnea
gynecomastia

53
Q

male 47 XXY

A

klinefelter syndrome

54
Q

small, firm testes
tall stature with long limbs
gynecomastia
female hair distribution
may have developmental delay

A

klinefelter syndrome

55
Q

presence of inactivated X chromosome (Barr body)

relatively common cause of infertility see in workup

A

klinefelter syndrome

56
Q

describe levels of inhibin B, FSH, Testosterone, and LH in klinefelter’s syndrome

A

inhibin B: low
FSH: high
T: low
LH: high

57
Q

phenotypically normal
very tall
normal fertility
may be associated with acne or learning disability

A

Jacobs syndrome (XYY)

58
Q

in hypogonadotropic hypogonadism, Testosterone will be […], and LH will be […]

A

T: low
LH: low

59
Q

in hypergonadotropic hypogonadism, Testosterone will be […], and LH will be […]

A

T: low
LH: high

60
Q

in exogenous androgenic steroid use, Testosterone will be […], and LH will be […]

A

T: high
LH: low

61
Q

in androgen insensitivity syndrome, Testosterone will be […], and LH will be […]

A

T: high
LH: high

62
Q

[…] deficiency results in the inability to convert testosterone to DHT

A

5a reductase

63
Q

form of hypogonadotropic hypogonadism that cause inability to complete puberty

A

Kallmann syndrome

64
Q

conversion of testosterone to DHT requires what enzyme

A

5a-reductase

65
Q

aromatization of testosterone to estrogen requires what enzyme?

A

CYP19/aromatase

66
Q

plays important roles in the development of prostate, skin, and hair follicles

A

DHT

67
Q

plays important role in maintaining bone health, fat mass, and epiphyseal fusion

A

estrogen

68
Q

DHT and T signal through […] receptor

A

androgen (AR)

69
Q

estrogens signal through the […] receptors

A

estrogen (ESR1, ESR2, GPER)

70
Q

androgen production […] with age

A

declines (andropause)

71
Q

visual symptoms in the setting of hypogonadism may suggest

A

prolactinoma

(impinging on optic chiasm)

72
Q

describe T, LH, and FSH in hypogonadotrophic hypogonadism

A

T low
LH: low
FSH: low

problem at level of pituitary

73
Q

how does exercise induced hypogonadism cause HH?

A

reduced leptin –> reduced GnRH release

74
Q

defective migration of neurons and subsequent failure of olfactory bulbs to develop

A

Kallmann syndrome

75
Q

hCG is homologous to […] but with longer half life

A

LH

(can be used as LH analog for hormone therapy)

76
Q

treatment for Klinefelter’s

A

testosterone if low

nothing if T is normal

77
Q

in hypogonadotrophic hypoganadism, what will FSH and LH levels be?

A

both low

78
Q

Kallmann’s syndrome is a type of […]gonadotrophic hypogonadism

A

hypo

79
Q

cystic fibrosis is accompanied with agenesis of

A

vas deferens

80
Q

how long does a spermatogenesis cycle take?

A

about 3 months

81
Q

what should be done to preserve male fertility prior to radiation therapy?

A

cryopreservation of sperm

82
Q

[IVF/ICSI]
requires only one spermatazoon

A

ICSI

83
Q

[IVF/ICSI]
requires a higher number of sperm

A

IVF

84
Q

[IVF/ICSI]
sperm is injected directly into the egg

A

ICSI

(doesn’t have to be motile)

85
Q

[IVF/ICSI]
requires that sperm is motile

A

IVF

86
Q

[IVF/ICSI]
followed by embryo transfer to mother

A

both

87
Q

causes of retrograde ejaculation [3]

A

diabetes
medications to relax bladder sphinter
spinal cord injury

(things that would affect control of the bladder sphincter)

88
Q

what test will confirm a diagnosis of retrograde ejaculation?

A

analysis of sperm in urine

89
Q

agglutination of sperm indicates

A

autoimmunity

(presence of anti-sperm antibodies)

90
Q

changes to volume/composition of sperm indicates

A

obstruction of genital tract

91
Q

what would you expect on semen analysis of a patient with retrograde ejaculation?

A

aspermia

92
Q

what would you expect on semen analysis of a patient with history of parotiditis (mumps)?

A

azoospermia or oligospermia

93
Q

most common complications of varicocelectomy [2]

A

orchitis
hydrocele

94
Q

couples are advised to have […] before radiotherapy is performed

A

sperm retrieval

95
Q

a semen specimen that is missing fructose indicates

A

absence of seminal vesicles

96
Q

what would you expect levels of inhibin, LH and FSH to be in a patient taking exogenous steroids?

A

all low

97
Q

asthenozoospermia is defined as a total sperm motility less than […]% and progressive motility less than […]%

A

asthenozoospermia is defined as a total sperm motility less than 40% and progressive motility less than 32%

98
Q

genetic disease in which cilia and flagellum are altered

A

Kartageners

99
Q

characterized by dextrocardia, bronchitis, disosmia, and infertility

A

Kartageners

100
Q

cause of azoospermia due to undescended testes

A

increase in temperature of testes affects spermatogenesis

101
Q

what will LH, FSH, and inhibin levels be in a patient who is taking exogenous steroids?

A

all low

102
Q

what would a semen analysis show following a successful vasectomy?

A

azoospermia

(ejaculate without sperm)

103
Q

hCG can be prescribed to males to treat

A

congenital cryptorchidism

(binds to LH receptor on Leydig cells to stimulate leydig insulin-like hormone release, which triggers testicular descent)

104
Q

defect in androgen receptor that is unlikely to be aided by exogenous androgens

A

androgen insensitivity syndrome

105
Q

describe inhibin, LH, FSH, and T levels in Klinefelters

A

LH high
FSH high
T low
inhibin low

(due to testicular failure)

106
Q

describe LH, FSH, and T levels in Kallmann syndrome

A

FSH low
LH low
T low

(due to failure for hypothalamus to stimulate testicles)

107
Q

symptoms of sexual dysfunction [3]

A

decreased thoughts about sex
erectile dysfunction
sex frequency

(need to have these to indicate testosterone therapy)

108
Q

once low T has been confirmed, what other labs should be assessed prior to starting testosterone therapy?

A

baseline PSA
baseline hematocrit
LH
FSH

109
Q

if LH levels were found to be low in a man who had low T levels with normal sex characteristics, then […] should be screened

A

prolactin

RDS Test 1 (23 decks)

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