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Undeleted > Clinical reproduction > Flashcards

Clinical reproduction Flashcards

1
Q

what gene determines sex

A

SRY

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2
Q

what does SRY lead to

A

testes

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3
Q

what 2 cells do testes contain of importance and what do they secrete

A
  1. sertoli - mullerian inhibitin factor

2. leydig - Testosterone

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4
Q

what does MIF do?

A

inhibs. mullerian duct - the growth of female internal genitalia

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5
Q

what does T do

A

develops the wolfian system - male gentials

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6
Q

what is CAIS karyotype

A

XY

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7
Q

CAIS gonads

A

testes - undescended

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8
Q

CAIS external genitals

A

female

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9
Q

CAIS internal genitals

A

none

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10
Q

CAIS T, E, LH levels

A

T -high
E - high
LH - HIGH - no feedback via receptor

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11
Q

where does E come from in CAIS

A

aromatized from T

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12
Q

what surgery is needed in CAIS

A

orchidectomy

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13
Q

how does T circulate?

A

2% free
38 % albumin bound
60% - SHBG bound

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14
Q

what T is bio T

A

albumin bound and free

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15
Q

what does T feedback into

A

hypothalumus - neg to GnRh

pit. - neg to LH/FSH

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16
Q

what are 8 target organs of T

A
  1. skin
  2. muscle
  3. male sex organs
  4. marrow - stims stem cells
  5. brain - libido, cognition
  6. liver - protein syn
  7. kidney - EPO porduction
  8. bone - linear growth
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17
Q

what are 2 types of hypogonadism

A
  1. primary - testicular insult

2. secondary - hypo or pit. insult

18
Q

what are LH, FSH, T levels in primary

A

LH/fsh - high

T -low

19
Q

what are LH, FSH, T levels in secondary

A

LH/FSH/T all low

20
Q

6 causes of primary hypogonad

A
  1. congenital
  2. infectious - mumps
  3. trauma
  4. drugs
  5. infiltration - hemochromatosis
  6. idiopathic
21
Q

7 causes of secondary hypogonad

A
  1. neoplasia - pit or hypo lesion
  2. congenital - Kallman’s
  3. trauma - TBI, radiation
  4. drugs
  5. infiltration
  6. anorexia
  7. idopathic
22
Q

how does prolactin effect T

A

supress GnRh> low LH/FSH > low T

23
Q

2 things that can affect T levels

A
  1. production

2. aromatization

24
Q

what is best way to treat with T

A

injections

25
Q

what is klinefelter karyotype

A

XXY

26
Q

how common is klinefelter

A

1/660

27
Q

what are complications of klinefelter

A
  1. low T
  2. infertility
  3. diabetes
  4. hypothyroidism
  5. low bone mineral
  6. gynecomastia
28
Q

what is 5 most common cause of infertility

A
  1. male factors30-50
  2. tubal factors 20-30
  3. ovulatory 10-15
  4. cervical 5-15
  5. idiopathic 10-20
29
Q

what does exogenous T do to male fert

A

bad via negative feddback

30
Q

when does one investiage for inferility

A

after 1 year of trying

31
Q

most important test for fertility

A

semen analysis ( more than one sample needed)

32
Q

3 DDx for abnomalr semen

A
  1. impaired production (hypogonadism)
  2. idiopathic
  3. obstruction (10-20%)
33
Q

which os more common type of hypogonadism

A

primary

34
Q

what is sertoli cell only syndrome

A
  1. have leydig and sertoli cells

2. no germs cell and spermatozoa

35
Q

therapy for obstruction

A

surgical intervention

36
Q

therapy for 2nd hypogonadism

A

E blockade or synthetic LH/FSH

37
Q

therapy for prolactin excess

A

dopamine agonist

38
Q

treatment of primary hypogonadism (klinefelters)

A

testicular sperm extraction

39
Q

5 causes of ED

A 
Psychogenic
Endocrine
Neurologic
Insufficent blood
Substances
40
Q

what does PDE-5is do

A

stop PDE-5 from degrading cAMP>more cAMP>smooth muscle relaxation

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