Clinical reproduction

Question 1

what gene determines sex

Answer 1

SRY

Question 2

what does SRY lead to

Answer 2

testes

Question 3

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

Answer 3

1. sertoli - mullerian inhibitin factor

2. leydig - Testosterone

Question 4

what does MIF do?

Answer 4

inhibs. mullerian duct - the growth of female internal genitalia

Question 5

what does T do

Answer 5

develops the wolfian system - male gentials

Question 6

what is CAIS karyotype

Answer 6

XY

Question 7

CAIS gonads

Answer 7

testes - undescended

Question 8

CAIS external genitals

Answer 8

female

Question 9

CAIS internal genitals

Answer 9

none

Question 10

CAIS T, E, LH levels

Answer 10

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

Question 11

where does E come from in CAIS

Answer 11

aromatized from T

Question 12

what surgery is needed in CAIS

Answer 12

orchidectomy

Question 13

how does T circulate?

Answer 13

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

Question 14

what T is bio T

Answer 14

albumin bound and free

Question 15

what does T feedback into

Answer 15

hypothalumus - neg to GnRh

pit. - neg to LH/FSH

Question 16

what are 8 target organs of T

Answer 16

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

Question 17

what are 2 types of hypogonadism

Answer 17

1. primary - testicular insult

2. secondary - hypo or pit. insult

Question 18

what are LH, FSH, T levels in primary

Answer 18

LH/fsh - high

T -low

Question 19

what are LH, FSH, T levels in secondary

Answer 19

LH/FSH/T all low

Question 20

6 causes of primary hypogonad

Answer 20

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

Question 21

7 causes of secondary hypogonad

Answer 21

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

Question 22

how does prolactin effect T

Answer 22

supress GnRh> low LH/FSH > low T

Question 23

2 things that can affect T levels

Answer 23

1. production

2. aromatization

Question 24

what is best way to treat with T

Answer 24

injections

Question 25

what is klinefelter karyotype

Answer 25

XXY

Question 26

how common is klinefelter

Answer 26

1/660

Question 27

what are complications of klinefelter

Answer 27

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

Question 28

what is 5 most common cause of infertility

Answer 28

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

Question 29

what does exogenous T do to male fert

Answer 29

bad via negative feddback

Question 30

when does one investiage for inferility

Answer 30

after 1 year of trying

Question 31

most important test for fertility

Answer 31

semen analysis ( more than one sample needed)

Question 32

3 DDx for abnomalr semen

Answer 32

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

Question 33

which os more common type of hypogonadism

Answer 33

primary

Question 34

what is sertoli cell only syndrome

Answer 34

1. have leydig and sertoli cells | 2. no germs cell and spermatozoa

Question 35

therapy for obstruction

Answer 35

surgical intervention

Question 36

therapy for 2nd hypogonadism

Answer 36

E blockade or synthetic LH/FSH

Question 37

therapy for prolactin excess

Answer 37

dopamine agonist

Question 38

treatment of primary hypogonadism (klinefelters)

Answer 38

testicular sperm extraction

Question 39

5 causes of ED

Answer 39

``` Psychogenic Endocrine Neurologic Insufficent blood Substances ```

Question 40

what does PDE-5is do

Answer 40

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