Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

* DIT each session > Day 11.1 Repro > Flashcards

Day 11.1 Repro Flashcards

1
Q

Innervation of male sex response

A

Erection- pelvic nerve (PNS)
Emission- hypogastric nerve (SNS)
Ejaculation- pudendal nerve (Visceral and somatic nerves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What PNS substances are proerectile and antierectile?

A

NO –> increased cGMP –> smooth musc relaxation –> vasodilation –> proerectile

NE –> increased intracellular Ca2+ –> smooth musc contraction –> vasoconstriction –> antierectile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the location and fn of spermatogonia?

A

Spermatogonia are the germ cells.
They line the seminiferous tubules
They maintain the germ pool and produce primary spermatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the location and fn of Sertoli cells?

A

Sertoli cells line the seminiferous tubules (like spermatogonia, altho Sertoli are not germ cells)
They secrete inhibin (which binds FSH)
They secrete ABP androgen-binding protein (which helps maintain levels of testosterone in the seminiferous tubule)
They produce anti-Mullerian hormone (mullarian inhibiting factor)
They support and nourish developing sermatozoa
Sertoli cells Support Sperm Synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What forms the blood-testis barrier?

A

Tight jns bt Sertoli cells (which line the seminiferous tubules)
The blood-testis barrier helps isolate gametes from autoimmune attack.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the location and function of Leydig cells

A

Located in the interstitium
Leydig cells are endocrine cells- they secrete testosterone
The testosterone is kept in the tubules by the ABP that comes from Sertoli cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the relative levels of Inhibin B and FSH in pt w one testicle?

A

If only one testicle, the overall amt of Sertoli cells lining the seminiferous tubules will be greatly reduced. Less Sertoli means less inhibin B is made. And since there is not as much neg fdbk from inhibin on FSH production, FSH will be high.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the composition of semen?

A

60% seminal vesicle products (fructose, ascorbic acid, prostaglandins (which cause uterine contractions), phosphorylcholine, flavins)
20% Prostate products (zinc, citric acid, phospholipids, acid phosphotase, fibrinolysin)
Sperm

So if vasectomy, will still have sem fluid, just no sperm in it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When does spermatogenesis being, how long does it last?

A

Starts in puberty

Full devt of sperm takes 2 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where does spermatogenesis take place?

A

Seminiferous tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the product of spermatogenesis?

A

Spermatids (Haploid, N) that undergo spermiogenesis- loss of cytoplasm, gain of acrosomal cap- to form mature spermatozoan.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the stages (with -ploid and N) of spermatogenesis?

A

Spermatogonium (diploid, 2N)
Primary spermatocyte (diploid, 4N)
Secondary spermatocyte (haploid, 2N)
Spermatid (haploid, N)

Spermiogenesis:
Spermatid –> Spermatozoan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How many chromosomes do spermatogonium have?

A

46 single chromosomes

Sex = XY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How many chromosomes do primary spermatocytes have?

A

46 sister chromatids

Sex = XX or YY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How many chromosomes do secondary spermatocytes have?

A

23 sister chromatids in each

one of the two secondary spermatocytes has X-X, the other one has Y-Y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many chromosomes do the spermatids have?

A

23 single chromatids

there are 4, so the sex in 2 of them is X, and the sex in the other 2 is Y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How are Leydig cells stimulated, and what do they produce?

A

GnRH –> Ant Pit –> Leydig cells –> Testosterone

The testosterone feeds back to inhibit both LH and GnRH
It is kept in the seminiferous tubules by ABP, which comes from Sertoli cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How are Sertoli cells stimulated, and what do they produce?

A

GnRH –> Ant Pit –> FSH –> Sertoli cells –> Inhibin and ABP
Sertoli cells support sperm production.

The inhibin feeds back to inhibit FSH.
ABP keeps testosterone (which comes from Leydig cells) around.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mechanism of sildenafil, vardenafil, tadalafil

A

aka viagra
Inhibit cGMP phophodiesterase, causing increased cGMP. This causes smth musc relaxation in the corpus cavernosum, increased blood flow, and penile erection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Clinical use of sildenafil, vardenafil, tadalafil

A

Treatment of ED
Raynaud’s (helps vasodilate)
Primary pulm HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Toxicity of sildenafil, vardenafil, tadalafil

A

Headache, flushing, dyspepsia, impaired blue-green color vision
Risk of life-threatening hypotension in pts taking nitrates.

Hot and sweaty, but then Headache, Heartburn, Hypotension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

At what phase of spermatogenesis do the cells go thru the blood-testes barrier

A

When they are undergoing replication (spermatogonium –> primary spermatocytes), they pass through the tight jns bt Sertoli cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What accumulates if Meiosis I is lost in spermatogenesis?

A

Primary spermatocytes (46 sister chromatids, 4N)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What accumulates if Meiosis II is lost in spermatogenesis?

A

Secondary spermatocytes (each of the 2 cells has 23 sister chromatids, one cell is X-X and one is Y-Y). Cells are 2N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

List the androgens and where they are made

A

Testosterone - Testis
Dihydrotestosterone (DHT) - Testis
Androstenedione - Adrenal

Potency: DHT > Testosterone > Androstenedione

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What enz converts Testosterone to DHT?

A

5a-reductase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What drug inhibits 5a-reductase?

A

Finasteride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the 5 functions of testosterone?

A
  1. Differentiation of epididymis, vas def, sem vesicles (all internal genitalia except prostate)
  2. Growth spurt (Penis, Sem Vesicles, Sperm, Muscle, RBCs)
  3. Deepening of voice
  4. Closure of epiphyseal plates (via estrogen converted from testosterone)
  5. Libido (in both M and F)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the early and late fns of DHT?

A

Early: differentiation of penis, scrotum, prostate
Late: prostate growth (BPH), balding, sebaceous gland activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Where are how are testosterone and androstenedione converted to estrogen?

A

Converted in adipose tsu and Sertoli cells

Enz is aromatase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does exogenous testosterone cause wrt gonads?

A

Inhibits the Hypothal-Gonadal-Pit axis, which causes decreased intratesticular testosterone. This leads to decreased testicular size and to azoospermia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mechanism and clinical use of exog testosterone

A

Mech: Agonist at androgen receptors
Used to Rx hypogonadism and promote devt of secondary sex characteristics
Stim’s anabolism to promote recovery after burn or injury
Treats ER-positive breast cancer (Exemestane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Toxicity of exog testosterone

A

Causes masculinization in females
Reduces intratesticular testosterone in males by inhibiting rls of LH (via neg fdbk), leading to gonadal atrophy
Premature closing of epiphyseal plates
Bad for lipids: increased LDL and decreases HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

BPH

A

Benign prostatic hyperPLASIA.
Common in men >50yo
May be d/t age-related increase in estradiol w possible sensitization of the prostate to the growth-promoting effects of DHT.

Nodular enlgmt of the periurethral (lateral and middle) lobes, which compress urethra into a vertical slit. Not pre-malignant.

Increased free PSA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Px of BPH

A

Increased freq of urination, nocturia, difficulty starting and stopping stream of urine, dysuria. Can lead to distention and hypertrophy of the bladder, hydronephrosis, and UTIs.

36
Q

Rx for BPH

A

a1 antagonists (terazosin, tamulosin)- these cause relaxation of smth muscle, but do not change size of prostate

Finasteride (5a-reductase inhibitor) does decrease it.

37
Q

List the anti-androgens

A

Finasteride (propecia)
Flutamide
Ketoconazole
Spironolactone

38
Q

How does finasteride work?

A

Testosterone is converted to the more potent form DHT by 5a-reductase. Finasteride is a 5a-reductase inhibitor, so it decreases this conversion.
Useful in BPH, since DHT causes prostate enlargement later in life.
Since DHT also causes baldness, finasteride (propecia) can also be used to promote hair growth for pts w male patterb baldness.
Can cause impotence, gynecomastia

39
Q

What is flutamide?

A

non-steroidal competitive inhibitor of androgens at the testosterone receptor.
Used in prostate carcinoma.

40
Q

What anti-androgenic effects do ketoconazole and spironolactone have?

A

Ketoconazole- inhibits steroid synthesis (inhib’s desmolase)
Spironolactone - inhibs steroid binding.
Both are used to treat the hirsutism of PCOS; both have side effects of gynecomastia and amenorrhea.

41
Q

Tamsulosin

A

a1-antagonist used to treat BPH bc it inhibits smooth musc contraction.
Selective for a1-A,D receptors, which are in urethral smooth musc
(So does not affect the a1-B receptors, which are vascular- so it does not have an effect on the BP)

42
Q

Prostatic adenocarcinoma

A

Common in men >50
In posterior lobe (peripheral zone) of the prostate
Most freq dx’s by digital rectal exam- feel hard nodule, and prostate biopsy
PAP and PSA are useful tumor markers (PAP is prostatic acid phosphatase)
Osteoblastic mets to bone may devp in later stgs- get lower back pain and incrsd serum alk phos and PSA

43
Q

Rx for prostatic adenocarcinoma

A

Flutamide

Resection of prostate

44
Q

What happens to the PSA level in prostatic adenocarcinoma

A

Increased total PSA

Decreased(!) fraction of free PSA

45
Q

Child w testicular and parotid gland swelling

A

Mumps

46
Q

Cryptorchidism

A

Undescended testis (one or both)
Lack of spermatogenesis d/t increased body temp.
A/w increased risk of germ cell tumors
Prematurity increases risk of cryptorchidism.
Rx: Orchioplexy

47
Q

Testicular torsion

A

Twisting of spermatic cord –>ischemia
Dx w US, but also: supporting testes gives no relief (vs epididymis, which it does give relief)
Rx: Surgical detorsion w bilateral orchioplexy w/in 6 hrs (or will have perm dmg)

48
Q

Epididymitis

A

Inflam of epididymis
Dx: support of testes gives relief
If 35 or hx of anal, prob enterobacteriaceae (UTI bugs)- Rx is fluroquinolone

49
Q

What is orchioplexy?

A

Suture testes to scrotum

Done for cryptorchidism, testicular torsion

50
Q

Prostatitis

A

Inflam of prostate, px’g w dysuria, freq, urgency, low back pain. (like a UTI)
If acute and 35yo: UTI bugs- e coli, kleb, proteus, enterobacter, serratus
If chronic can be abacterial (most common) or bacterial (UTI bugs)
Rx fluroquinolones, TMP-SMX for one month!

51
Q

List the testicular germ cell tumors

A 
95% of all tumors are germ cell! they can be:
Seminoma
Embroyonal carcinoma
Endodermal sinus (yolk sac) tumor
Choriocarcinoma
Teratoma
52
Q

List the testicular non-germ cell tumors

A

5% of all testicular tumors, mostly benign
Leydig cell tumor
Sertoli cell tumor
Testicular lymphoma

53
Q

Seminoma

A 
Testicular germ cell tumor.
Malignant
Painless, homogenous testicular enlgmt
Most common testicular tumor 15-35yo
Lg cells in lobules w watery cytoplasm and fried egg appearance.
Radiosensitive
Late mets, excellent pgx.
54
Q

Embryonal carcinoma

A 
Testicular germ cell tumor
Malignant
Painful
Worse pgx than seminoma
Glandular/papillary morphology.
Can differentiate to other tumors
May be a/w increased AFP, hCG
55
Q

Endodermal sinus/Yolk sac tumor

A 
Testicular germ cell tumor
Yellow, mucinous
Analagous to ovarian yolk sac tumor
Schiller-duval bodies resemble primitive glomeruli
Increased AFP
56
Q

Choriocarcinoma

A 
Testicular germ cell tumor
Malignant
Increased B-hCG.
Disordered synctiotrophoblastic and cytotrophoblastic elements.
Hematogenous mets.
57
Q

Teratoma

A

Testicular germ cell tumor

Mature teratoma in males is often malignant (vs benign in females)

58
Q

Leydig cell tumor

A

Testicular, non-germ cell tumor
Contains Reinke crystals
Usu androgen producing (excess testosterone)- causes gynecomastia in men (bc of periph conversion of testosterone to estrogen), precocious puberty in boys
Golden brown color

59
Q

Sertoli cell tumor

A

Testicular, non-germ cell tumor

Androblastoma from sex cord stroma

60
Q

Testicular lymphoma

A

Testicular non-germ cell

Most common testicular cancer in older men.

61
Q

Testicular cancer in young men? In old men? In young children up to 3yo?

A 
Young men (15-35): Seminoma
Old men: Testicular lymphoma
Up to 3yo: Yolk sac tumor (endodermal sinus)
62
Q

What is the female equivalent of a seminoma?

A

Ovarian dysgerminoma

63
Q

What other tumors are similar to seminomas in appearance?

A

Seminoma has a fried egg appearance, similar to koilocytes of HPV and oligodendrogliomas (adult primary brain tumor)

64
Q

Testicular tumor md of cytotrophoblasts and syncytiotrophoblasts

A

Choriocarcinoma

65
Q

Testicular tumor that px’s w gynecomastia initially

A

Leydig cell tumor

66
Q

Testicular tumor w elevated AFP

A

Yolk sac tumor

Embryonal carcinoma

67
Q

Testicular tumor w elevated hCG

A

Choriocarcinoma

Embryonal carcinoma

68
Q

Testicular tumor w cytoplasmic clearing (similar appearance to koilocytes

A

Seminoma

69
Q

Testicular tumor that can have alveolar or tubular appearance, sometimes w papillary convolutions (on histo)

A

Embryonal carcinoma

70
Q

Testicular tumor composed of multiple tsu types

A

Teratoma

71
Q

Testicular tumor w histological endodermal sinus structures (Schiller-Duval bodies)

A

Yolk sac tumor

72
Q

25% of this kind of testicular tumors have cytoplasmic rod-shaped crystalloids of Reinke

A

Leydig cell tumor

73
Q

Testicular tumor that makes androgen and is a/w precocious puberty

A

Leydig cell tumor

74
Q

Man w BPH undergoing treatment, has increased testosterone, decreased DHT, gynecomastia and edema. What’s his med?

A

5a-reductase inhibitor (finasteride)

75
Q

Tunica vaginalis lesions

A

Lesions in the serous covering of testis- px as testicular masses that can be transilluminated (vs testicular tumors, which can’t be).

  1. Varicocele- dilated vein in pampiniform plexus; a/w infertility. “bag of worms”
  2. Hydrocele- increased fluid secondary to incomplete fusion of processus vaginalis
  3. Spermatocele- dilated epididymal duct
76
Q

List the possible pathologies of the penis

A 
Carcinoma in situ (Bowen's, Queyrat, Bowenoid)
Sq Cell Carcinoma
Peyronie's dz
Balanitis
Priapism
77
Q

Bowen’s dz

A 
Carcinoma in situ of the penis
Gray, solitary, crusty plaque
Usu on shaft of penis or on scrotum
Peak incidence in 50-60yo
Progressive to invasive SCC in <10%
78
Q

Bowenoid papulosis

A

Carcinoma in situ of the penis
Multiple papular lesions
affects younger age group than other penile cancers
Usu does not become invasive

79
Q

Erythroplasia of Queyrat

A

Carcinoma in situ of the penis
Red velvety plaques
Usu involves glands
Other than location, similar to Bowen’s- peak incidence at 50-60

80
Q

Sq Cell Carcinoma of the penis

A

Commonly assoc w HPV, lack of circumcision

More common in Asia, Africa, S America

81
Q

Peyronie’s dz

A

Bent penis d/y acquired fibrous tsu formation

82
Q

T/F Bowen’s dz is a carcinoma of both men and women

A

True

Usu on shaft of penis or on scrotum, but can also be on female genitalia

83
Q

Types of HPV a/w SCC

A

16, 18, 31

84
Q

Balanitis

A

Infection of foreskin
Often fungal; 40% candidiasis
Rx: topical antifungal or 1 dose fluconazole

85
Q

Priapism

A 
Persistent penile erection
Caused by:
Trazodone (anti-depressant med)
Sickle cell dz
Trauma to the spinal cord

* DIT each session (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions