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Module 1 > Endocrine-2 (Male Reproductive) > Flashcards

Endocrine-2 (Male Reproductive) Flashcards

1
Q

H-P-gonad axes

A

GnRH
↓
LH
↓
Testes
↓
Testosterone production
————————————
GnRH
↓
FSH
↓
Testes
↓
Sperm

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2
Q

What is the percentage of testosterone in the testes?

A

95%

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3
Q

What are the functions of testosterone?

A
  • Male reproductive structure development
  • Maintenance of libido and erectile function
  • Required for sperm maturation
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4
Q

Primary hypogonadism

A

Primary disease - problem is in the testes

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5
Q

Hypogonadotropic hypogonadism

A

Secondary disease - lack of FSH/LH from the pituitary

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6
Q

What are some presentations of primary hypogonadism?

A
  • Absence of testes
  • Lack of testosterone production
  • Lack of functional sperm
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7
Q

What are some presentations of secondary hypogonadism?

A
  • Pituitary adenomas
  • Hyperprolactinemia
  • Hypothyroidism
  • Heavy marijuana use
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8
Q

What kind of drug therapy is used in primary male hypogonadism?

A

Testosterone replacement therapy

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9
Q

What are some adverse drug reactions in testosterone replacement therapy?

A
  • Increased BP
  • Major CV events
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10
Q

Does testosterone restore fertility?

A

No

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11
Q

What are some ways to treat secondary hypogonadism?

A
  • Give Human Chorionic Gonadotropin (hCG)
  • Give a source of FSH
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12
Q

What is a source of FSH that can be used to treat secondary hypogonadism?

A

Menotropins

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13
Q

What is benign prostatic hyperplasia?

A

A benign enlargement of the prostate gland that occurs as men age

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14
Q

What does prostate growth compress?

A

Urethra

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15
Q

What is LUTS?

A

Lower urinary tract symptoms

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16
Q

What are some obstructive symptoms of LUTS?

A
  • Difficult in getting urinary flow started
  • Weak urine stream
  • Dribbling
  • Bladder fullness
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17
Q

What are some irritative symptoms of LUTS?

A
  • Frequent urination
  • Urgency
  • Urinary incontinence
  • Nocturia
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18
Q

What are some complications of BPH?

A
  • Urinary retention
  • UTIs
  • Irreversible impairment of bladder function
  • Chronic renal failure
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19
Q

What are some recommended initial tests for a basic evaluation of any man with LUTS?

A
  • Urinalysis
  • Physical exam
  • PSA level
  • Frequency/volume charts
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20
Q

Is serum creatinine recommended for an initial evaluation for LUTS?

A

No

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21
Q

What is the recommended non-pharmacological treatment for LUTS?

A
  • Watchful Waiting
  • Lifestyle modifications
22
Q

What are some forms of drug therapy for patients with LUTS?

A

Alpha-1 receptor antagonists, 5 alpha-reductase inhibitors

23
Q

What is the mechanism of action of alpha-1 receptor antagonists?

A

Relaxes smooth muscle in the bladder neck and prostate

24
Q

Is urinary flow rate increased or decreased with the use of alpha-1 receptor antagonists in patients with LUTS?

A

Increased

25
Q

What are some examples of non-selective alpha-1 receptor antagonists?

A
  • Terazosin
  • Doxazosin
26
Q

What are some examples of selective alpha-1 receptor antagonists?

A
  • Tamsulosin
  • Silodosin
  • Alfuzosin
27
Q

What is the mechanism of action of 5 alpha-reductase inhibitors?

A

Decreases conversion of testosterone to DHT

28
Q

When should you follow up with patients taking 5 alpha-reductase inhibitors?

A

3 months

29
Q

How much do 5 alpha-reductase inhibitors decrease PSA levels by?

A

50%

30
Q

How can erectile dysfunction be classified?

A

Psychogenic, drug induced, or organic

31
Q

How does an erection begin?

A

Stimulation of parasympathetic nerves

32
Q

What do phosphodiesterase (PDE) enzymes metabolize?

A

cGMP

33
Q

What is the mechanism of action of PDE-5 inhibitors?

A

Prevents the metabolism of cGMP

34
Q

When does the initial release of nitric oxide occur?

A

With foreplay

35
Q

What is a common product used to treat erectile dysfunction?

A

Tadalafil (Cialis)

36
Q

What is considered an adequate trial for drug therapy treating ED?

A

7-8 doses

37
Q

What doses is tadalafil available in?

A

5mg, 10mg, 20mg

38
Q

What are some adverse effects of oral PDE-5 inhibitors?

A
  • Headache
  • Flushing
  • Nasal congestion
  • Cyanospia
39
Q

What is a contraindication of oral PDE-5 inhibitors?

A

Any organic nitrate
- causes severe hypotension

40
Q

Priapism

A

An erection lasting > 4hrs

41
Q

What is another treatment that can be used for ED?

A

Alprostadil

42
Q

What is the mechanism of action of alprostadil?

A

Stimulates adenyl cyclase, increase cGMP

43
Q

What dosage forms do alprostadil come in?

A
  • Urethral inserts
  • Intracavernosal injections
44
Q

Hypopituitarism

A

A clinical disorder characterized by diminished secretion of one or more of the pituitary hormones

45
Q

What is the number one cause of hypopituitarism?

A

Pituitary tumors

46
Q

What is the order in which the hormones are generally effected?

A

GH > FSH/LH > TSH > ACTH > Prl

47
Q

How is hypopituitarism typically treated?

A

Treat the underlying cause

48
Q

If hypopituitarism is not correctable, what do we do for a TSH deficit?

A

Levothyroxine

49
Q

If hypopituitarism is not correctable, what do we do for an ACTH deficit?

A

Glucocorticoid

50
Q

If hypopituitarism is not correctable, what do we do for a FSH/LH deficit?

A

Males: Testosterone
Females: Combination hormonal contraceptive
Fertility: Menotropins

Module 1 (5 decks)

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