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Endo/Repro: Week 4 > Hellkatz: Male Reproductive Physiology > Flashcards

Hellkatz: Male Reproductive Physiology Flashcards

1
Q

What is spermatogenesis?

A

production of mature haploid spermatozoa from spermatogonial sperm cells

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2
Q

What’s unique about male germ cells?

A

Capable of producing cells that undergo mitosis

Able to produce germ cells that differentiate into spermatozoa throughout life.

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3
Q

When do mitosis and meiosis occur in spermatogenesis?

A

Mitosis begins in the embryo

Mitosis and meiosis occurs through adult life

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4
Q

Where does spermatogenesis occur?

A

seminiferous tubules of testes

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5
Q

What’s a spermatogenic wave?

A

time it takes for reappearance of same stage w/in given segment of seminiferous tubule

*spermatogenesis is staggered throughout hte seminiferous tubule so ALL developmental phases occur at one time

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6
Q

What is the purpose of spmeratogenic waves?

A

ensures that spermatozoa are produced continuously & mature sperm are always available

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7
Q

How long is the total spermatogenesis cycle?

A

64 days

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8
Q

How many sperm are produced daily?

A

100 milion

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9
Q

What influences spermatogenesis?

A

directly proportional to testosterone levels

*decreases in older age goups

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10
Q

What regulates testosterone secretion?

A

NFB from testosterone and inhibin

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11
Q

Produces testosterone

A

testicle

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12
Q

produces DHT

A

prostate

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13
Q

produces dihydrioepiandrostendione

A

adrenal

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14
Q

Where are SHBG made and what do they do?

A

made in liver and sertoli cells, bind androgens and estrogens

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15
Q

What steroid receptor acts as a TF?

A

Androgen Receptor

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16
Q

What nourishes developing sperm and secretes androgen binding protein and inhibin?

A

sertoli cells

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17
Q

What stimulates sertoli cells leading to sperm proliferation and differentiation?

A

Testosterone and FSH

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18
Q

What does inhibin do?

A

inhibits FSH from AP

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19
Q

What promotes muscle building, bone growth and Na and water retention?

A

androgens

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20
Q

What is andropause?

A

androgen def w/ aging

Aging> decreased testosterone> decreased muscle mass and increased abdominal fat

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21
Q

What happens to testicular function w/ andropause?

A

loss of spermatocytes, Leydig cells, Sertoli cells

decrease of testosterone production

compensatory increases in secretion of GnRH and gonadotropins (FSH and LH)

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22
Q

Erectile dysfunction, weight gain and gynecomastia are all sxs of…

A

andropause (d/t shift in estrogen: testosterone ratio)

23
Q

How do you dx andropause?

A

measure morning total testosterone

24
Q

What are the normal circulating levels of testosterone in males and females?

A 
Males = 0.6 mcg/dL 
Females = 0.03 mcg/dL
25
Q

What are the androgenic effects of hormone replacement?

A 
Hypogonadism 
Hypopituitary f(x)
26
Q

What are the anabolic effects of androgens?

A

muscle building

Promotes prot synth → incr. muscle mass & strength [Counters glucocorticoid effects]

27
Q

What type of androgen therapy is good for reversing protein loss?

A

anabolic > androgenic

opposite is good hormone therapy

28
Q

What is used for testosterone hormone replacement?

A

Methyl testosterone (testosterone analog)

29
Q

Hepatotoxicity, acute cholestasis and increased tumor incidence w/ chronic use are SE of..

A

methyl testosterone

30
Q

What synthetic androgen is used to promote muscle growth and has low risk of hepatotoxicity?

A

Oxandrolene

31
Q

Growth interrruption, priapism, jaundice, hypogonadism, aggressive behavior are se of ….

A

synthetic androgens

32
Q

Why do synthetic androgens have so many SE?

A

Bind to MANY different receptors (glucocorticoid, progesterone, estrogen)> multiple effects

arromatization of steroids to estradiol compounds> adverse estrogenic efffects

33
Q

What are adverse effects of anabolic steroids in men?

A
  • Gynecomastia
  • Testicular shrinkage/ reduce sperm count
  • Impotence
  • Baldness
34
Q

What are adverse effects of anabolic steroids in women?

A
  • Menstrual irregularities
  • Clitoris enlargement
  • Increase in facial & body hair
35
Q

What is the purpose of medical castration drugs?

A

interfere w/ precocious puberty
tx androgen dep cancers
reduce libido

36
Q

What should you use if your goal is to shut down the HPO axis?

A

GnRH agonists/antagonists (don’t wipe out locally produced androgens in other tissues–prostate)

37
Q

What should you use if your goal is to reduce androgen signaling in the prostate gland?

A

androgen receptor antagonists or 5 alpha reductase inhibitors

38
Q

What drug is used to reduce excessive sex drive in men, and treat hirsuitism in women.

A

Cyproterone acetate

39
Q

What drug is used to tx prostate cancer but may cause gynecomastia and be hepatotoxic?

A

Flutamide

bicalutamide

40
Q

What is a diuretic that is used to tx hirsutism or acne in women?

A

spironolactone

41
Q

What is the difference between single/pulsatile GnRH agonists vs continuous GnRH agonists?

A

Single/pulsatile → stimulatory

Continuous → inhibitory but has **IMMEDIATE androgen flare

42
Q

What drugs bind GnRH receptors → block action of GnRH → reduced FSH/LH → reduced testosterone production by testes and have NO immediate androgen flare?

A

GnRH antagonists

43
Q

What drug is used to assess gonadal response and can improve sperm numbers after 3-6 mos of pulsatile infusion?

A

Gonadorelin

44
Q

What drug is used to tx advanced prostate cancer and BPH?

A

Degarelix

45
Q

What is a synthetic GnRH analog used to tx gonadotropoin dependent precocious puberty?

A

Leuprolide

46
Q

What drug is used to tx ovarian hypersecretion?

A

Ganirelix

cetrorelix

47
Q

What drugs inhibit the conversion of testosterone to DHT?

A

5 alpha reductase inhibitors

48
Q

What is androgen specific for growth and maintenance of the prostate gland?

A

DHT

49
Q

What is used to tx BPH and male patterned baldness?

A

Finasteride

50
Q

What is used to tx BPH, male pattern bladness, and hirsutism in women?

A

Dutasteride

slower onset and longer t1/2

51
Q

What is the physiology of an erection?

A

1) PS stimulation causes production/release of Nitric Oxide (NO)
2) NO binds membrane receptors in vascular smooth muscles
3) induces increase in intracellular cGMP
4) cGMP promotes arteriole dilation which causes penile engorgement (tumescence).
5) Phosphodiesterase 5 in vascular smooth muscle degrades cGMP
6) Vasodilation ensues which results in a flacid penis.

52
Q

What drugs prevent the degradation of GMP and can cause HA, flushing, dyspepsia and nasal congestion?

A

Sildenafil (viagra), verdena fil and tadalafil

53
Q

What drugs should not be used w/ other nitrates or alpha blockers?

A

sildenafil

Endo/Repro: Week 4 (14 decks)

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