Hypogonadism

Question 1

___ is a clinical syndrome that results from failure of teh testis to produce physiological levels of ___ and a normal number of ___ d/t disruption of one or more levels of the hypothalamic-pituitary-testicular (HPT) axis.

Answer 1

hypogonadism, testosterone, spermatozoa

Question 2

Symptoms of primary hypogonadism is more common with testosterone levels < ___ and increased ___ and ___.

Answer 2

300, luteinizing hormone (LH) and follicle-stimulating hormone (FSH)

Question 3

Congenital causes of hypogonadism include: ___ syndrome and congenital ___ ___.

Answer 3

Kleinfelter’s, adrenal hyperplasia

Question 4

Symptoms of secondary hypogonadism portrays ___ testosterone and ___ LH/FSH.

Answer 4

decreased, decreased

Question 5

Drugs such as ___, ___, and ___ can cause secondary hypogonadism.

Answer 5

opiates, glucocorticoids, androgens

Question 6

Drugs such as ___, ___, and ___ can cause primary hypogonadism.

Answer 6

ETOH, ketoconazole, chemorx

Question 7

Symptoms of hypogonadism include: ___ libido, ___ erections, ___, loss of body ___, shrinking ___, inability to ___, ___ loss, hot ___/sweats.

Answer 7

decreased, decreased, hair, testes, conceive, height, flushes

Question 8

When to test for hypogonadism: if they have a ___ mass, have been on long-term tx w/meds that affect ___ production, ___-associated wt loss, ___, ___, ___ or low trauma fracture.

Answer 8

sellar, testosterone, HIV, ESRD, infertility, osteoporosis

Question 9

It is best to test testosterone levels in the ___ b/c they are at their highest.

Answer 9

morning

Question 10

Contraindications for testosterone therapy include:

Answer 10

prostate or breast carcinoma, urinary symptoms d/t BPH, polycythemia

Question 11

Goals of testosterone therapy is to: improve ___ function and restore ___, increase ___ mass and ___, increase ___ density and reduce the risk for ___, improve ___, and increase ___.

Answer 11

sexual, libido, muscle, strength, bone, fractures, energy, hematocrit

Question 12

Achieve testosterone levels in range of ___-___.

Answer 12

350-750

Question 13

Adverse effects of testosterone therapy include: ___, ___ or oily skin, reduced ___ production.

Answer 13

erythrocytosis, acne, sperm

Question 14

First-line tx for hypogonadism is ___. May also use testosterone ___ and ___ as second-line tx.

Answer 14

testosterone cypionate (depo-testosterone), patches, gels

Question 15

If going w/patches, apply to non-___ areas.

Answer 15

pressure

Question 16

Testosterone patches include:

Answer 16

androderm and testoderm

Question 17

Testosterone gels include:

Answer 17

androgel

Question 18

Disadvantage of testosterone gel/patches is that it must be applied ___.

Answer 18

daily

Question 19

___ is a transbucal testosterone patch applied to the upper ___ every ___ hrs.

Answer 19

Striant, gum, 12

Question 20

Testosterone pellets are implanted via ___ and need to be changed out every ___-___ months.

Answer 20

SQ, 3-6

Question 21

All tx’s that apply to primary hypogonadism also applied to ___ hypogonadism.

Answer 21

secondary

Question 22

Exogenous testosterone decreases chance of ___. The medication ___ ___ preserves fertility.

Answer 22

fertility, clomphene citrate

Question 23

Clomphene citrate (aka ____ is used in the tx for ___ hypogonadism. It works by blocking pituitary ___ receptors, and also increases ___ and ___ which stimulates testicular function.

Answer 23

clomid, secondary, estrogen, LH, FSH

Question 24

Check testosterone levels every ___-___ wks after initiating tx. Goal of levels should be: ___-___.

Answer 24

4-6, 350-800

Question 25

Once testosterone levels are stable and in target range, monitor every ___-___ months, and check ___ and ___ annually.

Answer 25

6-12, hematocrit, PSA

Question 26

Primary is d/t ___ failure. Secondary is d/t ___ deficiency.

Answer 26

testicular, gonadotropin (LH/FSH)

Question 27

Gynecomastia is an indicator of ___.

Answer 27

hypogonadism

Question 28

Need to check a ___ level before starting on testosterone therapy. Goal of ___ or less.

Answer 28

PSA, 4

Question 29

Testosterone therapy is always given through the ___. Never given orally b/c it is potentially ___.

Answer 29

skin, hepatotoxic

Question 30

Greater tendency of ___ when you take IM testosterone d/t greater fluctuations

Answer 30

erythrocytosis

Question 31

Gonadotropins include ___ and ___.

Answer 31

LH, FSH