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AUA Fundamentals 2021 > Infertility > Flashcards

Infertility Flashcards

1
Q

Infertility is attributable to male factor in __% of cases

A

50

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2
Q

Blood-testis barrier is made up of ____ cells

A

sertoli

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3
Q

____ cells produce testosterone stimulated by ___ hormone

A

Leydig…. LH

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4
Q

Sertoli cells are stimulated by ____ hormone

A

FSH

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5
Q

Semen composition

Seminal vesicles - ___ cc, fructuose, alkaline

Prostate - ____ cc, acidic

Testes - ____ cc

A

SV - 1.5cc

Prostate - 0.5cc

Testes - 0.1cc

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6
Q

History taking in infertility exam

A 
Prior fertility
• Libido/sexual function
• Testis pain or swelling
• Cryptorchidism
• Prior inguinal or scrotal surgery
• Brothers’ fertility history
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7
Q

Medications that affect fertility

A 
Calcium channel blockers 
 Gout medications
• Cimetidine
• Sulfasalazine
• Exogenous testosterone
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8
Q

Physical exam for infertility

A

Body habitus (Klinefelters)
Hair distribution
Gynecomastia
GU exam - testicular size, palpable vas deferens, cryptorchidism, varicoceles

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9
Q

absence of sperm in ejaculate

A

Azoospermia

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10
Q

Azoospermia with FSH < 7.6 & testes > 4.5 cm

A

obstructive azoospermia

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11
Q

Low sperm count
Low volume
Low pH
No fructose

A

Ejaculatory duct obstruction

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12
Q

Endocrine labs for initial infertility workup

A

AM Testosterone & FSH

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13
Q

Low T
High FSH
High LH

A

Primary hypogonadism (i.e. testicular failure)

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14
Q

Low T
Low FSH
Low LH

A

Secondary hypogonadism (hypothalmic issue)

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15
Q

Exogenous testosterone replacement down regulates ___ which down stream leads to inhibition of spermatogenesis

A

GnRH

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16
Q

Treatment for Hypogonadotrophic Hypogonadism

A

hCG to stimulate leydig cells

FSH to stimulate sertoli cells

17
Q

Azoospermia, low T, elevated fsh, atrophic testes

A

Klinefelter (47XXY)

18
Q

Imaging for ___ anomalies should be offered in those with unilateral vasal agenesis or CBAVD

A

renal

19
Q

Grade ___ varicocele is palpable only with valsalva

A

I

20
Q

Grade ___ varicocele is palpable without valsalva

A

II

21
Q

Grade ___ varicocele is visible on exam

A

III

22
Q

Criteria to intervene on varicocele

A

Infertility, testicular size differential

AUA Fundamentals 2021 (11 decks)

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