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Endocrine > Male endocrinology > Flashcards

Male endocrinology Flashcards

1
Q

Explain the male HPA axis?

A

GnRH is released from the hypothalamus > LH & FSH release from the AP > act on the testes.

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2
Q

What cell does LH act on?

A

Leydig cells > release of testosterone.

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3
Q

What cell does FSH act on?

A

Sertoli cells > release of ABG & inhibin.

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4
Q

What is the function of ABG?

A

Keeps testosterone in the seminiferous tubules.

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5
Q

What is the function of inhibin?

A

Supports spermatogenesis & negative feedback.

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6
Q

What is male hypogonadism?

A

Dysfunctioning gonads > low serum testosterone.

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7
Q

What is primary hypogonadism?

A

Dysfunction within the gonads (i.e. failure of leydig cells).

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8
Q

What would primary hypogonadism show on blood investigations?

A

Low testosterone.

Elevated FSH & LH.

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9
Q

What causes primary hypogonadism?

A 
Klinefelters syndrome.
Surgical castration.
Trauma.
Infections.
Chronic liver & kidney disease.
Drugs & alcohol.
Radiotherapy & chemotherapy.
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10
Q

What is the treatment for primary hypogonadism?

A

Decanoate (synthetic testosterone).

PDE inhibitor - for erectile dysfunction.

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11
Q

What is secondary hypogonadism?

A

Low testosterone due to failure to secrete or insufficient GnRH.

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12
Q

What would secondary hypogonadism show on blood investigations?

A

Low testosterone.

Low FSH & LH.

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13
Q

What are the causes of secondary hypogonadism?

A

Kallmanns syndrome.
Cushing syndrome.
Diabetes.
Hypopituitarism - low FSH & LH secretion.

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14
Q

What is the treatment for secondary hypogonadism?

A

GnRH infusion.
HCG & FSH.
PDE inhibitor.

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15
Q

What is Kallmanns syndrome?

A

Genetic disorder > failure of GnRH neurones to migrate to the hypothalamus > absent/low GnRH release.

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16
Q

What is Klinefelters syndrome?

A

47 XXY.

17
Q

What are the symptoms of adult hypogonadism?

A 
Small or absent testes.
Small prostate.
Gynaecomastia.
Infertility & sexual dysfunction.
Reduced hair growth.
Osteoporosis.
18
Q

What are the symptoms of pubertal hypogonadism?

A 
Eunuchoid:
> lack secondary sexual characteristics.
> infantile genitalia.
>Gynaecomastia.
> infertility.
19
Q

What are the symptoms of foetal hypogonadism?

A

Development of a female.

20
Q

What is male infertility?

A

Inability to fertilise a fertile woman.

21
Q

What are the causes of male infertility?

A 
Idiopathic.
Varicocele.
Mumps.
Hypogonadism.
Testicular cancer.
Drugs & alcohol.
22
Q

What are the signs of male infertility?

A

Oligospermia.
Azospermia.
Small testes.

23
Q

What is the treatment for male infertility?

A

Intracytoplasmic sperm injections.
Vasectomy reversal.
GnRH therapy - if infertility is due to secondary hypogonadism.

24
Q

What is androgen insensitivity syndrome?

A

X-linked autosomal recessive disorder.

25
Q

What are the main causes of AIS?

A

Mutations in the androgen receptor.

Mutations in the 5a reductase gene.

26
Q

What does 5a reductase do?

A

Converts testosterone in DHT which is required for masculinsation of the foetus.

27
Q

What are the signs of AIS?

A 
Males born with ambigious genitalia:
> blind ended vaginas.
> small clitoris.
> small testes present.
> Bilateral inguinal hernias.
28
Q

What is the treatment for AIS?

A

Pre-pubertal orchidectomy.

Oestrogen replacement therapy.

29
Q

What is precocious puberty?

A

Puberty occurring at an unusually early age:
> puberty before 7-8 years in females.
> puberty before 9-10 years in males.

30
Q

What are the types of precocious puberty?

A

Central:
> Gonadotropin dependant (i.e. increased release of gonadotropins from the HPG axis).

Precocious pseudopuberty:
> Gonadotropin independent (not due to increased release of gonadotropins from the HPG axis).

31
Q

What are the causes of central precocious puberty?

A 
Idiopathic.
Hypothalamic hamartoma - benign tumour that produces GnRH.
Pineal gland tumour.
Hypothyroidisim.
CNS injury.
32
Q

What are the causes of precocious pseudopuberty?

A

Congenital adrenal hyperplasia.
Adrenal or gonadal tumours.
HCG secreting tumours - HCG is a analog of LH.

33
Q

What are the signs of precocious puberty?

A

Short stature.

Sexual precocity.

34
Q

What is the treatment for central precocious puberty?

A

GnRH agonist.

35
Q

What is the treatment for precocious pseudopuberty?

A

17a hydroxylase inhibitor (i.e. steroid synthesis inhibitor).

Endocrine (4 decks)

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