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Y2 Endocrine > Male Hypogonadism > Flashcards

Male Hypogonadism Flashcards

1
Q

what stimulates release of GnRH from the hypothalamus?

A

kisspeptin

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2
Q

what does GnRH do?

A

stimulates the anterior pituitary to release LH and FSH

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3
Q

what effect do LH and FSH have in males?

A

testes stimulated to produce testosterone

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4
Q

what cells produce testosterone and what hormone controls this?

A

leydig cells

LH

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5
Q

how does the majority of testosterone exist?

A

bound to SHBG and albumin

only <2% free and bioavailable

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6
Q

what two things is testosterone converted to?

A

dihydrotestosterone

oestradiol

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7
Q

what is the highly active form of testosterone?

A

dihydrotestosterone

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8
Q

what breaks down dihydrotestosterone?

A

5a reductase

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9
Q

what breaks down oestradiol?

A

aromatase

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10
Q

what is male hypogonadism?

A

low or reduced testicular function

clinical syndrome of testosterone deficiency

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11
Q

what type of male hypogonadism is caused by a problem with the testes?

A

primary

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12
Q

what type of male hypogonadism is caused by a problem with the hypothalamus or pituitary?

A

secondary

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13
Q

what hormone level abnormalities are seen in primary hypogonadism?

A

low testosterone

raised LH/FSH

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14
Q

what is another name for primary hypogonadism?

A

hypergonadotrophic hypogonadism

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15
Q

how can primary hypogonadism present and why?

A

to fertility clinics, as spermatogenesis is affected

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16
Q

name three congenital causes of primary hypogonadism

A

klinefelte’s syndrome
cryptorchidism
Y chromosome microdeletions

17
Q

name some acquired causes of primary hypogonadism

A 
testicular trauma 
chemotherapy 
varicocele 
orchitis 
infiltrative disease 
medications
18
Q

name an infiltrative disease that can cause primary hypogonadism

A

haemochromatosis

19
Q

what type of infection can commonly cause orchitis?

A

mumps

20
Q

name two medications that can cause primary hypogonadism

A

glucocorticoids

ketoconazole

21
Q

what causes klinefelter’s syndrome?

A

nondisjunction

47 XXY

22
Q

how is klinefelter’s syndrome diagnosed?

A

karyotyping

23
Q

how does klinefelter’s syndrome present?

A

infertile

small, firm testes

24
Q

what is there an increased risk of in patients with klinefelter’s syndrome?

A

cryptorchidism
learning disablities
breast cancer
non-hodgkin lymphoma

25
Q

describe the hormone levels seen in secondary hypogonadism

A

low/inappropriately normal LH/FSH

low testosterone

26
Q

what is another name for secondary hypogonadism?

A

hypogonadotrophic hypogonadism

27
Q

name two congenital causes of secondary hypogonadism

A

kalman’s syndome

prader willi

28
Q

what is another name for kalman’s syndrome?

A

isolated hypogonadotrophic hypogonadism

29
Q

name some acquired causes of secondary hypogonadism

A 
pituitary damage 
hyperprolactinaemia
diabetes
medications 
acute illness 
eating disorders
30
Q

name two medications that can cause secondary hypogonadism

A

steroids

opioids

31
Q

what is kalman’s syndrome?

A

a genetic disorder characterised by isolated GnRH deficiency and hyposmia/anosmia

32
Q

what other abnormalities may be seen in kalman’s syndrome due to isolated GnRH deficiency?

A

unilateral renal agenesis
red-green colour blindness
cleft lip
bimanual synkinesis

33
Q

how does hypogonadism present if onset is pre puberty?

A 
small sex organs 
decreased body hair 
high pitched voice 
low libido
gynaecomastia 
decreased bone + muscle mass
34
Q

how does hypogonadism present if onset is post puberty?

A 
normal sexual organs 
decreased libido + spontaneous erections 
decreased body hair 
decreased testicular volume 
gynaecomastia
35
Q

what is the initial test for hypogonadism?

A

AM testosterone

repeated if low

36
Q

how is testosterone measured?

A

total testosterone and SHBG measured and used to calculate the calculated free testosterone

37
Q

when should testosterone be measured and why?

A

between 8-11am

peaks in the morning

38
Q

how is male hypogonadism managed?

A

testosterone replacement therapy

39
Q

what are the four contraindications to testosterone replacement therapy?

A

hormone responsive cancer
possible prostate cancer
haematocrit >50%
severe sleep apnoea/heat failure

Y2 Endocrine (33 decks)

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