Male Infertility

Question 1

what is pathophys of peyronies?

Answer 1

connective tissue disorder where dense collagen plaque in tunica albuginea of penis leads to curvature of the erection

Question 2

what is first line rx for ED?

Answer 2

PDE-5 inhibitors or testosterone therapy

Question 3

explain the MoA of PDE-5 inhibitors

Answer 3

prevents breakdown of cGMP and this leads to increased cGMP and decreased intracellular calcium so more smooth muscle relaxation

Question 4

what is generic name for viagra?

Answer 4

sildenafil

Question 5

what is generic name for cialis?

Answer 5

tadalafil

Question 6

if PDE-5 inhibitors dont work…what is a second lin option for ED rx?

Answer 6

direct injection of vasodilators into corpora cavernosa

Question 7

what is primary hypogonadism?

Answer 7

testicular insufficiency

Question 8

what is secondary hypogonadism?

Answer 8

pituitary insufficiency

Question 9

what are sx of hypogonadism?

Answer 9

ED, low libido, low energy fatigue

Question 10

how do you diagnose hypogonadism?

Answer 10

measure serum testosterone and below 300 ng/dl

Question 11

what is the number 1 cause of infertilitiy in men?

Answer 11

varicocele

Question 12

what happens in a varicocele

Answer 12

dilation of pampiniform plexus

Question 13

how does varicocele lead to infertilitiy?

Answer 13

leads to hyperthermia or hypoxia of testicles

Question 14

which side is more common to have a varicocele?

Answer 14

LEFT

Question 15

what is karyotype of klinefelter?

Answer 15

XXY 47

Question 16

what are features of klinefelter syndrome?

Answer 16

primary hypogonadism, infertility, tall stature gynecomastia

Question 17

what is usual presentation of klinefeleter?

Answer 17

normal appearing male with hypgonadism and infertility

Question 18

what is CBAVD?

Answer 18

congenial bilateral absence of the vas deferens

Question 19

who gets CBAVD?

Answer 19

those with CF or CF carriers

Question 20

what is a genetic thing that can cause severe oligospermia?

Answer 20

Y chromosome microdeletion

Question 21

what hormone means you have normal spermatogenesis?

Answer 21

FSH

Question 22

if FSH is low, what does that mean about spermatogenesis?

Answer 22

likely messed up…pre testicular failure

Question 23

if FSH is high, what do you likely have?

Answer 23

testicular failure

Question 24

what does exogenous testosterone cause to testes?

Answer 24

it will lead to them atrophy and cessation of spermatogenesis and infertility

Question 25

what is first reccomended test in work up of infertility?

Answer 25

semen analysis