Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 1 ID+LC > Male Pathophys > Flashcards

Male Pathophys Flashcards

1
Q

Hypogonadism

A

a clinical syndrome that results from failure of testes to produce phys. lvls of T and the nl # of spermatozoa due to disruption of 1/m lvls of the HPG axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Sexual signs of hypogonadism

A
  1. diminished libido
  2. erectile dysfxn
  3. DIff achieving orgasm
  4. decreased performance

*but can present this way even if indiv doesnt have hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CLue for exogenous androgen exposure

A

undetectable gonadotropins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pathophys of testosterone deficiency: hypothalamic dysfxn

A

see slide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Genetic causes of GnRH deficiency

A

Kallman syndrome

Mut in KAL1 at pituitary
- Presents with Anosmia: can’t smell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acquired Central Hypogonadism

A

Low - low nl LH + FSH
Low T

  1. GnRH pulse generator defect due to:
    - stress
    - severe illness
    - abnl weight loss
  2. Narcotics:
    - opioids/marijuana: wipe out pulse generator
  3. Glucocorticoids:
    - steroid injxn: suppresses adrenal axis and T
  4. Supplements:
    - prohormones
    - anabolic steroids: cause undetectable LH/FSH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

nl T lvls for adult

A

240-800 ng/dl

Young men: 550 ng/dl
- more SHGB  makes higher total  T lvls 
Older men:
240 ng/dl
- Less SHGB makes a lower total T lvls
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of ED

A
  1. Vascular
  2. Neurogenic
  3. Hormonal
  4. Iatrogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Obstructive sleep apnea

A 
1. Hypoxia --> high cortisol and catacholamines -->
Insulin resistance + metabolic syndrome
2. SNoring, apnea
3. Fatigue daytime somnolence
4. ED: decreased NO in cavernosal muscle

T worsens untreated OSA
TX: CPAP, lifestyle intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Different causes of Pituitary hypogonadism
- Low LH + FSH
Low T

A
  1. Prolactinoma: increases Prl
  2. Tumors/Mass effects
    - craniopharyngioma
    - pituitary tumor
    - mets
  3. Infiltrative disorders: hemachromatosis (iron deposits selectively in gonadotropes)
  4. Inflammatory: lymphocytic hypophysitis due to new drug IPI when treating melanoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Loss of inhibin

A

FSH > LH

  • inhibin regulates FSH
  • FSH + LH are usually the same at ~10-12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

First sign of puberty in boy

A

testicular enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pathophys of T deficiency: testicular dysfxn

A

see slide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hypergonadotropic hypogonadism

high FSH
high/low LH
Low T

  • Different congenital causes
A
  1. Congenital: anorchia, vanishing testes syndrome
    - high GnRH is induced to try to stimulate failing gonad
  2. Klinefelter’s syndrome
    - failing testes
    - no sertoli, intact leydig
    - low inhibin B lvls
    - delayed puberty
    - genecomastia
    - risk for DVT/PE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of acquired hypergonadotropic hypogonadism

high FSH
high/low LH
Low T

A
  1. Trauma or torsion
    - testes dies –> sertoli dies –> loss of inhibin –> rise in FSH
  2. Mumps orchitis
  3. Alcohol: direct testicular toxin
  4. Diabetes
  5. Radiation/chemotherapy
  6. Autoimmune testicular failure: check TSH, glucose, B12, Vit D
  7. *Pituitary tumor:
    - High FSH:LH, low T
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gonadotrope pituitary tumor

:aka FSH/LH secreting tumor

A

glycoprotein tumor of the pituitary that overproduces abnl LH + FSH, while at the same time compresses the pituitary and prevent release of real LH+FSH –> T lvls end up low

Labs: high FSH/LH, low T

Hx: HA, lateral visual disturbances, ED

Exam: visual fields, sx of hypogonadism, softening of testes

Tx: surgery

17
Q

What should we do in pts with low-nl T lvls?

A
  1. diet
  2. lifestyle
  3. successful weight loss
    - increase T lvls
    - Improve OSA
    - Improve cardiovascular and metabolic fitness
    - Improve ED

DO NOt dz hypogonadism right away

18
Q

Cardiac Risks of T therapy

A

Increased cardiac events

  • esp in elderly men
  • ACS, MI, Syncope, HTN, arrhythmia, edema, CHF

*Too low or Too high T has adverse effects

19
Q

Potential risk of T therapy

A
  1. Stim prostate growth in previously undiagnosed prostate cancer
  2. risk of bladder outlet symptoms due to increase in prostate volume
  3. Edema in pts with pre-existing cardiac, renal, hepatic disease
  4. Gynecomastia (converted to E)
  5. Erythrocytosis
  6. PPT / worsening of sleep apnea
  7. increased CV risk
20
Q

Things that can cause hypogonadotropic hypogonadism: Low GnRH, LH, FSH, T

A
  1. genetic - rare
    - Kallman syndrome
  2. Acquired:
    - narcs, GC, hemochromatosis, tumor, XRT, stress, illness
21
Q

Things that can cause high FSH, LH, low testosterone

A
  1. Primary testicular failure

2. Gonadotrope pituitary tumor

22
Q

DHT acts specifically on what?

A

External genitalia and prostate

23
Q

what is the gonadal peptide that inhibits FSH in males and acts locally in the testes?

A 
Inhibin B (alpha and betaB)
- not betaA
24
Q

Hypogonadotropic hypogonadism can be due to:

A
  1. Congenital
    - GnRH neurons fails to migrate to hypothalamus (Kallman’s syndrome if anosmia is also included)
    - neurons migrate with olfactory neurons in utero
    (579)
  • intact hardware, but software program is missing
    2. Acquired deficits of GnRH or LH and FSH
25
Q

Prolactinomas

A

Most common pituitary tumor

  • Makes Prl which blocks GnRH induced LH and FSH signal
  • Acquired cause of Hypogonadotropic hypogonadism

Unit 1 ID+LC (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions