Male pathophysiology and Histology

Question 1

Effects of elevated temperature

Answer 1

Testicular atrophy

Spermatogenic cells atrophy

Leydig cell hyperplasia = increased risk of testicular cancer

Only Sertoli cells in SE

Question 2

Why is T not high with Leydig cell hyperplasia?

Answer 2

androgen resistance (defect in receptor)

low functioning Leydig cells (if hypogonadism)

neg feedback

Question 3

What are the two phases of testicular decent?

Answer 3

Transabdominal

Inguinoscrotal

Question 4

When does transabdominal and inguniscortal decent occur?

Answer 4

T- first 3-6 months

IS= last trimester (6 months –> birth)

Question 5

Hormones involved in Transabodminal testicular descent

Answer 5

INSL3 = Gubernaculum thickening

testosterone = degenerates cranial suspensory ligament.

Question 6

Hormone action of Inguinoscrotal testicular descent

Answer 6

testosterone = shortening and contraction of gubernaculum

Question 7

What is Cryptiochidism

Answer 7

incomplete descent of one or both testes

Question 8

why is there an increased risk of Cryptorchidism in premature babies?

Answer 8

as the IS phase occurs from 6 months –> birth, the reaction of gubernaculum is not likely to be complete

Question 9

What are the two treatments of Crytorchidism?

Answer 9

HCG
Acts on Leydig cells
Provides local, concentrated T

Early Surgery
Early to minimize time testes is in the body do reduce leydig proliferation

Question 10

How does Cyrptochormism lead to infertility?

Answer 10

Leydig cell hyperplasia and spermatogenic cell atrophy = decreased sperm count

Question 11

What is Varicocele and how does it lead to infertility?

Answer 11

Enlarged spermatic cord veins

Infertility
Reduced blood flow = reduced heat exchange = increased temp = infertility

Question 12

causes of primary hypogonadism

Answer 12

Testicular dysfunction

Klinefelter’s Syndrome

Question 13

Pathophysiology of Klinefelter’s syndrome

Answer 13

decreased T from Leydig cells = decreased responsiveness to LH

decreased inhibin = increased FSH

fibrosis of SE tubules = infetility

Question 14

treatment of Pri Hypogonadism

Answer 14

T supplementation

Question 15

Hormonal profile of pri vs sec hypogonadism

Answer 15

Pri = HYPERgonadotropic

Sec= HYPOgonadotrophic

Question 16

Causes of sec hypogonadism and treatment

Answer 16

Pituitary/ hypothalamus dysfunction

Tumor or Kallmann’s syndrome

treatment
hCG supplementation

Question 17

causes of Hypergonasim

Answer 17

Androgen-secreting tumors

Adrenal adenomas

Leydig cell tumors

Question 18

clinical features of Hypergonadism

Answer 18

Precocious puberty

Excessive muscle mass

Mood swings

Unusual body hair growth

Acne

Gynecomastia

Question 19

Hormonal profile of Hypergonasims

Answer 19

Increased T

Decreased GnRH

Question 20

Features of a normal SE tubule

Answer 20

colonised by sertoliu ells and spermatogenic cell

small clusters of leydig cells

Question 21

Features of an atrophied SE tubule and what conditions would you see it in?

Answer 21

Collagen fibers
Missing cells

(Orchitis)
(Klinefelter’s Syndrome)

Question 22

Features of SE tubule esposed to high temps and what conditions would you see it in?

Answer 22

Cells in center of tubule
Leydig cell hyperplasia

(cryptorchidism)
(Klinefelter’s syndrome)

Question 23

features of Infant testis histology

Answer 23

Lower density of SE tubules

NO spermatogenic cells in tubules

Question 24

Epididymis features (histology)

Answer 24

• pseudostratified cells with stereocilia
• lumen filled with spermatozoa and proteins