male reproductive

Question 1

finasteride MOA

Answer 1

5 alpha reductase inhibitor

Question 2

Almost all males with cystic fibrosis are unable to secrete semen due to congenital bilateral absence of the _____

Answer 2

vas deferens

Question 3

If patients have normal erections at night or during masturbation, but are impaired with a partner, what is the cause of ED?

Answer 3

Psychogenic erectile dysfunction

Question 4

Incomplete fusion of the urethral folds in men results in ____

Answer 4

hypospadias

Question 5

Faulty position of the genital tubercle in the fifth week of gestation in a male results in

Answer 5

epispadias

Question 6

what is the cause of epispadias vs hypospadiss in a male

Answer 6

epispadias: faulty position of genital tubercle
hypospadias: incomplete fusion of the urethral folds

Question 7

How do patients still have viable sperm for up to 3 mo/ 20 ejaculations after a vasectomy

Answer 7

viable sperm remain in the portion of the vas deferens distal to the transection

Question 8

Flutamide MOA

Answer 8

nonsteroidal anti-androgen, competitively inhibits testosterone receptors

Question 9

injury to the posterior urethra is associated with what injurie? what injuries are associated with anterior urethra damage

Answer 9

posterior: pelvic fracture
anterior: straddle injuries

Question 10

a communicating hydrocele develops if the _____ fails to obliterate, leading to persistent connection between the scrotum and peritoneal cavity

Answer 10

process vaginalis

Question 11

what type of hernia is most similar in pathophysiology to a communicating hydrocele

Answer 11

indirect inguinal hernia

Question 12

what is the karyotype of Klinefelter syndrome

Answer 12

47,XXY

Question 13

alpha adrenergic stimulation promotes a flaccid or erect penis?

Answer 13

flaccid

high vascular and smooth muscle tone prevents corporal engorgement

Question 14

A communicating hydrocele results when serous fluid accumulates within the ____ in the scrotom

Answer 14

tunica vaginalis

Question 15

what is the role of sertoli cells during male sexual differential in utero

Answer 15

release anti-mullerian hormone –> involution of paramesonephric ducts

Question 16

what is the role of Leydig cells during male sexual differentiation in utero

Answer 16

release testosterone –> wolffian duct develops into male internal genitalia
testosterone –> DHT –> genital tubercle and urogenital sinus develop into male external genitalia

Question 17

male sexual differentiation in utero occurs due to what gene on the Y chromosome

Answer 17

SRY

Question 18

lymph from the testes drains to what lymph nodes? lymph from glands penis? from the scrotom?

Answer 18

testes: para aortic
glands penis: deep inguinal
scrotum: superficial inguinal lymph nodes

Question 19

Patients with germ cell tumors may have high levels of hCG which has a structure similar to what which may produce symptoms of weight loss and elevated blood pressure

Answer 19

TSH

Question 20

What cancers cause elevated hCG

Answer 20

choriocarcinoma and germ cell tumors

Question 21

what nerves lie within the fascia of the prostate and innervate the corpus cavernosa of the penis which facilitates penile erection

Answer 21

prostatic plexus: inferior hypogastric nerves, pelvic nerves, and sacral splanchnic nerves

Question 22

what zone of the prostate is most commonly involved in prostate adenocarcinoma thus making transrectal ultrasound guided biopsy a useful diagnostic tool

Answer 22

peripheral zone

Question 23

The testis pass through the inguinal canal and enters the scrotum via the superficial inguinal ring which is a physiologic opening in the ______ muscle aponeurosis above the pubic tubercle

Answer 23

external oblique

Question 24

the deep inguinal ring is a physiologic opening in the ____ fascia

Answer 24

transversalis

Question 25

sertoli cells are equivalent to female ___ cells

Answer 25

granulosa

Question 26

sertoli cells release ____ in response to FSH from the anterior pituitary

Answer 26

inhibin

Question 27

what medication commonly used to treat heart failure can cause gynecomastia, decreased libido, and impotence

Answer 27

spironolactone

eplerenone is more selective and has fewer side effects

Question 28

bicalutamide MOA

Answer 28

androgen receptor antagonist

Question 29

buserlin MOA

Answer 29

GnRH analog

Question 30

poorly differentiated prostate tumors that do not resemble normal prostatic tissue and are generally arranged into sheets of invasive cells with no glandular elements are the highest gleason score of _____

Answer 30

5

Question 31

Finasteride MOA

Answer 31

5 alpha reductase inhibitor (prevents conversion of testosterone to DHT)

Question 32

Where do the left and right gonadal arteries arise from?

Answer 32

both arise from abdominal aorta

Question 33

what are serum testosterone levels like in patients taking exogenous testosterone

Answer 33

they can be low but are often within normal limits or elevated
(local testosterone levels in the seminiferous tubules will be decreased though)

Question 34

how does the MOA of doxazosin differ from tamsulosin

Answer 34

doxazosin = alpha 1 blocker
tamsulosin = uroselective alpha 1 blocker

Question 35

how is ED caused by primary hypogonadism (Klinefelters, etc.) treated

Answer 35

testosterone

Question 36

which cells are sensitive to temperature and are therefore prone to heat-induced damage in cryptorchidism

Answer 36

seminiferous tubules and sertoli cells within them

Question 37

how do prostate cancers spread to the spine?

Answer 37

hematogenously

prostatic venous plexus –> vertebral venous plexus

Question 38

what are the likely causes of epididymitis in patients under 35 vs over 35

Answer 38

<35: chlamydia or gonorrhoeae

>35: E. coli

Question 39

how is epididymitis usually diagnosed if a urinalysis is negative

Answer 39

nucleic acid amplification test

Question 40

What causes hypogonadism in patients with hereditary hemochromatosis

Answer 40

deposition of iron in the pituitary gland (secondary hypogonadism)