male reproductive Flashcards
finasteride MOA
5 alpha reductase inhibitor
Almost all males with cystic fibrosis are unable to secrete semen due to congenital bilateral absence of the _____
vas deferens
If patients have normal erections at night or during masturbation, but are impaired with a partner, what is the cause of ED?
Psychogenic erectile dysfunction
Incomplete fusion of the urethral folds in men results in ____
hypospadias
Faulty position of the genital tubercle in the fifth week of gestation in a male results in
epispadias
what is the cause of epispadias vs hypospadiss in a male
epispadias: faulty position of genital tubercle
hypospadias: incomplete fusion of the urethral folds
How do patients still have viable sperm for up to 3 mo/ 20 ejaculations after a vasectomy
viable sperm remain in the portion of the vas deferens distal to the transection
Flutamide MOA
nonsteroidal anti-androgen, competitively inhibits testosterone receptors
injury to the posterior urethra is associated with what injurie? what injuries are associated with anterior urethra damage
posterior: pelvic fracture
anterior: straddle injuries
a communicating hydrocele develops if the _____ fails to obliterate, leading to persistent connection between the scrotum and peritoneal cavity
process vaginalis
what type of hernia is most similar in pathophysiology to a communicating hydrocele
indirect inguinal hernia
what is the karyotype of Klinefelter syndrome
47,XXY
alpha adrenergic stimulation promotes a flaccid or erect penis?
flaccid
high vascular and smooth muscle tone prevents corporal engorgement
A communicating hydrocele results when serous fluid accumulates within the ____ in the scrotom
tunica vaginalis
what is the role of sertoli cells during male sexual differential in utero
release anti-mullerian hormone –> involution of paramesonephric ducts
what is the role of Leydig cells during male sexual differentiation in utero
release testosterone –> wolffian duct develops into male internal genitalia
testosterone –> DHT –> genital tubercle and urogenital sinus develop into male external genitalia
male sexual differentiation in utero occurs due to what gene on the Y chromosome
SRY
lymph from the testes drains to what lymph nodes? lymph from glands penis? from the scrotom?
testes: para aortic
glands penis: deep inguinal
scrotum: superficial inguinal lymph nodes
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
TSH
What cancers cause elevated hCG
choriocarcinoma and germ cell tumors
what nerves lie within the fascia of the prostate and innervate the corpus cavernosa of the penis which facilitates penile erection
prostatic plexus: inferior hypogastric nerves, pelvic nerves, and sacral splanchnic nerves
what zone of the prostate is most commonly involved in prostate adenocarcinoma thus making transrectal ultrasound guided biopsy a useful diagnostic tool
peripheral zone
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
external oblique
the deep inguinal ring is a physiologic opening in the ____ fascia
transversalis
sertoli cells are equivalent to female ___ cells
granulosa
sertoli cells release ____ in response to FSH from the anterior pituitary
inhibin
what medication commonly used to treat heart failure can cause gynecomastia, decreased libido, and impotence
spironolactone
eplerenone is more selective and has fewer side effects
bicalutamide MOA
androgen receptor antagonist
buserlin MOA
GnRH analog
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 _____
5
Finasteride MOA
5 alpha reductase inhibitor (prevents conversion of testosterone to DHT)
Where do the left and right gonadal arteries arise from?
both arise from abdominal aorta
what are serum testosterone levels like in patients taking exogenous testosterone
they can be low but are often within normal limits or elevated
(local testosterone levels in the seminiferous tubules will be decreased though)
how does the MOA of doxazosin differ from tamsulosin
doxazosin = alpha 1 blocker tamsulosin = uroselective alpha 1 blocker
how is ED caused by primary hypogonadism (Klinefelters, etc.) treated
testosterone
which cells are sensitive to temperature and are therefore prone to heat-induced damage in cryptorchidism
seminiferous tubules and sertoli cells within them
how do prostate cancers spread to the spine?
hematogenously
prostatic venous plexus –> vertebral venous plexus
what are the likely causes of epididymitis in patients under 35 vs over 35
<35: chlamydia or gonorrhoeae
>35: E. coli
how is epididymitis usually diagnosed if a urinalysis is negative
nucleic acid amplification test
What causes hypogonadism in patients with hereditary hemochromatosis
deposition of iron in the pituitary gland (secondary hypogonadism)
