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MLSCI 263 > Male Reproductive Hormone Testing > Flashcards

Male Reproductive Hormone Testing Flashcards

1
Q

delayed puberty

A

no puberty by age 14 for boys
> constitutional delay
> Hypogonadotropic hypogonadism
> Hypergonadotropic hypogonadism

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2
Q

Kallman’s syndrome

A

deficiency in GnRH + anosmia (no sense of smell)

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3
Q

hypogonadotropic hypogonadism

A
  • tumors
  • hypothalamic dysfunction
  • pituitary disorders
  • Kallman’s syndrome
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4
Q

hypergonadotropic hypogonadism

A
  • primary testicular failure
  • Klinefelter’s syndrome
  • congenital, anorchia
  • cryptorchidism
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5
Q

Klinefelter’s syndrome

A
  • increase FSH, LH
  • decreased testosterone
  • sex-linked chromosomal anomaly
  • 47 chromosomes (XXY)
  • 1/500 live newborn males
  • rarely diagnosed before puberty
    > small testes, infertility, reduced body hair, gynecomastia, and tall stature (eunuchoid)
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6
Q

anabolic effects of testosterone

A
  • increases bone density
  • increases muscle mass
  • increases skin thickness
  • increase RBC mass

= libido, potency, fertility

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7
Q

androgen deficiency (from low testosterone) AFTER puberty

A
  • ostopenia/osteoporosis
  • proximal muscle wasting
  • fine wrinkling of the face
  • pallor, anemia
  • decreased endurance
  • erectile dysfunction
  • infertility
  • low E (may be mistaken for depression)
  • decreased body hear and thus shaving
  • obesity, gynecomastia
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8
Q

hypogonadism after puberty:

the following features are irreversible androgen effects that are NOT lost if hypogonadism occurs after puberty

A
  • deep voice
  • male sexual orientation
  • penis size
  • body proportions
  • baldness
  • linear height
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9
Q

decline in testosterone is thought to be due to:

A
  • decreased Leydig cell numbers
  • decreased GnRH pulse amplitude
  • increases in SHBG (meds can interfere with binding of hormones)
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10
Q

to diagnose hypogonadism these must be met:

A
  • patients must exhibit at least three symptoms
  • low concentration of serum testosterone
  • total serum testosterone is most widely used
  • test free and bioavailable testosterone
    > when total test… is not diagnostic in a patient with symptoms of hypogonadism
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11
Q

hypogonadism in general

A

inability to make testosterone or sperm or both

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12
Q

Sertoli cells (3)

A
  • maintain high [testosterone] for sperm development
  • convert testosterone to estrogen which help Sertoli cell adhesion
  • release inhibin
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13
Q

main source of androgens

A

testes

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14
Q

other sources of androgens

A
  • 5% DHEA and androstenedione by adrenal glands

- 80% dihydrotestosterone by peripheral conversion

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15
Q

mode of action of testosterone

A

testosterone is converted by 5-alpha-reductase to dihydrotestosterone (most potent androgen)

this binds intracellular receptor => enters nucleus

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16
Q

actions of testosterone

A
  • embryonic differentiation of external and internal genitalia
    0 male secondary sexual characteristics
17
Q

clinical evaluation of male hypogonadism = beforep uberty

A
  • developing fetus
    > ambiguous genitalia (not enough testosterone exposure)
    > male pseudohermaphroditism
  • prepubertal
    > poor 2ry sexual development
  • eunuchoid body habitus
  • small firm or rubbery testes
18
Q

eunuchoid body habitus

A

A body habitus that is tall, slim and underweight, with long legs and long arms

19
Q

what is the problem if GnRH is not present?

A

Kallman’s syndrome

20
Q

what is the problem if FSH is elevated but testosterone is very low?

A

Klinefelter’s syndrome

21
Q

male menopause

A
  • testosterone deficiency with age
    > 50% of healthy men between 50-70 have low levels of bioavailable testosterone
  • Leydig cell insufficiency = declines slowly after 50
  • LH levels unchanged or increased = set pt for neg feedback decreased
  • circadian rhythm lost = naturally high in mornings
  • fatigue and decreased libido
22
Q

T or F. testosterone is highest in the morning

A

T!

23
Q

SHBG is ________ in hypogonadal men with hypothyroidism

A

elevaatedd

24
Q

bioavailable testosterone

A 
2% = free
38% = weakly bound to albumin

the rest is tight bound to SHBG

25
Q

Erectile dysfunction

A
  • can be psychogenic or oganic
  • androgen def only accounts for 10% of ED
  • systemic possibilities likely = neurologic, endcrine, vascular, systemic illness, urogenital, drugs, ethanol
26
Q

T or F. androgen deficiency is a common contributor to ED

A

F! only 10% of the time

27
Q

infertility

A

40% for either male, female
; even split
20% couple factors

MLSCI 263 (31 decks)

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