Male Reproductive System - Test 2

Question 1

What are the 4 major functions of the testes

Answer 1

male differentiation during fetal life

induction of secondary sex characteristics at puberty

sperm production

maintenance of the adult male phenotype and sex drive

Question 2

What artery(ies) supply the testes?

Answer 2

testicular artery (primary from aorta)

cremasteric artery (inferior epigastric)

artery to the ductus deferens (internal iliac)

Question 3

Where does testicular arterial blood drain into?

Answer 3

pampiniform plexus

Question 4

What organs contribute to the components of ejaculation?

Answer 4

testicle (sperm)

prostate (PSA - breaks down semen to allow sperm to swim)

seminal vesicles

bulbourethral glands

Question 5

What are the layers of the scrotum?

Answer 5

Scrotal skin

Dartos fascia

External spermatic fascia

Cremaster muscle

Internal spermatic fascia

Tunica vaginalis

Tunica albuginea

Question 6

Describe the Hypothalamic-pituitary-gonadal axis

Answer 6

Question 7

How is testosterone transported in serum?

Answer 7

SHBG and albumin (albumin > SHBG)

Question 8

What hormone is responsible for BPH and baldness?

Answer 8

DHT

Question 9

Do men produce estradiol?

Answer 9

yes! via aromatase

Question 10

What stimulates Leydig cells? Sertoli cells? What do these cells make?

Answer 10

LH –> Leydg cells –> testoterone

FSH –> Sertoli cells –> spermatogenesis, ABH, inhibin B

Question 11

What is clomiphene used for?

Answer 11

Clomiphene (clomid)

Partial Estrogen receptor agonist/antagonist

Prevents end products from creating the negative feedback resulting in more FSH and LH secretion –> increased testosterone

can be used to tx male infertility

Question 12

What is anastrazole used for in men?

Answer 12

Anastrazole

Aromatase inhibitor

Prevents conversion of estradiol thereby inhibiting the negative feedback resulting in more FSH and LH secretion

can be used to tx male infertility

Question 13

What is Klinefelter syndrome?

Answer 13

primary hypogonadism (hypergonadotropic hypogonadism)

dem balls don’t work

Increased FSH, LH, and estrogen

decreased testosterone

Question 14

What is Kallman syndrome?

Answer 14

secondary testicular dysfucntion

hypogonadotropic hypogonadism

low FSH and LH

anosmia (can’t smell)

Question 15

Define infertility

Answer 15

the inability to conceive after 12 months of regular, unprotected intercourse

Question 16

When a patient comes to you complaining of low/no ejaculant, what do you want to determine?

Answer 16

evalutate for retrograde ejaculation into the bladder and for obstruction

Question 17

Define azoospermia. What are the 2 types?

Answer 17

Azoospermia is the absence of sperm in the ejaculate

Non obstructive azoospermia (impaired spermatogenesis)

Obstructive azoospermia (impaired sperm transport)

Question 18

What are the 3 types of subfertility?

Answer 18

Oligozoospermia (<15 million sperm/mL)

Asthenozoospermia (<40% motility)

Teratozoospermia (<4% morphologically normal sperm)

Question 19

What does a Y-micro deletion in either the AZFa, AZFb, or AZFc gene on the p arm lead to?

Answer 19

azoospermia

Question 20

In what condition do you see bilateral absence of the vas deferens?

Answer 20

Cystic fibrosis

Question 21

What is a varicocele? How is it described? How is it treated?

Answer 21

dilated pampiniform plexus

described as a bag of worms

varicocelectomy

Question 22

Define Intrauterine insemination (IUI)

Answer 22

Sperm is collected by masturbation, washed, concentrated, and instilled into the uterus

“turkey baster” method

Question 23

Define IVF

Answer 23

Sperm is collected by masturbation, washed, concentrated, and mixed with eggs in vitro. Embryos grow in vitro through several cell cycles and then are transferred into the uterus

Question 24

Define Intracytoplasmic sperm injection (ICSI)

Answer 24

Direct injection of sperm into egg

Question 25

Name the tumor markers for testicular cancers

Answer 25

Question 26

How is testicular cancer treated?

Answer 26

surgical removal via inguinal (add cisplatin f metastatic)

Question 27

What Gleason grade is this?

Answer 27

Grade 1

notice the glands

Question 28

What gleason grade is this?

Answer 28

gleason grade 5

no glands

Question 29

What is the treatment for prostate cancer?

Answer 29

surveillance

radiation

surgery

chemical castration (leuprolide, abarelex, testosterone blocker [flutamide/bicalutamide])

Question 30

What is a hydrocele? When do you treat?

Answer 30

Fluid collection in the tunica vaginalis layers

Only treat if symptomatic

Question 31

What is a spermatocele? When do you treat?

Answer 31

Cyst of epididymis or rete testis

Only treat if symptomatic

Question 32

What is testicular torsion? is it an emergency?

Answer 32

Twisting of the spermatic cord cutting off the testicles blood supply

Emergency! surgery to untwist the testicle

Question 33

What is epididymitis caused by?

Answer 33

Chlamydia and N gonorrhoeae in men <35

E coli in men >35

Question 34

What is the treatment for BPH?

Answer 34

medical: alpha antagonists (tamsulosin), 5-alpha reductase inhibitors (finasteride)
surgical: TURP

Question 35

Where in the prostate does BPH occur? cancer?

Answer 35

transitional zone = BPH

peripheral zone = cancer

Question 36

What type of testicular cancer is this?

Answer 36

smeinoma

fried egg appearance