Patho of Male Repro

Question 1

Spermatogenesis

Answer 1

Spermatogonia (2N) –> Primary spermatocytes (2N) –> Secondary spermatocytes (2N) –> Spermatids (1N)

Question 2

Spermiogenesis

Answer 2

spermatids mature into spermatozoa and make acrosome and flagella

Question 3

How much sperm do the testes produce?

Answer 3

Each sperm produces 120 million sperm/day

Question 4

Where does testosterone bind?

Answer 4

In the cytoplasm since steroid hormone on androgenic receptor
Converted to DHT by 5a-reductase (DHT has greater affinity to receptors)
Testosterone can also be converted to estradiol via aromatase

Question 5

Functions of testosterone

Answer 5

Secondary sex characteristics, acne, muscle development, increased bone growth and Ca retention, increased RBCs (reason the RBC count is higher in men than in women)

Question 6

HPA Axis

Answer 6

Hypo [GnRH] –> Ant Pit [LH & FSH] –> LH acts on Leydig cells to secrete testosterone and FSH acts on Sertoli cells to stim spermatogenesis

Question 7

Inhibin

Answer 7

secreted by Sertoli cells; provides feedback to Ant Pit to inhibit FSH secretion

Question 8

Stages of erection

Answer 8

PS stim –> secretion of NO –> increases guanylate cyclase & increase prod of cGMP –> decrease in intracellular Ca –> less smooth muscle contraction –> vasodilation –> increased blood flow to penile arteries

Question 9

Emission

Answer 9

contraction of vas deferens, prostate gland, and seminal vesicles propels sperm into urethra

Question 10

Ejaculation

Answer 10

Propels sperm out of urethra

Question 11

Physiology for therapy of erectile dysfunction

Answer 11

cGMP is degraded by phosphodiesterase 5 (PDE5) so most drugs are PDE5 inhibitors

Question 12

Primary hypogonadism

Answer 12

problem is with gonads themselves (testes won’t produce testosterone as they should)
decreased levels of testosterone, low sperm count, increased FSH and LH

Question 13

Secondary hypogonadism

Answer 13

problem is with Hypo or Ant Pit

FSH/LH/GnRH are low, testosterone and sperm count are low

Question 14

Testosterone replacement therapy

Answer 14

• Testosterone= rapid first pass metabolism (not PO)
• Testosterone esters= more lipophilic
• Alkylated androgens= can be given PO but can cause hepatotox
• Transdermal patch= avoids first pass

Question 15

ADR’s of testosterone

Answer 15

aggressive sexual behavior, acne/ oily skin, balding, Na retention (exacerbates HTN and heart failure), predisposed to prostatic hyperplasia (decreased urinary flow rate), increases Hct

Question 16

What drugs can cause gynecomastia?

Answer 16

anabolic steroids, alcohol, drugs of abuse, androgen receptor antagonists, spironolactone, chemotherapy, psychiatric meds, ACE-I

Question 17

Benign prostatic hyperplasia

Answer 17

treated with finasteride (5a-reductase inhibitor)

growth of prostate gland from increased testos