Reproductive Organs Lab Questions

Question 1

The laboratory parameters of a 42-year-old man are: plasma prolactin and cortisol decreased, urinary 17-ketosteroid excretion is decreased, plasma prolactin level is not influenced by TRH. The administration of hCG increased the urinary excretion of 17-ketosteroids.

What is the possible diagnosis?

Answer 1

• PRL and Cortisol↓→ Pituitary Hypofunction (also because no PRL increase by TRH )
• 17-Keto-Steroids↓ + HCG↑→17-Keto-Steroids↑→ Rule out Primary! Secondary Hypofunction.
• Diagnosis: Panhypopituitarism (Simmond’s)
• Treatment: Administration of Pituitary Hormones

Question 2

The laboratory parameters of a 19-year-old man are: plasma testosterone decreased, FSH and LH are elevated, urinary 17-ketosteroid excretion is decreased. The administration of hCG did not increase plasma testosteron level or the urinary excretion of 17-ketosteroids.

What is the possible diagnosis?

Answer 2

• Primary Hypogonadism: No normalization in testosteone by HCG, FSH or LH
• Possible Diagnosis: Kleinfelter Syndrome(XXY) or Childhood Infection leading to Orchitis (Mumps, Gonorrhea..).
• Treatment - Lifelong Testosterone Injections

Question 3

The laboratory parameters of a 42-year-old man are: plasma testosteron increased significantly, FSH and LH are barely detectable, urinary excretion of androgens
are increased.

The right testis is enlarged.
What is the possible diagnosis?

Answer 3

• Increased Testosterone with low gonadotroph → Primary Hypergonadism
• Unilateral Enlargment of Testis→ Adrogen Secreting Testicular Tumor (“Seminoma”)
• FSH and LH low due to Negative Feedback