Reproductive System

Question 1

What cells secrete testosterone

Answer 1

Leydig

Question 2

What cells secrete inhibin?

Answer 2

Sertoli

Question 3

What does LH and FSH act on?

Answer 3

LH acts on leydig cells

FSH acts on sertoli cells

Question 4

What are common physical causes of erectile dysfunction?

Answer 4

old age 
deterioration of arteries 
smoking
obesity
alcohol - brewers droop
diabetes
s/e of some drugs
anti depressants
anti hypertensives

Question 5

What are some psychological causes of ED?

Answer 5

Nerves
Guilt 
relationship problems 
depression 
exhaustion

Question 6

What is the mechanism of action of viagra - sildenafil citrate?

Answer 6

Phosphodiesterase 5 inhibitor - competitively inhibits enzyme responsible for degradation of cGMP to GMP
Stabilisation of cGMP prolonged action of 2nd mesenger then greater more sustained dilation of sinusoidal smooth muscle

Question 7

What are some side effects of sildenafil?

Answer 7

Flushing
Headache
Nasal. congestion
stomach discomfort 
blurry vision
hearing loss 
bladder pain
dizziness

Question 8

What are some contraindications/cautions of sildenafil?

Answer 8

CVD
Low BP
people in nitrates
Angina 
Predisposition to priaprism e.g. sickle cell anaemia, leukaemia, multiple myeloma (blood thickens and causes occlusion in penis leading to unwanted erection)

Question 9

What are the treatments for BPH?

Answer 9

• waiting /monitor
• alpha adrenoceptor blockers e.g. tamsulosin, terazocin
• 5-alpha reductase inhibitors - finasteride (Proscar)

Question 10

Which alpha. adrenoceptor blockers are used in BPH?

What are the side effects

Answer 10

Tamsulosin (Flomax MR)
Teraozocin (hytrin)
But side effects e.g. postural hypotensioin, headache, drowsy

Question 11

If a patient is on alpha blocker - what is used in caution?

Answer 11

Viagra - sildenafil - they both cause vasodilation and increase risk of falls (postural hypo)

Question 12

What are the risk factors for prostate cancer

Answer 12

Age >50
family history
ethnicity afro-caribbean
diet

Question 13

What is menopause?

Answer 13

Depletion of the finite ovarian reservce by the age of 50, follicle development and ovulation ceases. Menstrual cycle ceases, reduced production of ovarian hormones

Question 14

What are the symptoms of menopause

Answer 14

Hot flushes
mood changes 
gas
bladder problems 
sleep disturbances 
Night sweats

Question 15

What is HRT?

How long is it given for?

Answer 15

Given cyclically - artifically replace the hormones you hve lost e.g. natural oestrogens - oestradiol, oestrone, oestriol

Lowest dose for shortest period of time

Question 16

Which oestrogens are used in contraception vs which ones are used in HRT?

Answer 16

HRT = natural oestrogens e.g. oestradiol, estrone, oestriol

Contraceptions = synthetic e.g. ethinylestradiol

Question 17

Does HRT increase risk of VTE/stroke after years of use

Answer 17

Yes and breast cancer

Question 18

How often should women have a HRT review?

What is the requirement for HRT?

Answer 18

at least annually

Must have an intact uterus

Question 19

What are safety concerns over HRT?

Answer 19

Increased risk of breast cancer, endometrial cancer
stroke/VTE

Endometrial cancer risk is reduced by adding a protestogen

There isnt a Risk of CVD if you start it in women under 60

Question 20

What is a drug treatment for menorrhoea (heavy perirods)?

Answer 20

antifibrinolytic - tranexamic acid