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Endo > Testicular Disorders > Flashcards

Testicular Disorders Flashcards

1
Q

What hormone stimulates Leydig cells?

Sertoli cells?

A

LH

FSH

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2
Q

What hormone stimulates LH and FSH?

A

GnRH

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3
Q

What is the function of follistatin?

A

inhibit production of activins/inhibins

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4
Q

What is the function of activins?

A

stimulate beta-subunit FSH production

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5
Q

What is the function of inhibins?

A

suppress FSH production

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6
Q

Activins are produced in ___ and act on ___.
Inhibins are produced in ___ and act on ___.
Follistatin is produced in ___ and acts on ___.

A
  1. sertoli cells; pituitary
  2. seminiferous tubules + sertoli cells; pituitary
  3. testes; testes (autocrine)
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7
Q

Injury to seminferous tubules results in:

A

elevated FSH (relative to LH)

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8
Q

Primary hypogondism is failure of:

A

yo balls (testes, sorry)

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9
Q

Low Gnrh →

A

failed FSH and LH production

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10
Q

Low LH/FSH →

A

failed testosterone production +/- spermatogenesis

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11
Q

Leydig cells’ function:

Sertoli cells’ function:

A

→ T

→ spermatogenesis

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12
Q

No feedback from Leydig or Sertoli cells results in:

A

elevated FSH/LH

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13
Q

Hormone abnormalities in germinal aplasia?

A

↑FSH

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14
Q

Hormone abnormalities in testicular failure?

A

↑LH + ↑FSH

↓T

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15
Q

Hormone abnormalities in hypogonadotropic hypogonadism?

A

↓T

nml or mildly ↓LH/FSH

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16
Q

Signs/symptoms of Kallman’s syndrome?

hypothalamic disease

A

↓T
nml LH/FSH
anosmia

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17
Q

Signs/symptoms of Prader-WIlli syndrome?

hypothalamic disease

A 
↓T
nml LH/FSH
obesity
hypotonia
micropenis
small hands/feet
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18
Q

Signs/symptoms of Lawrence-Moon syndrome?

hypothalamic disease

A

↓T
nml LH/FSH
retinitis pigmentosa
polydactyly

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19
Q

Signs/symptoms of fertile eunuch syndrome?

pituitary disease

A

LH deficiency

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20
Q

Signs/symptoms of hyperprolactinemia?

pituitary disease

A

inhibited GnRH release

low libido

21
Q

Signs/symptoms of hemochromatosis?

pituitary disease

A 
loss of LH/FSH
testes abn (1' or 2' hypogonadism)
22
Q

Signs/symptoms of Kleinfelters?

A 
tall
gynecomastia
eunuchoid habitus
(MR theoretically common)
XXY
23
Q

Signs/symptoms of XYY individuals?

A

oligo/azospermia

24
Q

Signs/symptoms of Noonan’s syndrome?

A

phenotypically similar to Turner’s

XO

25
Q

Signs/symptoms of XX Male syndrome?

A

azospermia

nml height/no MR

26
Q

Signs/symptoms of pre-pubertal gonadal failure?

A
  1. delayed puberty
  2. gynecomastia
  3. disproportionately long arms/legs
  4. related pre-pubescent symptoms
    (high-pitched voice, reduced male musculature, scant pubic/axillary hair, small testes + phallus + prostate)
27
Q

Signs/symptoms of post-pubertal gonadal failure?

A
  1. progressive decrease in muscle mass
  2. loss of libido + impotence
  3. abn bone metabolism
  4. oligo/azospermia
  5. menopausal-like hot flashes
  6. poor ability to concentrate
28
Q

Physical exam of a hypogonadal patient should include:

A
  1. arm span to height
  2. axillary + pubic hair
  3. phallus and testes
29
Q

Provocative testing of a hypogonadal patient may include:

A
  1. GnRH stimulation
  2. clomiphene stimulation
  3. hCG stimulation (blocks estrogen to ↑GnRH)
30
Q

Lab testing of a hypogonadal patient may include:

A

T
FSH
LH
PRL

31
Q

Highest levels of T are during…

A

early morning

32
Q

How does T circulate in blood?

A

Mostly bound to sex-hormone binding globulin and albumin

2% free (available for activity)

33
Q

Normal T but elevated SHBG results in:

A

hypogonadism

34
Q

How does SHBG change with aging?

A

levels increase (=less free T)

35
Q

Most accurate way to measure T?

A

equilibrium dialysis

36
Q

Low SHBG may be seen in what 3 conditions?

A

obesity
acromegaly
hypothyroidism

37
Q

GnRH, LH and FSH are all released in a ____ pattern.

A

pulsitile

38
Q

LH has a (shorter/longer) t1/2 than FSH

A

shorter (thus single low measurements may be misleading)

39
Q

Test used to measure biologic activity of FSH/LH

A

2-site radioimmunometric assay

40
Q

What affects biologic activity of FSH/LH?

A

post-translational glycosylation

41
Q

What hormone directly down-regulates the release of LH/FSH?

A

PRL

42
Q

Elevated PRL directly decreases ___ independent of T

A

libido

43
Q

Primary test to assess a male’s fertility

A

semen analysis

44
Q

To evaluate semen, it should be collected after:

A

2-5 days of not doin’ it (or spankin’ it)

*and evaluated w/in 2 h

45
Q

Fertility =
motility of > ___%
sperm count > ____
semen vol of ___mL

A

50%
20 mil/mL
1.5-6

46
Q

What test should be performed in a semen sample showing azospermia?

A

fructose
none = possible obstr of ejaculatory ducts or congenital absence of ej ducts +/- vas deferens

**fructose secreted by seminal vesicles

47
Q

↓ or inappropriately nml LH/FSH
↓ T
= hallmark of…

A

hypothalamic or pituitary defects

48
Q

↑LH/FSH

= hallmark of…

A

testicular failure

49
Q

Soft (but nml) testes are evident of what hormonal deficit?

Firm testes are evident of what hormonal deficit?

A

↓ LH/FSH

↑ GnRH

Endo (28 decks)

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