Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
SC produce
|
they're stimulated by FSH;
anti-Muellerian hormone inhibin and activins secreted after puberty and work together to regulate FSH secretion estradiol - aromatase from Sertoli cell convert testosterone to 17 b - estradiol to direct spermatogenesis |
|
|
Leydig cell
|
cholesterol transport into the cell by STaR is rate limiting step...
then all the way to testosteone can still be converted to estradiol and also to DHT(5a-reductase) |
|
|
what is the hormone making Epidydimus, Vas Deferens and Seminal Vesicle?
|
Testosteone
|
|
|
what hormone makes prostate, external genitalia?
|
DHT
|
|
|
3 important times in life to make T
|
2nd trimester(for testicles), in first yr of life (priming penis or else-micropenis), puberty
|
|
|
testosterone types
biologically active? |
free testosterone 2%
albumin bound testosterone 44% SHBG bound Testosterone 54% |
|
|
older men > 50 with normal total T??
|
is not actually normal becuase: they make more SHBG and so there is proportionally more of the inactive hormone.
you have to measure the free T |
|
|
obese men and Testosteron?
|
they have less SHBG
so they don't actually have low T,-- measure the free T /albumin bouns = bioavailable |
|
|
Eunuchoid skeleton
|
androgen deficiency after birth - prior or during puberty: they'll have too long legs compared to torso; failure of the eipphyseal plates to fuse at puberty
|
|
|
hypogonad before birth
|
genital ambiguity
|
|
|
gynecoid escutcheon
|
feminine hair distribution
|
|
|
Clomiphene test
|
increse the GnRH
should be increase in T > 2.7 |
|
|
dynamic stimulation test of the androgen deficiency (what we do after we find a low T or low bioavailable T)
|
GnRH stimulation
hCG stimulation Clomiphene |
|
|
when do we do an MRI of brain for androgen deficiency?
|
when there is <200 testosterone and LH inapropriately nl or low
prolactin >50 in absence of other cause |
|
|
causes of primary testicular failure
|
Klinefelter, Orchitis, trauma, autoimmune, chemo, ketokenazole, cryptorchidism
|
|
|
secondary testicular deficiency
|
low T low LH
mass lesion (craniopharyngioma, prolactimoma...) apoplexy/infarction exogenous gonadal steroids chronic systemic illness malnutrition |
|
|
tertiary test def
|
aging
infiltrating disease (sarcoid, hemochromatosis) gene mutations (Kallman's) |
|
|
what is present if the androgen deficiency is before puberty?
what is present if it's after puberty? |
Before birth
Ambiguous genitalia After birth Altered hair distribution Low muscle mass / strength / endurance Low libido Infantile genitalia and prostate Testicular atrophy Small prostate, osteoporosis If before puberty: Eunuchoid skeleton |
|
|
complete androgen insensitivity
|
female phenotype but lack of axillary and pubic hair
|
|
|
incomplete androgen insensitivity
|
phenotype varies from infertility to gynecomastia and hypospadias
|
|
|
high LH and high testorone?
|
Androgen resistance syndrome
|
|
|
5-alpha reductase deficnecy
|
look like girl phenotype, but have testicles, but at puberty they'll look male
|
|
|
organic causes of erectile dysfunction
|
vascular disease
endocrine -diabetes -hypogonadism neurological diseases bicycling organ system failure: -cardiac, hepatic, pulmonary, renal Genitourinary -Peyronie's disease perineal surgery, prostate irradiation, prostatectomy (pudendal nerve) |
|
|
drugs causing ED
|
antidepressants, methadone, heroin, cocaine, nicotine
anticholinergic antiadrenergic (b-blockers, clonidine, methyldopa) antiandrogen (spironolactone, cimetidine, ketoconazole) antihypertensive (acebutolol, amlodipine, doxazosin, enalapril, thiazide) |
|
|
causes of gynecomastia
|
Physiological: neonatal, pubertal, senescent
Neoplasms: steroid producing (adrenal, testis) hCG(testis and lung) male breast cancer drugs: antiandrogen antiulcer chemo cardiovascular drug: spironolactone alcohol, amphetamine, heroin, marijuana, methadone testosterone estrogen halperidol congenitcal causes of hypoandrogenism (klinefeleter...) testicular damage systemic disorders: renal failure hepatitis cirrhosis thyrotoxicossis |
