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27 Cards in this Set
- Front
- Back
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what stimulates the fetal testis to secrete anti-Mullerian hormone and testosterone
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Maternal hCG
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what induces the formation of the male urethra, prostate and penis
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fetal dihydrotestosterone
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what does masculinization require
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presence of a Y chromosome and hormones produced by the fetal testis (maternal hCG stimulates secretion)
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differentiate first indication that gonadal axis has begun to function in young boys vs. girls
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boys - testicular enlargement
girls - breast budding |
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clinical manifestations of testosterone deficiency
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lack of body hair
underdeveloped skeletal muscles long arm and legs (due to decreased estrogen from decreased testosterone) |
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3 examples of hypergonadotropic hypogonadism in males
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1. Kleinfelter's XXY
2. infection with mumps 3. cryptorchidism |
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patient presents with azoospermia, gynecomastic, and elevated FSH and LH
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Kleinfelter's syndrome
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how would you distinguish between cryptorchidism vs. vanishing testis syndrome
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administration of hCG
vanishing testis syndrome will NOT show increase in testosterone while cryptorchidism would |
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patient presents with both low levels of LH, FSH, testosterone and anosmia
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Kallman syndrome
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examples of hypogonadotropic hypogonadism in males
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Kallmann syndrome
hyperprolactinoma pituitary trauma glucocorticois excess |
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what is the first clinical manifestation of apoplexy in both men and women
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hypogonadotropic hypogonadism
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what type of collagen do chondrocytes produce
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type II collagen
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what is instrumental in modulating cartilage destruction by increase NO production and decreasing metalloproteinase inhibitors
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IL-1B
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what does increased production of NO lead to when stimulated by IL-1B
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stimulate production of ADAMTS-4 and 5 (metalloproteinases)
mediates chondrocyte dead via H2O2 production |
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differentiate joints affected by: OA, RA, CPPD
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OA - DIP and PIP
RA - PIP and MCP CPPD - knee |
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which radiograph finding is associated with osteophytes formation
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osteoarthritis
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which radiograph finding is associated with linear radiodense deposits of crystals
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CPPD
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which radiograph finding is associated with periarticular osteopenia and joint space narrowing
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rheumatoid arthritis
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IgM or IgG autoantibody with high affinity for IgG
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rheumatoid factor
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what three things are changed in aging cartilage to enchance production of pyrophosphate
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1. increased NTPPPHase activity (ATP --> AMP + PP)
2. increased ANKH which stimulates intracellular-to-extracellular movement of PP 3. decreased pyrophosphatase activity |
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what is the initiating event for CPPD cystals to inflammatory mediator release
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phagocytosed by neutrophils which release inflammatory mediators, activate complement, spill lysosomal enzymes and oxygen-derived free radicals
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3 metabolic abnormalities that lead to development of CPPD and mechanism for increased PP
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1. hyperparathyroidism
2. hemochromatosis 3. hypophosphatemia and hypomagnesemia **ALL inhibit pyrophosphatase |
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differentiate synovial fluid characteristics between OA and RA
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OA - WBC 200-2000 with <10% PMN
RA - WBC 2000-50,000 with 85% PMN |
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differentiate the crystals found in CPPD vs. gout
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CPPD - rhomboid crystals that are positively birefringent (turn blue when parallel)
gout - needle-shaped crystals that are negatively birefringent (turn yellow when parallel) |
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mechanism and treatment of stress incontinence
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weakened pelvic floor when leakage of urine with increased intra-abdominal pressure
*a1-agonist |
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mechanism and treatment of overflow incontinence
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bladder is unable to empty fully, high post-void volume is diagnostic
*a1-blocker |
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mechanism and treatment of urge incontinence
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decreased cortical inhibition or detrusor hyperactivity with involuntary bladder contractions
*M3-cholinergic antagonist |
