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27 Cards in this Set

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