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68 Cards in this Set
- Front
- Back
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what do sertoli cells of the testis produce and the effect of this hormone?
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Mullerian-inhibiting subtstance (MIS)- caues Mullerian duct to degenerate
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what d the leydig cells produce?
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testosterone- causes Wolffian ducts to develop
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What makes the internal male parts develop? external? mature parts?
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MIS to kill mullerian ducts, testosterone to develop wolffian ducts. DHT (dihydrotestosterone) for ourward parts (needs 5a-reductase), testosterone to develop to maturity
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what causes penis at 12 syndrome?
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5a-reductase defect- pseudohemaphroditism with normal virilization at puberty. no DHT in unterine to form male parts but develop at 12
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Swyer's syndrome or pure gonadal dysgenesis 46
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male pseudohermaphrodite- SRY deleted or defected (short arm of Y)- phenotypically female with all female internal organs minus the ovaries
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sex-reversal syndromer XX male
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female pseydohermaphrodite- due to presence of SRY on X chromosome- small firm testes similar to klinefelter syndrome
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XY female lack of enzyme 17-hydroxylase
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defect in this enzyme=no synthesis of androgens or estrogens- male pseudohermaphrodite that does not develop female secondary sexual characteristics
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XY partially functional androgen receptors
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male pseudohermaphrodite- defect in androgen receptor- body in between male and female- small breasts, small testes w/ little or no penis, pubic hair, lack of body hair
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XY individuals with androgen receptors with weak function
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appears to be a completely normal female- go through puberty due to large amount of estrogen produced because of high levels of testosterone, never menstrate. Pubic hair
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lack of androgen receptors
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normal female appearance with normal breast development. no pubic hair cause requires actions of androgens
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pure gonadal dysgensis 46, xx
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XX females that have degeneration of ovaries due to loss of short arm of one of the x chromosome- don't develop secondary characteristics because have no estrogen cause have no ovaries- can correct this with injections but will never be fertile
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XX true hermaphrodite
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have both female and male systems- both penis and breasts
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when is puberty considered delayed?
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girls= 13. Boys= 14. 95% of time a constitutional delay. 5% from disruption of hypothalamic-pituitary-gonadal axis.
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causes of delayed puberty
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type i diabetes (insulin needed for sexual maturation), excessive exercise, hypothyroidism, marijuana use, pituitary tumor, etc.
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precocious puberty definition
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before 6 in black and hispanic girls and 7 in white girls. Before 9 in boys
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precocious puberty classes
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central (GNRH secreting tumor), peripheral (GnRH independent)
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secondary effects of precocious puberty
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early bone maturation, possible indication of tumor, social ramifications
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causes of precocious puberty?
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obesity (leptin- leptin receptors in hypothalamus and anterior pituitary GnRH and LH/FSH. pound for pound girls produce more leptin). More insulin sensitive girls experience slower breast development, lower levels of testosterone, and leptin levels. Maybe pollutants
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primary dysmenorrhea
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painful menstruation associated with prostaglandin release in ovulatory cycles (have higher prostaglandins in blood)- related to duration and amount of menstrual flow- cna be treated with hormonal contraceptives
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secondary dysmenorrhea
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painful menstration related to pelvic pathology- can occur any time in the mestrual cycle- can be treated with hormonal contraceptives
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primary vs secondary amenorrhea
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failure of menarche by age 14, or absence of menstration for 6 month in women who have previously menstruated
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polycystic ovarian syndrome- about
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oligoovulation (infrequent) or anovulation- elevated levels of androges or clinical signs of hyperandrogenism and polycystic ovaries. leading cause of infertility in US (~5-10%)- dysfunction of follicle development. every month, a few keep developing becasue no LH (normally cause one to diminate and the rest to degreade)- Hirsutism (facial hair)
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Polycystic ovarian syndrome and weight/IR
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characterized by hyperinsulinemia and IR. about 50% normal weight women with PCOS are IR- all obese women are. Insulin stimulates androgen secretion by ovaries- causes too much testosterone cause too much insulin- stimulates follicle development and maintenance, but no LH for the surge thing- improve insulin resistance with drugs and low CHO diet possibly
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Pelvic Inflammatory disease (PID)
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may involved any organ (salpingitis- fallopian tubes; ovaries- Oophoritis). Sexually transmitted, then disease migrates. often polymicrobial (from mixed bacteria)
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vaginitis
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infection of vagina- major causes are sexually transmitted pathogens and Candida albicans.- acidic nture of vagina provides some protection- maintained by cervical secretions and normal flora
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Cervicitis
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inflammation or infection of cervix- Mucopurulent cervicitis (MPC)- purulent endocervical exudate
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Vulvitis
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inflammation of female external genitalia- contact with soaps, detergents, lotions, hygienic sprays, shaving, menstrual pads, perfumed toilet paper, nonabsorbing or tight-fitting clothing- can spread to the labia
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benign ovarian cysts
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unilateral- produced when a follicle or number of follicles are stimulated but no dominant follicle develops and reaches maturity.
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types of benign ovarian cysts
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follicular (common/normal). Corpus luteum (common/normal). Dermoid cysts- tumors- can contain diverse types of tissues (teeth, hair)
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endometrial polys
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benign mass of endometrial tissue- Premenstrual, intermenstrual, and excessive bleeding can occur- malignancy is rare
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Leimyomas
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commonly called uterine fibroids- benign tumors of smooth muscle cells in myometrium- cause abnormal bleeding, pain, symptoms related to pressure on nearby structures
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adenomyosis
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benign ingrown of endometrium into myometrium
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difference between cyts and fibroid
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cyst= fluid filled. Fibroid- a mass
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endometrioisis
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presence of functioning endometrial tissue or implants outside uterus- still sloughs- possibly from retrograde menstruation- goes up through fallopian tubes and spills into cavity
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cervical cancer
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usually from viral infection (~70% from HPV) (now have vaccines)
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Galactorrhea
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persistent and sometimes excessive secretion of milky fluid from breasts of woman who is not pregnant or nursing- can also occur in men- women also experience menstrual anbnormalities
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breast cancer
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most common among american women- second most common killer after lung- ages 40 to 44 leading cause of death
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gynecomastia
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overdevelopment of male breast from hormones
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male breast cancer
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still happens- most commonly after 60- tumors resemble carcinomas seen in women- crusting and nipple discharge are common clinical manifestations
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rethritis
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inflammation of urethra usually but not always from STD. nonSTD can be from urologic procedures, insertion of foreign objects, trauma, anatomical abnormalities
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urethral strictures
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fibrotic narrowing of urethra caused by scarring- commonly due to trauma or untreated or severe urethral infections
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"too tight" disorders
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phimosis: inability to retract foreskin from glans to penis (distal to proximal)
Paraphimosis: inability to replace or cover glans with foreskin (proximal to distal). Frequently caused by poor hygiene or chronic infections |
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Peyronie disease
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"bent nail syndrome"- slow development of fibrous plaques (thickening) in erectile tissue of corpus cavernosa- causing lateral curvature during erection- occurs in middle-aged men and causes painful erections
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penile cancer
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carcinoma rare- mostly squamous cell carcinomas
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hypospadia
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where urine exit is somewhere other than where it's supposed to be- fix with surgery
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Varicocele
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inflammation/dilation of veins in the spermatic cord- caused by inadequate or absent valves in the spermatic veins- scrotum disorder
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hydrocele
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scrotal swelling due to collection of fluid w/in the tunica vaginalis- imbalance between fluid secretion and reabsorption
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spermatocele
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painless dilation of epididymis- scrotum disorder
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cryptorchidism
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failure of one or more of the testes to descend from abdominal cavity into scrotum
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ectopic testis
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testis that has strayed from the normal pathway of descent
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tortion of tests
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painful and swollen testis- may be spontaneous or follow physical exertion or trauma- causes twisting of blood vessels in spermatic cord
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Orchitis
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acute inflammation of testis- complication of systemic disease or related epididymitis
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cancer of testis
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among most curable- common in men between 15 and 35- causes painless testicular enlargement
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epidiymitis
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inflammation of epidiymis- common in sexually active men- pathogenic micoorganism reached e by ascending the vas deferens from an already infected bladder or urethra
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Benign prostatic hyperplasia (BPH)
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enlargement of prostate gland- symptoms associated with urethral compression- relationship to aging- evaluated by digital rectal exams and prostate-specific antigen (PSA) monitoring
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cancer of prostate
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prostatic cancer is asymptomatic until in advanced stages- symptoms similar to BPH- circumsision may reduce this- most common cancer for american males- Vasectomy, family, hormones affect growth/development, dietary factors
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how is testosterone related to BMI and WHR
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inversely related in men, directly related in women
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what does testosterone treatment in middle-aged abdominally obese men do?
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decreases visceral fat. improves insulin sensistivity
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obesity and repro in women
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present at 4X higher rate in women with mentrual distrubances. 45% amenorrheic women obese. teenage obesity associated with menstrual irregularity later in life
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obesity in men
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potential for milk hypogonadotropic hypogonadism
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adipose and hormone
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active. Leptin (signals magnitude of energy stores to brain- absence of receptors or hormone leads to obesity and reproductive dysfunction- increased in women with anovulation, especially PCOS), able to convert androgens to estrogens (aromatase), estrdiol to estrone, estrogen to 2-Hydroxy estrogen (relatively inactive), Androstenediol- can sore steroid hormones
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obesity and high-birth weight baby
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maternal obesity in early pregnancy more than doubles risk of childhood obesity and increases risk of Metabolic syndrome. Risk for developing GDM increases with weight gain (exponentially for overweight, obese, severely obese starting with 2)
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obesity and repro (android, WHR)
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gynecoid vs. android (higher LH, Androstenedione, estrone, insulin, lipids, lower HDL). higher WHR associated with lower conception rates, menstrual abnormalities. Hperandrogenic obesity increases androgen synthesis (increased PCOs risk in women)
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obesity and miscarriage
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higher BMI associated with higher miscarriage risk
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obesity and fertility treaments
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higher BMI required higher clomid dose (induces ovulation). Excess use associated with ovarian cancer
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weight loss and exercise
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plasma androgens reduce with weight loss (changes insulin, IGF, menstruation, Hirsutism decreased, spontaneous pregnancies increased). Same with exercise (lower miscarriage rate, increased conception, even before appreciable weight loss- even in infertility unrelated to ovulation (tubal blockage, male partner with oligospermia)
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male vs. female tests for infertility
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man: semen analysis includes sperm antibody, ultrasonographic scan of pathway, sperm function test, testosterone level and other hormones.
woman: endometrial biopsy, serum progesterone, laparoscopy, hysterosalpingogram, postcoital test |
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male infertility
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infections, torsion of testis, high fever/temperatures, trauma, chromosome defect, durgs/toxins, poor sperm motility, antisperm antibodies by man or woman, congenital defects (varicoele), hormonal (decreased FSH, LH, testosterone, T3, T4, cortisol or increased prolactin
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