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129 Cards in this Set
- Front
- Back
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where are the spermatogonium located and what do they do?
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line the seminiferous tubules and provide a pool for primary spermatocytes
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what are the 2 secretions of sertoli cells and their functions?
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1. androgen binding proteins- to keep testosterone in the testes
2. inhibin- to keep FSH in check |
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what kind of physical prtection do the sertoli cells offer the spermatozoa? from what?
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they form tight junctions to form a blood-testes barrier to protect the developing sperm from the immune system
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what happens to sertoli cells in higher heat? what functions are lost? 2
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1. lose inhibin secretion
2. spermatogenesis rate goes down |
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what are 2 conditions that cause the testes to be too warm? how so?
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1. varicoceles- blood is being suck there and not in the counter current exchange
2. cryporchidism- testes too high |
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function of leydig cells?
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just to secrete testosterone
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where are the sertoli and leydig and sperm cells? what separates them?
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inside seiniferous tubules- sertoli and spermatozoa
interstitium- leydig cells in between is a basement membrane |
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where are the oldest spermatids?
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closer to the lumen of the tubules
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list the stages from spermatogonium to the final stage
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spermatogonium --> primary spermatocyte --> secondary spermatocyte --> spermatids --> spermatozoa (sperm cells)
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say the process that causes each stage change and the chromosome number in each.
spermatogonium --> primary spermatocyte --> secondary spermatocyte --> spermatids --> spermatozoa |
spermatogonium 46n -(mitosis)->
primary spermatocyte 46n -(first meiotic division)-> secondary spermatocyte 23n -(second meitic division)-> spermatids 23n -(maturation)-> spermatozoa 23n |
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how can you divide twice in meiosis and still only have haploid cells?
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the chromosomal material doubles before the first meiotic division
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what happens in the first step of spermatogenesis? cells produced?
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1 spermatogonium to replenish and 1 primary spermatocyte to make sperm
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What do the chromosomes look like during meiosis? what sticks together?
are any of the germ cells the same? (in terms of whole chromosomes not counting crossing over) |
1. prophase- each mommy and daddy chromosome doubles and hangs onto it's sister
2. 1st meiotic division - the mommy and daddy chromosomes get scrambled to different primary germ cells, but still have their sisters 3. 2nd meiotic division- sister chromatids must separate and the two ovum/spermatids are the same 23n |
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difference between spermatogenesis and spermiogenesis?
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spermiogenesis is the final phase of spermatogenesis where the spermatids mature inro spermatozoa
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what is the critical step in spermatogenesis not present in poogenssis that allows sperm to be created infinitey?
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the first mitosis step to regenerate the spermatogonium
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when does a primary oocyte become secondary?
a secondary to become an ovum? mnemonic for both? stages and events. |
primary to secondary- prOphase I for Ovulation
secondary to ovum- metaphase II for fertilization (the egg MET the sperm) |
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in a graffian follicle, what kind of oocyte is inside? how do you know?
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primary in prophase 1 or secondary in metaphase II depending on how far along the graffian follicle is
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what does the sperm gain in spermiogenesis? what is lost? how is the shape changes
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acrosomal cap, midpiece
loss of cytoplasm to be more oval than round |
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what stage of life does spermatogenesis begin? implications for early sex havers?
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puberty
a boyu having sex before pubertty cannot impregnate someone |
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what is the ploidy change in meiosis 1?
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fro diploid to haploid (but with sister chromosomes)
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what cells will accumulate if you lose the abiloty for meiosis 1?
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primary spermatocytes
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change in cells in meiosis II?
cell accumulation in failure of this process? |
from haploid sister chromatids (secondary spermatocytes) to haploid spermatids
accumulation of secondary spermatocytes |
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what is the pattern of GnRH release in males?
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pulsatile
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What is the effect of GnRH agonists and antagonists?
2 effects of agonists based on style of administreation. |
antagonist- lower pulsatile GnRH
agonist- will lower if continuous, but raise if also pulsatile |
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what two drugs can inhibit leydig cell production of testosterone? how? what enzymes?
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ketoconazole- inhibits desmolase
spironolactone- inhibits 17 a-hydroxylase and desmolase |
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what other anti androgen effect does spironolactone have? how do you know?
what off label uses is it used for? |
it is a potent androgen antagonist because it also antagonizes another steroid, aldosterone
can be used to treat male pattern baldness or hirsuitism |
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what can excess DHT do to you besides hair loss?
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benign prostatic hyperplasia
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what drug can be used to treat both male pattern baldness and BPH? mechanism?
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finasteride- inhibition of 5-a reductase
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what are 3 androgen receptor blockers? do they work for just DHT or testosterone?
mnemonioc? |
works for both
flutamide, cyproterone, spironolactone a bald cyclop[s tripping on acid playing a flute that is also a spear used to cut his hair - all these things block androgen receptors |
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what organs produce DHT, testosterone, and androstenedione in males?
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testes- testosterone
adrenals- androstenedione periphery- DHT |
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what does testosterone do in embryonic develpopment?
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helps devlop all the mesonephric ducts things
epididymus, VD, seminal vesicles not prostate |
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What does testosterone help do in puberty??
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growth spurts (why boys are taller) and closing of epiphyseal plates
deepening of voice develops sperm, penis, seminal vesicles, etc |
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why may you not want to give testosteone to a person who hasn;t finished puberty yet"?
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you could close their epiphyseal plates
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what common thing does testosterone do in males and females?
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stimulate sex drive
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what is the function of DHT early and late in life?
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early- differetiation of early external genitalia (helpful!)
late- continues to make prostate grow and causes increased sebaceous gland activity and hair loss |
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how do you remember that testosterone doesn't induce prostate growth? 2 reaons
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1. it is only responsible for the mesonephric duct early on and prostate is past this
2. it is DHT that causes BPH |
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what 2 places can testosterone become estrogen? what is special about these places?
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1. sertoli cells
2. fat they have aromatase |
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what are some consequences of taking male steroids for body building? why?
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hypogonadism and azoospermia
you suppress the HPG axis and no longer get gonadotropins keeping the testes in function |
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what is the synthetic testosterone that we use?
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methyltestosterone or just testosterone
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What are 3 clinical uses of methyltestosterone?
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1. giving secondary male sex characteristics
2. supplement for hypogodnadism in males 3. stimulation of anabolism to increase recovery rate after burn or injury |
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What does overdoase of testosterone do in fameles vs males?
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females- masculinization
males-hypogonadism or even atrophy |
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at hwta point does exogenous testosterone cause azoospermia?
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at gonadal atrophy
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What is the bone risk of giving too much testosterone?
The blood lipid risk? mnemonic? |
bone- premature plate closure
blood lipid- increase LDL, lower HDL (why men get more heart attacks) |
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What disease that a pt has should be a big warning not to give testosterone? why?
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prostate cancer- could make it grow more
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what are some mechanisms of antiandrogens?
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decrease testosterone synthesis
decrease T-->DHT conversion decrease androgen binding to receptor |
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full name for desmolase?
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17, 20 desmolase
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2 mechanisms to treat BPH?
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1. inhibit DHT synthesis
2. relax the smooth muscle there |
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what medications will do the following?
1. inhibit DHT synthesis 2. relax the smooth muscle there |
1. inhibit DHT synthesis- finasteride, butasteride
2. relax the smooth muscle there- a1 A,D anatagonists - ending with "zosin" or "osin" |
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What drug will treat BPH via the SM relaxation mechanism? how does it not cause hypotension?
mnemonic? |
Tamsulosin
it is selective for a1 A,D instead of the a1 B in blood vessel smooth muscle must TAME the angry prostate |
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mechanism and only approved use for flutamide?
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non steroidal competitive inhibitor of androgen receptor
used for prostatic carcinoma If the prostate is malignantly angry, sooth it with a flute |
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what drugs are used to treat PCOS and what aspect of it specifically? 2
mechanism for each? mnemonic? |
ketoconazole and spironolactone used to preven hirsuitism in females
ketoconazole- block synthessis with desmolase spironolactone- block synthesis with desmolase and 17 a hydroxylase AND androgen receptor antagonist Landon with a spear going to cut the beard off the PCOS peacock |
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side effects of spironolactone and ketoconazole? 1 male and 1 female
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males- gynocomastia
females- amenorrhea don't understand cause these drugs are used to treat women |
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what kind of defect do people with androgen insensitivity syndrome have?
what is their chromosomes? |
something wrong with androgen receptor/response sequence
they are 46XY and normal |
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what is responsible for pubic hair?
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testosterone
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what do males with androgen insensitivity syndrome look like on the outside? Why?
what reproductive structures do they have? |
they are externally female- no DHT
they have no internal female structures- no testosterone no secondary male sex characteistics- no testosterone |
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What kind of vagina with men with androgen insensitivity have? Why?
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only the lower 2/3rds because they did have MIF that prevented paramesonephric duct development
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will men with androgen insensitivity have pubic hair? why?
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no because no testosterone
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will men with androgen insensitivity syndrome have female secondary sex characteristics without ovaries?
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yes because the excess androgen will be turned into estrogen at the periphery
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what kind of external feature can you look for to check for androgen insensitivity syndrome? where?
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two lumps in the labia majora that are the testes
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What does a man with AIS look like?
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strikingly tall and beautiful female
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why may you want to take these testes in the labia majora out?
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to prophylactically prevent malignancy.
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What do you need to do after taking out the testes? consequence if you don;t?
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treat with estrogens to prevent menopause sx
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will you have a normal amount of testosterone and estrogen in the bod of AIS? Why?
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raised because the body is insensitive to it and even the hypothalamus think that there is none
all of this will be pushed over to estrogen |
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what are some differences in the structure (inside and out) of people with AIS vs people with 5a-reductase deficiency? why for each?
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AIS- no male maturation inside or out. genitals are female from estrogen.
5aRD- male maturation, but externally ambiguous (no DHT or estrogen) until puberty |
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Compare testosterone, estrogen, and LH levels in people with AIS vs 5aRD
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AIS- raised T and LH and E
5aRD- normal T and LH and E |
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define pseudohermaphroditism.
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difference between phenotype and sex
disagreement between inside and outside |
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difference between pseudohermaphrodotism and hermaphrodistism
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hermaphrodites have both gonads
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what is a female with hermaphroditism? what do they look like inside and out?
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female internal organs
outside is either male or ambiguous |
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2 possible causes of female pseudohermaphroditism? common mechanism?
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exposure to androgens during development
1. congenital adrenal hyperplasia 2. mother is exposed to testosterone |
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example of disease causing male pseudohermaphroditism?
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AIS
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what karyotypes can be true hermaphrodites?
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46 XX or 46 XXY
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alternate name for true hermaphroditism?
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ovotesticular disorder of sex development
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what do hermaphrodites look like on the outside vs the inside?
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outside- ambiguous genitalia and features
inside- have ovotestes |
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what do ambiguous genitalia look like?
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how many carbons are on testosterone and androstenedione?
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19
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what is the cause of klinefelter's?
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nondysjunction of sex chromosomes in meiosis II
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what is the karyotype of klinefelter's?
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47 XXY
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what can you see under the microscope to check for kline felter's?
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barr body
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how common is kline felter's?
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pretty common 1/850
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what are some physical appearances of XXY? 5
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1. gynocomastia
2. long limbs 3. female hair pattern 4. small penis 5. testicular atrophy 6. eunuchoid body habitus |
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what are the Lh and FSH levels in males with klinefelter's?
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both high
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Why is FSH high in XXY?
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dysgenesis of seminiferous tubules --> sertoli cells secrete less inhibin --> FSH rises
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why do you get raised LH in XXY?
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abnormal leydig function --> low testosterone --> high LH
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physical appearance in turner's syndrome?
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short stature
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signs of epididymitis on physical exam?
where is it in the testes? |
very tender lumps in back of testes
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physical manipulations to reduce tenderness in epididymitis? 2 why does this work?
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put pressure on it or elevate it like all inflammation
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1 cause of epididymitis
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bacteria infection through the urinary tract
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most common 2 causes of epididymitis in men under 35. why?
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chlamydia and gonorrhea because they are acute STI's
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what about men over 35? why?
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e. coli because then it;s probably from the rectum
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what is twisted in testicular torsion?
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the spermatic cord
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what can go wrong in torsion if not fixed soon?
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the testes become ischemic and die
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what do they do in surgery to prevent future torsion? specific name and describe and dissect
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orchiopexy- tack the testes to the scrotum
testes- orchio surgical fixation- pexy |
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dissec cryptorchidism
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mysterious/hidden
testes |
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what happens in cryptorchisidsm? is it symmetric usually?
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failure of testes to descend, usually unilateral
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when do the testes descend?
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in the 1st year of life
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why would we care so much about cryptorchidism clinically? 2
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the high temperature predispose males to germ cell malignancy
can lead to decreased fertility |
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what is the treatment for cryporchidism?
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orchiopexy
drab the testes down and fixate it |
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so why can't people with AIS keep their beauty producing testes?
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35x greater risk of malignancy with undescended testes
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why would you do a oriectomy rather than a orchioplexy?
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when there is nowhere for the testes to descend like in AIS or in male cryporchidism past infancy
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what should you rule out before diagnosing cryptorchidism? 2 why?
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that this isn't actually a masculinized woman
congenital adrenal hyperplasia and early exposure to testosterone |
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what proportion of testicular cancers will be germ cell tumors?
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95%
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what exam can you do to see if a testicular mass may be a tumor?
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transilluminate it and see if it shines through- cancer should not
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what if the enlarged testes does transilluminate?
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hydrocele
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picmonic for 5 a-reductase deficiency
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picmonic for AIS
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wjhy is estrogen increased in klinefelter?
mnemonic? |
xxy- more x's mean more estrogen
unknown mechanism so stop trying to rach your brain over it! |
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picmonic for klinefelter's
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mnemonic for name of process of creating barr bodies?
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lyonization- lions are cats. cats have calico color from shutting off one x chromosome.
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is klinefelter's always xxy?
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no it can have many X's
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what are some variations of Turner's syndrome chromosomes? most common?
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a missing or partially defective X chromosome
45 XO with it completely missing is the most common |
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what is wrong with the lymph vessels in Turner's? name and description
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the lymph vessels are dilated- lymphangiectasis
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what are 3 consequences of lymphangiectasia in Turners? location and reason why
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cystic hygroma- dilation of lymph vessels out the posterior triangle of the neck
webbed neck- a reminant of skin from the cystic hygroma lymphedema of hands and feet- where lymph tends to accumulate |
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what is the estrogen level in people with turner's? mnemonic?
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again with the X's
low due to only having 1 X |
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why is the estrogen low?
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turner's pts have poorly developed ovaries, wich are the main sources of estrogen
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level of FSH and LH in Turner's? Why?
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high due to lack of neg feedback
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what kind of menstrual disorder do Turner's have?
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primary amenorrhea
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define primary amenorrhea
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menstruation that never starts
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what stages get mixed up in primary amenorrhea?
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menopause comes before menarche
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what other endocrine disorder do Turner's pts frequently suffere from? mnemonic?
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hypothyroidism
think about a goiter on the neck along with the webbing |
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what kind of associated congenital malformations are with Turner's? 3
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bicuspid aortic valve
preductal aortic coarctation horseshoe kidney |
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what cancer is associated with Turner's
picmonic? |
dysgerminoma
"disc-german-gnome" |
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what kind of chest do Turner's pts have?
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shield chest with widely spaced nipples
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picmonic for Turner's?
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difference between hydrocele and varicocele? pathogenesis and feel.
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variicocele- veins engorging from being backed up- bag of worms
hydrocele- tunica vaginalis unfused and letting in fluid- very tight scrotum in newborns |
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treatment for hydrocele? why?
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nothing, it usually goes away on it's own
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what happens in a spermatocele?
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you have a dilated epididymal duct where sperm gathers
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which of the last 3 celes transilluminate?
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all 3
hydrocele, varicocele, and spermatocele |
