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Endocrine > Pathophysiology: Testicular Disorders > Flashcards

Pathophysiology: Testicular Disorders Flashcards

1
Q

19 year old male with failure to enter puberty and anosmia (cant smell anything)

A

Kollman’s syndrome: no migration of nerves? Treatment: GnRH

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2
Q

65 year old male with fatigue and erectile dysfunction with viral illness within 2 years. Testes normal size and firm.

A

Mumps orchitis! Tx: give T

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3
Q

43 year old male with erectile dysfunction and headaches, mastodynia, bitemporal field defects, gynecomastia, normal testes but soft.

A

Prolactinoma. (vision defect) low FSH LH, high prolactin. Tx: MRI and Dopaminergics: Cabergoline, bromocriptine, T

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4
Q

54 year old male with impaired memory while on testoterone therapy

A

SHBG

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5
Q

What oes GnRH signal?

A

FSH from anterior pit

LH from anterior pit

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6
Q

What does FSH do?

A

+ sertoli cells sperm production (testes)

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7
Q

What does LH do?

A

+ leydig cells testosterone (testes)

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8
Q

What does follistatin do?

A

Inhibits neighboring teste activins and inhibins

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9
Q

What do activins do?

A

Sertoli cells make them, and they stimulate FSH beta subunit production

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10
Q

What do inhibins do?

A

Seminiferous tubules and Sertoli cells make them, they suppress FSH secretion in the anterior pit.

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11
Q

What does injucry to seminiferous tuble lead to chemically?

A

Elevated FSH, since inhbins are gone.

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12
Q

Hypothalamic disorders look like what in testes/

A

Low GnRH–>low LH and FSH

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13
Q

Pituitary disorders lead to what in the tests?

A

Low GnRH, low LH/FSH, low T, no spermatogenesis

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14
Q

Gonadal disorders mean what?

A

Failure of testosterone production from leydig cells or spermatogenesis, no feedback leads to elevated LH and FSH

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15
Q

Post gonadal disorders are caused by what?

A

No testosterone recepotr function

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16
Q

Testicular failure labs?

A

FSH: High
LH: High
T: low

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17
Q

Germinal aplasia labs?

A

FSH: high
LH: normal
T: normal

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18
Q

Hypogonadotropic hypogonadism labs?

A

FSH: normal-low
LH: normal-low
T: Low

19
Q

Anabolic hormone labs?

A

Body builder +
FSH: 0
LH: 0

20
Q

What are testicular hypothalamic diseases?

A

*No puberty:
Kallman’s syndrome
Prader willi
Lawrence moon

21
Q

Kallman’s syndrome presentation?

A

Anosmia

22
Q

Prader Willi presentation?

A 
Hyperphagia
Obesity
Hypotonia
Micropenis
Small hands
Small feet
23
Q

Lawrence moon syndrome presentation?

A

Retinitis pigmentosa

Polydactyly

24
Q

Pituitary diseases?

A

Fertile eunich syndrome: LH def.
Isolated FSH def.
Hyper prolactinemia: inhibit GnRH and libido
Hemochromatosis: loss of LH and FSH

25
Q

Marijuana effect on prolactin?

A

Decrease Dopa, increase prolactin

26
Q

Testicular disorders have high what?

A

Low T

HIGH FSH and LH due to absent feedback of T

27
Q

What are chromosomal disorders of testes?

A

Klinefelters XXY: tall, breasts, euchanoid, mar fan
XYY- no sperm
Noonan’s syndrome (XO)-looks like turner’s
XX Male syndrome-normal height, no MR, azospermia

28
Q

What determines body shape in lack of androgens?

A

Prepubertal or Postpubertal

29
Q

What does pre puberty gonadal failure look like?

A

A child

30
Q

What does post puberty gonadal failure look like?

A 
Decrease muscle mass
Loss of libido
Impotence
No sperm
Hot flashes
Poor concentration
31
Q

When is testosterone usually highest?

A

Morning

32
Q

What is T bound to in blood?

A

Sex hormone binding globulin (SHBG)

33
Q

What percent of T is free?

A

2%

34
Q

What is the increase in SHBG in aging?

A

1% per year… this causes decline in free T

35
Q

What is the most accurate T test?

A

Equilibrium dialysis of free T

36
Q

What can cause low SHBG?

A

Hypothyroidism
Acromegaly
Obesity

37
Q

Is the half life of LH or FSH longer?

A

FSH is longer

38
Q

What does tonic release of FSH and LH cause? How is FSH and LH usually released?

A 
Tonic= hypogonadism (like leupron)
Pulsatile= normal
39
Q

What is the only tonic hormone released?

A

Prolactin

40
Q

What shuts off prolatin release?

A

Dopamine

41
Q

What does prolactin do to FSH and LH?

A

Decrease FSH and LH

42
Q

What does prolactin do to libido?

A

Decrease libido independent of T levels

43
Q

If you have a prolactin increase, think what iatrogenic?

A

DRUGS! OTC or illicit or prescription

44
Q

High prolactin does what?

A

Prevents fertility! Stress causes low dopa,increasing prolactin, cutting off libido and saving the herd from infants at a stressfull time.

Endocrine (15 decks)

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