Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

443-SRH and MSK > Hypogonadism > Flashcards

Hypogonadism Flashcards

(72 cards)

Start Studying
1
Q

T functions (4)

A

Fetal masculinization (ex- becomes male)
Pubertal changes (boy to men)
Sexual function (have sex)
Sperm production (reproduce)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what happens with testosterone with age?

A

↓ testicular production (testes less responsive)
↑ in sensitivity of the hypothalamus
Peripheral conversion to estrogen
SHBG ↑

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a condition resulting from or characterized by abnormally↓ functional activity of the gonads, with retardation of growth and sexual function

A

hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

disorders of the pituitary or hypothalamus resulting in inadequate gonadotropin stimulation of the testes

A

secondary hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

primary disorder of testicular function

A

primary hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

a clinical and biochemical syndrome associated with advancing age and characterized by typical symptoms and deficiency in serum testosterone levels- first used in guidelines in 2022

A

(Symptomatic) late onset hypogonadism (S)LOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the correct medical terminology for hypogonadism

A

(Symptomatic) late onset hypogonadism (S)LOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does (P)DAAM stand for

A

(partial) androgen decline in the aging male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

the term previously used to describe LOH

A

andropause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

a clinical and biochemical syndrome characterized by a deficiency of testosterone, or testosterone action, and relevant s/s

A

testosterone deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 specific sx of hypogonadism

A

↓ libido
ED
↓ freq of morning erections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

signs of hypogonadism

A

↓ body/ facial hair
Central obesity
↓ testicular volume
↓ muscle mass, ↑ body fat
Gynecomastia
Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

higher BMI = _____ testosterone

A

lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

are screening tools for hypogonadism recommended? why or why not

A

not recommended -mostly been made by the pharmaceutical industry (bias)
poor sensitivity/ specificity- most sx listed are less specific + may encourage pts to take testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does T change from 25-75

A

T ↓ 35%, free T ↓ 50-60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

FT and TT decreases ___/yr starting around ~28yrs old

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

there may be some variability in testosterone decreased by _________

A

racial group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T can be measured in (3)

A

urine, saliva, blood work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

free T is ~___% of of total T

A

2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ideal time to measure T is

A

fasting morning level, between 7-11am

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are some difficulties with measuring free T

A

cold standard equilibrium dialysis methods are too complex
no common RR to aid result interpretation
equations for free T may not be accurate due to SHBG variability + pt population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

genetics are responsible for ___% of T variability

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how does exercise impact T levels

A

short, intense exercise increase T (~30%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how does smoking imapct T levels

A

5-15% higher T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how does substance and alcohol use impact T levels
lower T
26
how does diet impact T
vegetarians have lower T
27
how do chronic diseases impact T
poor disease control generally associated with lower T and/or FT
28
COVID mechs for ED
endothelial dysfunction, psychological distress, impaired pulmonary hemodynamics, exacerbation of CV disease, impact on T levels, sensory loss (anosmia, ageusia)
29
before starting T therapy, what should be done?
address chronic conditions (obesity, increase exercise, osteoporosis, sleep apnea) discontinue meds that interfere with T
30
what is classified as late onset hypogonadism
>30ysr old
31
what is the goal for prepubertal hypogonadism
goal to stimulate long bone growth and induce mild virilization- do not interfere with spontaneous pubertal onset
32
when should tx for prepubertal hypogonadism be started
age 14 (withhold tx until then)
33
T therapy is recommended in hypogonadal men to induce and maintain
secondary sex characteristics
34
what are some consistent findings of T trials in hypogonadal men
increased lean body mass and BMD + decreased fat in those with low serum T levels (but not in those with normal) overall increased QoL
35
T or F: T consistently decreases fat mass and increases BMD even in men that are not deficient
F- consistency only found in deficient men
36
T derm effects
↑ in hair growth (beard, pubic, axillary)
37
T CNS effects
improvement in fatigue (3-6mths), small improvement in depressive mood (1mth max benefit may take longer to show)
38
T genitourinary effects
improvement in libido (1mth), ED (6-12mths)
39
T endocrine effects
improvement in T levels, insulin sensitivity (few days) and glycemic control (3-12mths)
40
T CV effects
↑ in fat free mass + lean mass (6-12mths), ↓ waist circ, ↓ in total cholesterol and LDL (1mth), improvement in HF and exercise capacity improvement in ECG ST segment depression due to exercise
41
T trials that are typically not adequately powered to assess ____ or ____ events
CV or prostate cancer
42
hematologic T effects
↑ hematocrit in anemic men (3-6mths)
43
T effect MSK
improvement in BMD (6mths), ↓ fracture risk, ↑ muscle strength, slowed progression of mobility limitations
44
AEs of T (with evidence of association) (5)
Erythrocytosis Acne and oily skin Detection of subclinical prostate cancer Growth of metastatic prostate cancer ↓ sperm production and fertility (less endogenous production = shuts down spermatogenesis)
45
Uncommon AEs for which there is weak evidence of association with T admin:
Gynecomastia Male pattern hair loss Growth of breast cancer Induction or worsening of OSA
46
IM T specific AEs
Fluctuations in mood or libido Pain at injection site Coughing episodes immediately after injection
47
transdermal T gels and solutions specific AEs
Potential risk for T transfer to partner or another person who is in close contact Skin irritation, odor at application site Stickiness, slow drying, dripping
48
are oral T tablets recommended for hypogonadism?
no- effects on liver and cholesterol
49
T nasal gel SEs
Rhinorrhea, epistaxis, nasal discomfort, nasal congestion, parosmia
50
which of the following is a formulation specific AE for IM testosterone 1. irritation of gums 2. parosmia 3. coughing episodes immediately after administration 4. effects on liver and cholesterol after admin
3
51
testosterone increases risk of _________, _________ , ______ compared to placebo (CV RF)
total CV events atherosclerotic events major adverse CV events
52
____ suppression is often used for prostate cancer tx
testosterone suppression
53
men with hx of _____ often have low T and sx
prostate cancer
54
can you use T supplementation if pt has hx of prostate cancer, resulting in hypogonadism
may consider if 1yr of cure psot cancer tx avoid if mod-high risk prostate cancer or still under active surveillance
55
oral T issues
hepatotoxicity, erratic absorption, cholesterol raising, high first pass effect
56
transdermal T reaches SS in
2-3d
57
transdermal T characteristic includes 1. reach SS in 4-5 d 2. be applied to the scrotum 3. wait to shower or swim after application 4. have hepatotoxicity
3
58
where should TD T not be applied
scrotum
59
which T inj contains cottonseed oil
Testosterone cypionate (depot-testosterone)
60
which T inj contains sesame oil
Testosterone enanthate (Delatestryl)
61
T distribution depends on
SHBG, albumin (small amount bound to albumin, mostly SHBG)
62
T si metabolized by ___________ to ___, _____
5 alpha reductase to DHT, estradiol
63
T interacts with
Warfarin (↑ INR) Insulin / hypoglycemics (T ↓ glucose) Cyclosporin (↑ levels, nephrotoxicity)
64
is DHEA recommended for hypogonadism
no but may still be used
65
DHEA production peaks in _________ and decliens ________
peaks in early adulthood declines over time
66
what is the evidence behind CAM for hypogonadism
some evidence that T can be normalized
67
clomiphene MOA in hypogonadism
Competes with estrogen at receptors at hypothalamus and pituitary negative feedback leads to ↑ FSH and LH from anterior pituitary leads to ↑ T production
68
clomiphene class
SERM
69
GnRH MOA in hypogonadism
GnRH stimulatesLH and FSH from anterior pituitary, leading to T production
70
hCG is an analog of
LH
71
aromatase inhibitors MOA in hypogonadism
inhibit peripheral conversion of T to estradiol lower feedback from reduced estradiol levels on HPA ↑ gonadotropins
72
what are 3 classes of investigational tx for hypogonadism
SERM gonadotrophins aromatase inhibitors

443-SRH and MSK (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions