Male Reproductive Physiology - Montemayor

Question 1

35yo M unable to conceive after 3 years

sparse facial hair
decreased axillary and pubic hair growth

testes small and firm
low testicular volume

high LH and FSH
low Testosterone
low sperm

karyotype XXY

Answer 1

klinefelters

Question 2

klinefelters

Answer 2

XXY

seminiferous tubule dysgenesis

most common form male hypogonadism**

Question 3

intrauterine development of testes

Answer 3

SRY - on Y chromosome

transcription factor - TDF

Question 4

AMH

Answer 4

antimullerian hormone
-for mullerian duct regression

from sertoli cells

Question 5

sertoli cells

Answer 5

produce AMH

cause regression of female sex tract

Question 6

seminal vesicles, ejaculatory duct, vas deferens development

Answer 6

testosterone

Question 7

testosterone production

Answer 7

leydig cells

Question 8

before LH effect

Answer 8

hCG promotes fetal leydig to form testosterone**

Question 9

hCG

Answer 9

can be used to stimulate spermatogenesis

similar to LH effects

Question 10

penis, scrotum, prostate development

Answer 10

DHT
-dihydrotestosterone

binds greater affinity to testosterone angrogen receptor

Question 11

testosterone > DHT conversion

Answer 11

5 alpha reductase 2

can be deficient - ambiguous external genitalia

Question 12

retention of wolffian ducts

Answer 12

testosterone

Question 13

gynecomastia

Answer 13

elevated estradiol

-increased E:T ratio

Question 14

androgen to estrogen conversion

Answer 14

CYP-19 aromatase

Question 15

hormone initiate puberty

Answer 15

pulsatile GnRH**

Question 16

primary hypogonadism

Answer 16

elevated gonadotropin

androgen decreased levels

Question 17

androgen actions

Answer 17

variety of androgenic and anabolic effects

Question 18

internal genitalia

Answer 18

testosterone

Question 19

external genitalia

Answer 19

DHT

Question 20

circulating testosterone

Answer 20

majority is bound

SHBG - 45-60%
serum albumin 40%

Question 21

protein testosterone concentration in testes

Answer 21

androgen binding protein - ABP

Question 22

high T in testes

Answer 22

100x circulating

of promotion of adequate spermatogenesis

Question 23

promote LH and FSH secretion

Answer 23

GnRH pulsatile

Question 24

target of LH in testes

Answer 24

leydig cells

Question 25

target of FSH in testes

Answer 25

sertoli cells

Question 26

continuous GnRH

Answer 26

will inhibit gonadotropin secretion for prostate cancer

Question 27

sertoli functions

Answer 27

``` produce aromatase blood testis barrier hormone receptors produce ABP produce AMH produce inhibin B - neg feedback on FSH ```

Question 28

T, DHT, and E

Answer 28

negative feedback on LH

Question 29

3 hormones for spermatogenesis

Answer 29

testosterone - high testicular concentration (ABP bound) FSH and LH also estradiol and GH

Question 30

tx for patient with klinefelter

Answer 30

androgen replacement therapy exogenous T - virilzation of secondary male sexual traits fertility - testes fibrotic - no work in this klinefelters

Question 31

exogenous testosterone for fertility

Answer 31

no - just has negative feedback on entire axis need ABP - to keep high concentration in testes but low circulating

Question 32

eunuchoidism

Answer 32

absense of secondary sex characteristics gonadal failure before puberty

Question 33

13yo M b/l testicles absence testes in inguinal canal failure to descend causes defect of?

Answer 33

maturation of spermatogonia

Question 34

25yo M not able to conceive decreased facial and axillary hair decreased penile length hypogonadism due to?

Answer 34

DHT

Question 35

DHT

Answer 35

external genitalia and secondary sex characteristics

Question 36

continuous long lasting of what to delay puberty

Answer 36

GnRH agonist

Question 37

FSH Abs for male contraception men expected to have?

Answer 37

decreased serum inhibin B remove FSH on sertoli cell function**

Question 38

22yo M seminiferous tubule dysgenesis sertoli cells do what

Answer 38

maintain blood testis barrier

Question 39

leydig cell vs. sertoli cell function

Answer 39

study it