Week 8 Flashcards
(25 cards)
What are some things that would make it onto the differential diagnosis list for male infertility?
hypothyroidism Sperm antibodies Cortisol deficiency (would see skin pigmentation) Pituitary problems (headaches) Endocrine Neoplasms Being underweight or overweight Gynecomastia Klinefelter's
What are some things that could cause gynecomastia? bilateral?
marijuana
increased estrogen
If the gynecomastia were one-sided, what could cause it?
cancer
local infection
What can obesity do to hormone levels?
it decreases testosterone levels
What do small testicles & a short penis indicate?
low testosterone levels during development
What are different methods for administering testosterone to a man?
cream
injection
buccal
axeron
When do you get anger issues with testosterone?
with a spike in testosterone…usu w/ the injection (cheapest method of administration)
What is one of the problems with treating a patient with testosterone?
heart disease risk increases
What can pituitary problems do to vision? Why?
can cause loss of peripheral vision
double vision
**b/c the pituitary gland is right next to the optic chiasm…
What is used to measure testes size?
orchidometer
Describe how you test testosterone levels. What is one of the complications of testing them?
test it twice in the morning
**each lab’s reference range is different
If your testosterone level is >200 what do you do?
don’t treat–there will be no response
If your testosterone level is b/w 150 & 200 what do you do?
treat if symptoms are present
If your testosterone level is less than 150 what do you do?
treat always, patient will probably respond
What does low testosterone do to bones?
decreased bone mass, possible osteoporosis
What are the possible causes of small testes?
testicular injury alcoholism hormone disorders feminization genetic disorders drugs
What are some causes of low testosterone?
pituitary insufficiency hypogonadism testicular cancer testicular cancer radiation therapy obesity trauma to testicles type II Diabetes Chronic liver or kidney disease HIV/AIDS Normal Aging Autoimmunity against Leydig cells Klinefelter's
What are some possible causes of bilateral gynecomastia?
anti-androgen meds anabolic steroids antidepressants antibiotics ulcer medications chemotherapy alcohol marijuana amphetamines heroin Klinefelter syndrome Too much prolactin & estrogen kidney failure liver disease malnutrition
Explain the physiology behind low testosterone & high FSH & LH.
Low testosterone b/c of decreased functionality of the testes…
decreased negative feedback on the pituitary gland-increased release of FSH & LH
Testosterone vital for maintaining sperm count & spermatogenesis.
Could hypopituitarism be a cause of low testosterone levels if there is high FSH & LH?
No. B/c w/ a hypo problem there would be low levels of these 2 things.
Why does a diagnosis of Klinefelter’s syndrome fit w/ this patient?
hypogonadism gynecomastia infertility low testosterone High FSH & LH High estradiol low sperm count normal motility, morphology & WBC.
What type of hypogonadism: primary or secondary does a patient with Klinefelter’s have?
they have primary hypogonadism.
What is the medical treatment for Klinefelter’s?
testosterone replacement
fertility wise: testicular sperm extraction
T/F Patients with Klinefelter’s syndrome have better bone health than the general population.
False. Because of the lack of testosterone they are at increased risk for osteoporosis.
