L23 (T1): Endocrine aspects of male hypogonadism
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Questions and Answers

What is the most common cause of elevated SHBG?

  • Androgenic steroids
  • Aging (correct)
  • Hypothyroidism
  • HIV infection

    • What condition is associated with low testosterone and high LH+FSH?

  • Prostate cancer
  • Secondary Hypogonadism (correct)
  • Klinefelter Syndrome
  • Hypothyroidism

    • What is the most common cause of gynecomastia during puberty?

  • Idiopathic (correct)
  • Hypogonadism
  • Hyperthyroidism
  • Testicular tumor

    • What is the main investigation for gynecomastia?

    <p>Testosterone</p> Signup and view all the answers

    What is the primary site of testosterone production in men?

    <p>Testes</p> Signup and view all the answers

    What is the main cause of gynecomastia in chronic renal insufficiency?

    <p>Leydig cell dysfunction</p> Signup and view all the answers

    What is the most common cause of low SHBG?

    <p>Hepatic cirrhosis</p> Signup and view all the answers

    What is the primary treatment for persistent pubertal gynecomastia?

    <p>Tamoxifen</p> Signup and view all the answers

    What is the main cause of elevated SHBG in moderate obesity?

    <p>Progestins</p> Signup and view all the answers

    What is the most common cause of primary hypogonadism?

    <p>Testicular tumour</p> Signup and view all the answers

    What is synthesized by Sertoli cells in the seminiferous tubules?

    <p>Inhibin B and anti-Müllerian hormone</p> Signup and view all the answers

    Which cells in the testes produce Testosterone?

    <p>Leydig cells</p> Signup and view all the answers

    What is involved in the release of Testosterone?

    <p>LH</p> Signup and view all the answers

    Which hormone is involved in spermatogenesis?

    <p>FSH</p> Signup and view all the answers

    What type of secretion does GnRH exhibit?

    <p>Pulsatile</p> Signup and view all the answers

    What is synthesized by Leydig cells?

    <p>Testosterone</p> Signup and view all the answers

    What is the primary role of FSH?

    <p>Spermatogenesis</p> Signup and view all the answers

    Which cells in the seminiferous tubules are involved in sperm production?

    <p>Sertoli cells</p> Signup and view all the answers

    What do Leydig cells produce?

    <p>Testosterone</p> Signup and view all the answers

    What is the function of inhibin B?

    <p>Regulation of FSH secretion</p> Signup and view all the answers

    What is the primary source of testosterone production in normal young men?

    <p>Testes</p> Signup and view all the answers

    What percentage of testosterone is present as free hormone in the blood?

    <p>2%</p> Signup and view all the answers

    What is the primary hormone to which androgen target cells convert testosterone before binding to the androgen receptor?

    <p>Dihydrotestosterone (DHT)</p> Signup and view all the answers

    How is primary hypogonadism characterized?

    <p>Low testosterone and elevated serum LH and/or FSH</p> Signup and view all the answers

    What is a suggested condition for screening male hypogonadism?

    <p>Pituitary mass</p> Signup and view all the answers

    Which investigation is recommended for diagnosing male hypogonadism?

    <p>Serum testosterone</p> Signup and view all the answers

    What is the recommended focus for screening male hypogonadism?

    <p>History, physical examination, and hormone levels</p> Signup and view all the answers

    What do guidelines recommend for initial morning total testosterone levels?

    <p>Consideration of age-dependent normal ranges</p> Signup and view all the answers

    What is the definition of male hypogonadism?

    <p>Failure of the testes to produce adequate testosterone</p> Signup and view all the answers

    What is the primary source of testosterone in both men and women?

    <p>Testes</p> Signup and view all the answers

    What percentage of testosterone is present as free hormone in the blood?

    <p>Less than 2%</p> Signup and view all the answers

    Where is testosterone primarily secreted from in both men and women?

    <p>Testicles, ovaries, and adrenals</p> Signup and view all the answers

    What is the primary source of testosterone production in a normal young man?

    <p>Testicles</p> Signup and view all the answers

    Which hormone is the key hormone required for the actions of testosterone in the body?

    <p>Free testosterone</p> Signup and view all the answers

    What is the primary protein to which testosterone is bound in the blood?

    <p>Albumin</p> Signup and view all the answers

    In a normal young man, how much testosterone is made each day?

    <p>Around 7 milligrams</p> Signup and view all the answers

    What is a potential indicator of testosterone deficiency?

    <p>Increased body fat and BMI</p> Signup and view all the answers

    Which condition is NOT associated with an increased risk of testosterone deficiency?

    <p>Hypertension</p> Signup and view all the answers

    What symptoms can overlap between testosterone deficiency and depressive symptoms?

    <p>Poor concentration and memory</p> Signup and view all the answers

    What can small testicles lead to?

    <p>Reduced sperm counts</p> Signup and view all the answers

    What can long-term opioid use do to the pituitary axis?

    <p>Suppress it</p> Signup and view all the answers

    What is a potential consequence of prolonged testosterone deficiency?

    <p>Reduced motivation and aggression</p> Signup and view all the answers

    Which of the following is a primary cause of male hypogonadism?

    <p>Genetic conditions</p> Signup and view all the answers

    What are the clinical features of hypogonadism?

    <p>Incomplete sexual development and reduced libido</p> Signup and view all the answers

    Which condition can be a sign of imbalanced testosterone and estrogen in hypogonadism?

    <p>Gynecomastia</p> Signup and view all the answers

    What can hypogonadism lead to apart from erectile dysfunction and reduced sex drive?

    <p>Osteoporosis</p> Signup and view all the answers

    Which type of hypogonadism results from issues in the hypothalamus or pituitary?

    <p>Secondary hypogonadism</p> Signup and view all the answers

    What is crucial for diagnosing and managing male hypogonadism?

    <p>Understanding the physiology and anatomy of testosterone</p> Signup and view all the answers

    In the assessment of testosterone levels, what is the impact of nutritional deficiencies on hypothalamic pituitary suppression and testosterone levels?

    <p>Nutritional deficiencies can lead to hypothalamic pituitary suppression and affect testosterone levels</p> Signup and view all the answers

    What should be considered in the assessment of testosterone levels regarding family history?

    <p>Examining family history for familial links to testosterone deficiency is important</p> Signup and view all the answers

    What is the potential impact of major life events on testosterone deficiency?

    <p>Major life events can have an impact on testosterone deficiency</p> Signup and view all the answers

    What is the significance of inquiring about recent changes in the body, such as gynaecomastia or testicle problems, in the assessment of testosterone levels?

    <p>Inquiring about recent changes in the body is important as they may indicate testosterone-related issues</p> Signup and view all the answers

    What is the consideration regarding starting testosterone therapy after investigations?

    <p>Consideration of starting testosterone therapy after investigations is important</p> Signup and view all the answers

    What is the impact of medications on testosterone levels?

    <p>Review of medications that can affect testosterone levels is crucial</p> Signup and view all the answers

    Which enzyme is responsible for the conversion of testosterone to dihydrotestosterone (DHT)?

    <p>5-alpha reductase</p> Signup and view all the answers

    What is the primary hormone involved in the pulsatile secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH)?

    <p>Luteinizing Hormone (LH)</p> Signup and view all the answers

    Which hormone is a concern for those taking excess androgens due to its aromatization from testosterone?

    <p>Estradiol</p> Signup and view all the answers

    What is the primary hormone responsible for the increased risk of myocardial infarction due to its impact on cholesterol levels?

    <p>Testosterone</p> Signup and view all the answers

    Which hormone has a role in the development of reproductive organs in the fetus?

    <p>Anti-Mullerian Hormone (AMH)</p> Signup and view all the answers

    What is the primary hormone responsible for the impact on cholesterol levels and its association with increased risk of myocardial infarction?

    <p>Testosterone</p> Signup and view all the answers

    Study Notes

    Understanding Testosterone and Male Hypogonadism

    • Testosterone is a steroid hormone secreted in both men and women from the testes, ovary, and adrenal glands, with normal young men producing about 7 mg each day, primarily from the testes.
    • In blood, testosterone is predominantly bound to plasma proteins, with less than 5% derived from adrenal secretions and only about 2% present as free hormone.
    • The synthesis of androgens involves the conversion of cholesterol to various intermediates, ultimately leading to the production of testosterone and its conversion to dihydrotestosterone (DHT) and estradiol.
    • Testosterone, like other steroid hormones, penetrates target cells to stimulate growth and function, with androgen target cells generally converting testosterone to DHT before binding to the androgen receptor.
    • Male hypogonadism is defined as the failure of the testes to produce adequate testosterone, leading to a decrease in sperm production or testosterone production, and can be caused by primary (testicular) or secondary (hypothalamic or pituitary) factors.
    • Primary hypogonadism is characterized by low testosterone and elevated serum LH and/or FSH, while secondary hypogonadism features low testosterone and normal or low serum LH and/or FSH.
    • Causes of male hypogonadism include genetic disorders, infections, trauma, tumors, medications, and systemic illnesses, with clinical features ranging from incomplete sexual development to decreased libido and infertility.
    • Screening for male hypogonadism is suggested in conditions such as pituitary mass, medication use affecting testosterone production, HIV-associated weight loss, and infertility, with a focus on history, physical examination, and investigations including hormone levels, semen analysis, and imaging.
    • Key investigations for male hypogonadism include serum testosterone, LH/FSH, SHBG, liver function tests, semen analysis, karyotyping, pituitary function testing, and DEXA scan for bone density.
    • Guidelines on screening for male hypogonadism recommend initial morning total testosterone levels, with consideration of age-dependent normal ranges and exclusion of reversible causes before diagnosis and follow-up.
    • The text provides a comprehensive overview of the synthesis, action, regulation, and clinical aspects of testosterone, as well as the diagnosis and management of male hypogonadism.
    • The link provided offers further resources on testosterone testing and related information for clinical use.

    Understanding Testosterone and its Effects

    • The testicle contains sertoli cells that produce anti-mullerian hormone (AMH) and inhibit follicle-stimulating hormone (FSH), and leydig cells that produce testosterone.
    • Testosterone synthesis begins with cholesterol, which is converted to pregnenolone, then to progesterone and DHEA, eventually leading to testosterone production.
    • Testosterone can be converted to dihydrotestosterone (DHT) or aromatized to estradiol, the latter being a concern for those taking excess androgens.
    • The hypothalamic-pituitary-testicular axis involves the pulsatile secretion of luteinizing hormone (LH) and FSH, which stimulate testosterone and spermatogenesis production.
    • Excess testosterone leads to negative feedback regulation, reducing the production of LH and FSH to prevent further testosterone increase.
    • Testosterone can enter cells and be converted to DHT, which has about five times more potency than testosterone, affecting specific induced proteins and resulting in various effects.
    • Testosterone has numerous effects, including increased beard growth, prostate growth, laryngeal development, penis size, sperm production, muscle mass, and cholesterol levels.
    • Testosterone increases the risk of myocardial infarction due to its impact on cholesterol levels, and it affects sex drive, external genitalia production, and the development of reproductive organs in the fetus.
    • Low testosterone levels can lead to depression, fatigue, memory loss, and an increased risk of Alzheimer's disease.
    • The effects of testosterone are influenced by its conversion to DHT or estradiol, with potential synergistic or antagonistic effects.
    • Testosterone has a wide range of effects on the human body, impacting physical, reproductive, and psychological aspects.
    • Understanding the synthesis and effects of testosterone is crucial for comprehending its role in the body and in medical conditions related to hormonal imbalance.

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    Male Hypogonadism Jan 23 (wecompress.com).pptx

    Description

    Test your knowledge of testosterone and male hypogonadism with this informative quiz. Explore the synthesis, action, regulation, and clinical aspects of testosterone, and learn about the diagnosis and management of male hypogonadism. Test your understanding of key investigations and guidelines for screening, and enhance your knowledge of this important hormone and its implications for men's health.

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