Hypogonadism, Cryptochordism, Gynecomastia, and Testicular Cancer – Flashcards
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Deficiency in testosterone produced or secreted by testes
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Male hypogonadism
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failure of adolescent male to begin puberty by age 15
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Primary hypogonadism
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Idiopathic, acquired hypogonadism with testosterone level less than 150ng/dL; delayed or absence of puberty AND an impaired sense of SMELL.
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Kallmann Syndrome
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Serum testosterone between 150-300ng/dL; also characteristically obese, poor health, or aging.
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Partial male hypogonadotropic hypogonadism
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Normal testes during childhood that change in adolescence to fibrous or solid.
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Klinefelter's Syndrome
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75% of patients with this develop gynecomastia; also may experience delayed speech, learning disabilities, and psychiatric disorders; physical signs include thinning body hair, and gain of adipose tissue.
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Klinefelter's Syndrome
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Tests appropriate for investigating hypogonadism
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Morning serum testosterone and TSH
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Serum testosterone is considered low when less than
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320ng/ml
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Weight loss will increase testosterone levels. T/F
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True
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Testosterone therapy is useful for men with low serum testosterone combined with...
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at least three symptoms of hypogonadism.
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Absence of one or both testes
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Cryptorchism
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Study used to differentiate cryptorchism from retractile testes
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MRI
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Common condition in preterm or low birth weight male babies
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Cryptochism
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Presence of glandular breast tissue in a male
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Gynecomastia
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Gynecomastia is never considered a normal finding in a male. T/F
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False- up to 60% of boys have this at puberty, and it resolves spontaneously.
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A palpable discoid tissue that extends 2-3cm under the areola
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Indicates breast tissue rather than adipose tissue.
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Beta-HCG levels detected in male
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Suspicious for testicular, lung or liver cancer
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Low levels beta-HCG in male (<5mu/ml)
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Indicative of hypogonadism-- f/u with serum LH, total and free testosterone to r/o primary hypogonadism. Also consider TSH, T4, and karyotype to r/o Klienfelter's syndrome.
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Selective estrogen receptor modulator-- used to treat true gynecomastia.
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Raloxifene (Evista) and tamoxifen (Soltamox)
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Aromatase inhibitor (Arimidex)
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6 mo treatment for gynecomastia that reduces glandular tissue.
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Most common neoplasm in men between the ages of 20-35 years, but is a rare finding.
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Testicular cancer
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The primary source of malignancy in testicular cancer
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Germ cell tumors
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Testicular cancer incidence is slightly greater in the left testicle. T/F
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False
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Painless enlargement of the testicle, usually found by the patient.
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Testicular cancer
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Advanced testicular disease may manifest as
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abdominal mass or supraclavicular adenopathy
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To determine if testicular mass is intra or extra-testicular, order a
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Scrotal US
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If scrotal US indicates intra-testicular mass (cancer), next order
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CT of chest, abdomen, and pelvis
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Survival rates for testicular cancer discovered and treated in early stages
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90-95%
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Men with HIV have the same risk as other men for acquiring testicular cancer. T/F
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False-- They have higher risk
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Pubertal gynecomastia
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resolves spontaneously within 12-24 mo
