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Flashcards in Diagnostic Testing Deck (65)
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1

Hormones in Gonadal Function

Testosterone
FSH
LH

2

Symptoms of Testosterone Deficiency

Decreased energy
Decreased libido
Decreased muscle mass
Decreased body hair
Hot flashes
Gynecomastia
Infertility

3

What is the single most important diagnostic test for male hypogonadism?

Testosterone

4

Test to Measure Testosterone

Serum total testosterone

5

What is measured with serum total testosterone

Free testosterone
Protein bound testosterone

6

Issues when Sex Hormone Binding Globulins (SHBG) is Increased & Less Free Testosterone

Aging
Hyperthyroidism
Increased estrogen
Liver disease
HIV
Anti-seizure meds

7

Issues when Sex Hormone Binding Globulins (SHBG) is Decreased & More Free Testosterone

Obesity
Insulin resistance
T2DM
Hypothyroidism
Increased GH
Exogenous androgens
Glucocorticoids
Nephrotic syndrome

8

When should one measure a testosterone level?

8 AM when testosterone levels are the highest

9

If testosterone is low twice, what should you measure next?

LH
FSH

10

What is the disorder if testosterone is low and LH & FSH is high?

Primary hypogonadism
Klinefelter

11

What is the disorder if testosterone is low and LH & FSH are not elevated?

Secondary hypogonadism
T2DM
Liver or kidney disease
Agining

12

Causes of Primary Hypogonadism

Klinefelter syndrome
Cryptorchidism
Varicocele
Trauma
Testicular torsion
Medications
Autoimmune damage

13

Causes of Secondary Hypogonadism

Prader Willi
Hyperprolactinemia
Glucocorticoids
Opiates
DM
Benign tumors & cysts
Trauma

14

Define PSA

Prostate specific antigen

15

Where is PSA secreted from?

Epithelial cells of the prostate

16

PSA Function

Liquefy semen in the seminal coagulum to allow sperm to swim freely

17

Causes of Elevated PSA

BPH
Prostate cancer
Prostatic inflammation or infection
Perineal trauma: bike riding, sexual activity, DRE (rare)

18

What is elevated PSA an indirect measurement of?

Prostate glandular size in men without cancer
Values increase with age

19

Causes of Decreased PSA

Obesity
Medications

20

Medications that Reduce PSA

5-alpha-reductase inhibitors (50% reduction)
NSAIDs
Statins
Thiazides

21

PSA & Prostate Cancer

Determine extent of cancer
Response to treatment
Screening method for detection??

22

What is most important for PSA values?

The trend of the individual

23

Parameters of PSA

PSA density (serum PSA/prostate volume)
PSA velocity (change in PSA over time)
Free/Total PSA (PSAII)

24

PSA Density (PSAD)

Levels higher in men with BPH
Higher PSAD indicates greater likelihood of cancer

25

How is PSAD measured?

Volume (size) of the prostate with a TRUS and divides the PSA number by the prostate volume

26

Define PSA Velocity (PSAV)

Rate of change in PSA over time

27

How is PSA velocity (PSAV) measured?

Transrectal prostate biopsy

28

Disorder with Free PSA Elevated Compared to Bound PSA

BPH

29

Disorder with High Level of Bound PSA

Likely prostate cancer

30

Semen Analysis

Mainstay in investigating male fertility potential
Abstain from coitus 2-3 days
Collect ejaculate
Analyze within an hour
Obtained via masturbation
Provides immediate information