Testosterone

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Testosterone

Metabolism HYMS year 3

Metabolism HYMS year 3

Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Anatomy of the urinary organs of the pelvis
Anatomy of the female urogenital triangle
Anatomy of the perineum
Anatomy clinical correlates: Male pelvis and perineum
Anatomy clinical correlates: Female pelvis and perineum
Development of the renal system
Ureter, bladder and urethra histology
Kidney histology
Renal system anatomy and physiology
Hydration
Body fluid compartments
Movement of water between body compartments
Renal clearance
Glomerular filtration
TF/Px ratio and TF/Pinulin
Measuring renal plasma flow and renal blood flow
Regulation of renal blood flow
Tubular reabsorption and secretion
Tubular secretion of PAH
Tubular reabsorption of glucose
Urea recycling
Tubular reabsorption and secretion of weak acids and bases
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Renin-angiotensin-aldosterone system
Sodium homeostasis
Potassium homeostasis
Phosphate, calcium and magnesium homeostasis
Osmoregulation
Antidiuretic hormone
Kidney countercurrent multiplication
Free water clearance
Vitamin D
Erythropoietin
Physiologic pH and buffers
Buffering and Henderson-Hasselbalch equation
The role of the kidney in acid-base balance
Acid-base map and compensatory mechanisms
Respiratory acidosis
Metabolic acidosis
Plasma anion gap
Respiratory alkalosis
Metabolic alkalosis
Renal agenesis
Horseshoe kidney
Potter sequence
Hyperphosphatemia
Hypophosphatemia
Hypernatremia
Hyponatremia
Hypermagnesemia
Hypomagnesemia
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypocalcemia
Renal tubular acidosis
Minimal change disease
Diabetic nephropathy
Focal segmental glomerulosclerosis (NORD)
Amyloidosis
Membranous nephropathy
Lupus nephritis
Poststreptococcal glomerulonephritis
Rapidly progressive glomerulonephritis
IgA nephropathy (NORD)
Alport syndrome
Kidney stones
Hydronephrosis
Acute pyelonephritis
Chronic pyelonephritis
Prerenal azotemia
Renal azotemia
Acute tubular necrosis
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Renal papillary necrosis
Renal cortical necrosis
Chronic kidney disease
Polycystic kidney disease
Multicystic dysplastic kidney
Medullary cystic kidney disease
Medullary sponge kidney
Renal artery stenosis
Renal cell carcinoma
Angiomyolipoma
Nephroblastoma (Wilms tumor)
WAGR syndrome
Beckwith-Wiedemann syndrome
Posterior urethral valves
Hypospadias and epispadias
Vesicoureteral reflux
Bladder exstrophy
Urinary incontinence
Neurogenic bladder
Lower urinary tract infection
Transitional cell carcinoma
Non-urothelial bladder cancers
Congenital renal disorders: Pathology review
Renal tubular defects: Pathology review
Renal tubular acidosis: Pathology review
Acid-base disturbances: Pathology review
Electrolyte disturbances: Pathology review
Renal failure: Pathology review
Nephrotic syndromes: Pathology review
Nephritic syndromes: Pathology review
Urinary incontinence: Pathology review
Urinary tract infections: Pathology review
Kidney stones: Pathology review
Renal and urinary tract masses: Pathology review
Osmotic diuretics
Carbonic anhydrase inhibitors
Loop diuretics
Thiazide and thiazide-like diuretics
Potassium sparing diuretics
ACE inhibitors, ARBs and direct renin inhibitors
Endocrine system anatomy and physiology
Hunger and satiety
Insulin
Glucagon
Somatostatin
Diabetes mellitus
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Parathyroid disorders and calcium imbalance: Pathology review
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Hyperthyroidism medications
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Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Diabetes mellitus: Pathology review
Prostatitis
Prostate disorders and cancer: Pathology review
Prostate cancer
Prostate gland histology
Androgens and antiandrogens
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Hyperthyroidism
Graves disease
Thyroid eye disease (NORD)
Toxic multinodular goiter
Thyroid storm
Euthyroid sick syndrome
Thyroid hormones
Hashimoto thyroiditis
Subacute granulomatous thyroiditis
Hypothyroidism
Thyroglossal duct cyst
Riedel thyroiditis
Thyroid cancer
Congenital adrenal hyperplasia
Primary adrenal insufficiency
Waterhouse-Friderichsen syndrome
Hyperaldosteronism
Adrenal cortical carcinoma
Cushing syndrome
Conn syndrome
Hyperparathyroidism
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Pituitary adenoma
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Gigantism
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Sheehan syndrome
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Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Precocious puberty
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Premature ovarian failure
Polycystic ovary syndrome
Androgen insensitivity syndrome
Kallmann syndrome
5-alpha-reductase deficiency
Autoimmune polyglandular syndrome type 1 (NORD)
Multiple endocrine neoplasia
Zollinger-Ellison syndrome
Carcinoid syndrome
Pheochromocytoma
Neuroblastoma
Opsoclonus myoclonus syndrome (NORD)
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Multiple endocrine neoplasia: Pathology review
Adrenal hormone synthesis inhibitors
Mineralocorticoids and mineralocorticoid antagonists
Synthesis of adrenocortical hormones
Cortisol
Testosterone
Estrogen and progesterone
Parathyroid hormone
Calcitonin
Adrenocorticotropic hormone
Growth hormone and somatostatin
Oxytocin and prolactin
Pituitary gland histology
Pancreas histology
Thyroid and parathyroid gland histology
Adrenal gland histology
Iron deficiency anemia
Alpha-thalassemia
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Glucose-6-phosphate dehydrogenase (G6PD) deficiency
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Lead poisoning
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Hereditary spherocytosis
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Fanconi anemia
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Folate (Vitamin B9) deficiency
Aplastic anemia
Vitamin B12 deficiency
Diamond-Blackfan anemia
Acute intermittent porphyria
Porphyria cutanea tarda
Hemophilia
Vitamin K deficiency
Hemolytic-uremic syndrome
Bernard-Soulier syndrome
Glanzmann's thrombasthenia
Immune thrombocytopenia
Thrombotic thrombocytopenic purpura
Von Willebrand disease
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Heparin-induced thrombocytopenia
Factor V Leiden
Protein C deficiency
Protein S deficiency
Antiphospholipid syndrome
Antithrombin III deficiency
Hodgkin lymphoma
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Chronic leukemia
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Polycythemia vera (NORD)
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Leukemoid reaction
Langerhans cell histiocytosis
Multiple myeloma
Monoclonal gammopathy of undetermined significance
Waldenstrom macroglobulinemia
Mastocytosis (NORD)
Microcytic anemia: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Extrinsic hemolytic normocytic anemia: Pathology review
Macrocytic anemia: Pathology review
Heme synthesis disorders: Pathology review
Coagulation disorders: Pathology review
Platelet disorders: Pathology review
Mixed platelet and coagulation disorders: Pathology review
Thrombosis syndromes (hypercoagulability): Pathology review
Lymphomas: Pathology review
Leukemias: Pathology review
Plasma cell disorders: Pathology review
Myeloproliferative disorders: Pathology review
Anticoagulants: Heparin
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Antiplatelet medications
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Hematopoietic medications
Ribonucleotide reductase inhibitors
Topoisomerase inhibitors
Platinum containing medications
Anti-tumor antibiotics
Microtubule inhibitors
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Monoclonal antibodies
Antimetabolites for cancer treatment
Anatomy of the thyroid and parathyroid glands
Pharyngeal arches, pouches, and clefts
Blood histology
Blood components
Blood groups and transfusions
Platelet plug formation (primary hemostasis)
Coagulation (secondary hemostasis)
Role of Vitamin K in coagulation
Clot retraction and fibrinolysis
Anatomy clinical correlates: Other abdominal organs
Anatomy of the male urogenital triangle
Membranoproliferative glomerulonephritis
von Hippel-Lindau disease
Klinefelter syndrome
Turner syndrome
Benign prostatic hyperplasia
Cryptorchidism
Varicocele
Orchitis
Testicular cancer
Epididymitis
Testicular torsion
Priapism
Penile cancer
Urethritis
Proteus mirabilis
Testicular tumors: Pathology review
Kidney stones: Clinical
Renal cysts and cancer: Clinical
Testicular and scrotal conditions: Pathology review
Anatomy clinical correlates: Inguinal region
Blood products and transfusion: Clinical
Venous thromboembolism: Clinical
Hypernatremia: Clinical
Hyponatremia: Clinical
Hyperkalemia: Clinical
Hypokalemia: Clinical
Metabolic and respiratory acidosis: Clinical
Metabolic and respiratory alkalosis: Clinical
Acute kidney injury: Clinical
Transplant rejection
Graft-versus-host disease
Cytomegalovirus infection after transplant (NORD)
Post-transplant lymphoproliferative disorders (NORD)
Rhabdomyolysis

Transcript

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When someone mentions testosterone, it might conjure up images of a burly alpha male.

That’s because testosterone, the primary male hormone, is an androgen, andro meaning male and gen meaning “to produce”, which means testosterone helps generate the characteristics associated with male sexuality.

The effects of testosterone are first seen in the fetus.

During the first six weeks of development, the reproductive tissues of males and females are identical,

but in week seven, genes in the sex-determining region of the Y chromosome initiate the development of testicles.

Once they form, the fetal testicles secrete testosterone which guides development of the male urogenital tract and external genitalia,

as well as testicular descent through the inguinal canal which happens in the last two months of fetal development.

The fetal ovaries also secrete testosterone but at much lower levels, and this largely explains the differences in fetal development between boys and girls.

In puberty, the hypothalamic-pituitary axis takes center stage in regulating testosterone levels and gonadal function - which are the testes in young men.

The hypothalamus secretes gonadotropin-releasing hormone which moves through the bridge between the hypothalamus and the pituitary gland, called the hypothalamo-hypophyseal portal system, and gets to the anterior lobe of the pituitary.

In response, the anterior pituitary secretes luteinizing hormone and follicle-stimulating hormone - two gonadotropic hormones which get secreted into the blood and reach the gonads.

Leydig cells, slowly turn cholesterol into testosterone through a number of steps, and the first step of this process is stimulated by luteinizing hormone.

Two important intermediate molecules in that process are dehydroepiandrosterone, also called DHEA, and the molecule that it gets converted into - androstenedione.

The testes have the enzyme 17β-hydroxysteroid dehydrogenase, which takes androstenedione and turns it into testosterone.

The majority of the testosterone gets bound to plasma proteins like sex hormone–binding globulin and albumin, whereas only a minority remains free and unbound in the blood.

The protein-bound testosterone acts like a reservoir for testosterone, and it’s the unbound testosterone that reaches tissues like the seminal vesicles, prostate gland, muscles, and bone.

In some tissues, testosterone directly affects the target cells, whereas in others, the enzyme 5ɑ-reductase converts testosterone into dihydrotestosterone - and that’s the molecule that ultimately has an effect on the cell.

Testosterone or dihydrotestosterone bind to cell surface receptors and move into the target cell, where they initiate expression of a variety of proteins.

Testosterone is responsible for primary sexual development, which are the changes necessary for reproduction like enlargement of the penis and testes, as well as increasing libido.

Testosterone also helps with secondary sexual characteristics which aren’t required for reproduction but are associated with masculinity, like a male pattern of hair growth on the face, chest, axillary, and genital areas.

The hair itself changes from thin soft hair of childhood to thick and coarse hair of adulthood.

Key Takeaways

Testosterone is the primary male sex hormone and an anabolic steroid. In men, it plays a key role in the development of male reproductive tissue and secondary sexual characteristics. It is produced mainly in the testes and is responsible for several functions, including sexual differentiation during fetal life, and the development of primary sexual characteristics like an enlarged penis and testes, as well as secondary characteristics like a male pattern of hair growth, voice changes, and various anabolic effects.

Sources

  1. "Medical Physiology" Elsevier (2016)
  2. "Physiology" Elsevier (2017)
  3. "Human Anatomy & Physiology" Pearson (2018)
  4. "Principles of Anatomy and Physiology" Wiley (2014)
  5. "Biological Actions of Androgens" Endocrine Reviews (1987)
  6. "The benefits and risks of testosterone replacement therapy: a review" Therapeutics and Clinical Risk Management (2009)
  7. "Testosterone, Bone and Osteoporosis" Frontiers of Hormone Research (2008)