Q. B/L cryptorchidism - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-25-2015
USMLE Forums Addict
 
Steps History: ---
Posts: 137
Threads: 62
Thanked 3 Times in 3 Posts
Reputation: 13
Default Q. B/L cryptorchidism

why testosterone level decreases in B/L cryptorchidism when Leydig cells are not affected by temperature? (From FA 2014, repro patho, p.587)
Reply With Quote Quick reply to this message



  #2  
Old 05-25-2015
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 6
Threads: 1
Thanked 3 Times in 2 Posts
Reputation: 13
Default

Sertoli cells are affected by the high temperature of bilateral cryptorchidism testes,so it secretes less inhibin, which makes negative feed back so more FSH and LH are secreted which also with negative feed back on testosterone lvl
Reply With Quote Quick reply to this message
  #3  
Old 05-25-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 12
Thanked 6 Times in 5 Posts
Reputation: 16
Default

Quote:
Originally Posted by BahiAhmed95 View Post
Sertoli cells are affected by the high temperature of bilateral cryptorchidism testes,so it secretes less inhibin, which makes negative feed back so more FSH and LH are secreted which also with negative feed back on testosterone lvl
testosterone level when it is high only then would be negative feedback right? following which further production will stop??? kindly elaborate pls.
Reply With Quote Quick reply to this message
 
  #4  
Old 05-25-2015
USMLE Forums Addict
 
Steps History: ---
Posts: 137
Threads: 62
Thanked 3 Times in 3 Posts
Reputation: 13
Default

Thanks bahiahmed. But, More LH should give rise to more testosterone, why less testosterone, since Leyding cells are not affected by temperature.

I understand less inhibit can lead to increased FSH and LH by ant pituitary but I never heard of increased LH giving negative feedback to testis causing less tetstosterone??? Are you sure???
Reply With Quote Quick reply to this message
  #5  
Old 05-25-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 12
Thanked 6 Times in 5 Posts
Reputation: 16
Default

the thing is when LH an FSH are released in excess in response to less inhibin, testosterone prodution under the effect of LH would increase?
Reply With Quote Quick reply to this message
  #6  
Old 05-25-2015
USMLE Forums Addict
 
Steps History: ---
Posts: 137
Threads: 62
Thanked 3 Times in 3 Posts
Reputation: 13
Default

Yes, that is what I mean to say. But, In FA, it's mentioned testosterone level decreases in B/L cryptorchidism, not increase and I am looking for the explanation for the cause of this decrease in testosterone.
Reply With Quote Quick reply to this message
  #7  
Old 05-25-2015
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 6
Threads: 1
Thanked 3 Times in 2 Posts
Reputation: 13
Default

I'm not really sure about that . but this is how it is in Kaplan:-
Sertoli cells, and therefore germ cell maturation, are adversely affected by the elevated temperature of cryptorchdism testes . in adults with bilateraly undesended testes, FSH secretion is elevated,probably as a result of decreased sertoli production of inhibin. TESTOSTERONE secretion byy the leydig cells of cryptorchid testes also tendes to be low , and as a result. LH secretion of adults with bilateral cryptorchidism is elevated
Reply With Quote Quick reply to this message
  #8  
Old 05-25-2015
USMLE Forums Addict
 
Steps History: ---
Posts: 137
Threads: 62
Thanked 3 Times in 3 Posts
Reputation: 13
Default

explanation is good. But, particularly what I am asking is-

In first aid,FA 2014, repro patho, p.587, it is said that Leydig cells are not affected by temperature (as we know there is increased temp in cryptorchidism which will affect only sertoli cells and spermatogonia) , the explanation of which is correctly applied to unilateral cryptorchidism where testosterone levels are normal.But, it's said that in B/L cryptorchidism, testosterone level decreases. If leydig cells are not affected by temperature at all, whether it is U/L or B/L, it shouldn't be affected, right? this is my point.

Can anybody help us pls?
Reply With Quote Quick reply to this message
  #9  
Old 05-25-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 12
Thanked 6 Times in 5 Posts
Reputation: 16
Default Found it

Basic reproductive physiology

1. Sertoli cells produce inhibin, which has a negative feedback on fsh that influences spermatogenesis in the seminiferous tubules.

2. LH influences Leydig cell to produce testosterone, and this testosterone has a negative effect on LH release. INHIBIN HAS NO ROLE IN REGULATING LH.

Thus :

In Bilateral cryptorchidism(a type of hypogonadism) Sertoli cells in body temp n also being hypoplastic/damaged, produce less Inhibin, So by negative feedback, more FSH, no effect on lh.

LH stimulates leydig cells to synthesize Testosterone. but Bilateral Cryptorchidism is a type of hypogonadism, so leydig cells will be defective or hypoplastic, so less testosterone, which through negative feedback will increase lh secretion, but no amount of lh can increase testosterone in a defective/hypoplastic leydig cell irrespective of any temperature influence over it.
Reply With Quote Quick reply to this message
  #10  
Old 05-25-2015
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 2
Threads: 0
Thanked 0 Times in 0 Posts
Reputation: 10
Default

I'm not sure it's right, but something like that I read in a book on pediatrics. the whole issue in the etiology of occurrence of cryptorchidism.... cryptorchidism b/l often arises initially due to low testosterone levels, due to violation of the sensitivity of cells to testosterone, or initially low level of testosterone secretion by cells leydig. and u/l cryptorchidism occurs for other reasons not related to the violation of testosterone secretion by cells. consequently testosterone levels will be normal.
Reply With Quote Quick reply to this message
  #11  
Old 05-25-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 12
Thanked 6 Times in 5 Posts
Reputation: 16
Default

Quote:
Originally Posted by Lubawa View Post
I'm not sure it's right, but something like that I read in a book on pediatrics. the whole issue in the etiology of occurrence of cryptorchidism.... cryptorchidism b/l often arises initially due to low testosterone levels, due to violation of the sensitivity of cells to testosterone, or initially low level of testosterone secretion by cells leydig. and u/l cryptorchidism occurs for other reasons not related to the violation of testosterone secretion by cells. consequently testosterone levels will be normal.
Merck manual says Cryptorchidism is a type of Hypergonadotrophic hypogonadism, and in Hypergonadotrophic hypogonadism leydig cells are always damaged, thus impairs testosterone production! damage to seminiferous tubules thus oligozoospermia/azoospermia and elevated gondotropins( FSH as a result of less inhibin, LH as a result of Testosterone and GnRH also high as testosterone has negative feedback on it too)

Hope this answer, you can be sure now.
Reply With Quote Quick reply to this message
The above post was thanked by:
Lubawa (05-25-2015)
  #12  
Old 05-25-2015
USMLE Forums Addict
 
Steps History: ---
Posts: 137
Threads: 62
Thanked 3 Times in 3 Posts
Reputation: 13
Default

Hey Ahmed thanks and I loved your explanation but is that simply your logic OR what you explained is in a reliable textbooks/review books/websites. I would like to stick to your explanation if that is mentioned somewhere. where did you read the explanation mentioned by you.

Thanks lubaba for you too.
Reply With Quote Quick reply to this message
  #13  
Old 05-25-2015
USMLE Forums Addict
 
Steps History: ---
Posts: 137
Threads: 62
Thanked 3 Times in 3 Posts
Reputation: 13
Default

Great relief from this doubt. Thanks a ton.

Just want to conclude this asking you one more question-

why then in FA it's mentioned Leydig cells are not affected by temperature? This statement is making many students confused on regard to this topic.

OR, there is nothing to do with temperature in this case ?If it is not affected by temp, it should be normal, right? But, we found testosterone to be decreased.
Reply With Quote Quick reply to this message
  #14  
Old 05-25-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 12
Thanked 6 Times in 5 Posts
Reputation: 16
Default

Quote:
Originally Posted by Aumsai View Post
Hey Ahmed thanks and I loved your explanation but is that simply your logic OR what you explained is in a reliable textbooks/review books/websites. I would like to stick to your explanation if that is mentioned somewhere. where did you read the explanation mentioned by you.

Thanks lubaba for you too.
Physiology which i mentioned i referred from GOLJAN AND THEN FA 2015, even i thought inhibin increases both fsh and lh at first, thus i referred n found out, theres an amazing diagram in fa, where inhibin is nowhere near LH.

the second part of cryptorchidism, i referred from merck manaual, ive not even changed the words. its just linking those two concepts is what ive done.
Reply With Quote Quick reply to this message
  #15  
Old 05-25-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 12
Thanked 6 Times in 5 Posts
Reputation: 16
Default

Quote:
Originally Posted by Aumsai View Post
Great relief from this doubt. Thanks a ton.

Just want to conclude this asking you one more question-

why then in FA it's mentioned Leydig cells are not affected by temperature? This statement is making many students confused on regard to this topic.

OR, there is nothing to do with temperature in this case ?If it is not affected by temp, it should be normal, right? But, we found testosterone to be decreased.
leydig cell is not affected by temperature, thats a concept. but in hypogonadism they are hypoplastic & damaged. how would a hypoplastic cell function to near normal level, since it is not affected by temperature it atleast produces some testosterone. not NIL.
Reply With Quote Quick reply to this message



  #16  
Old 05-25-2015
USMLE Forums Addict
 
Steps History: ---
Posts: 137
Threads: 62
Thanked 3 Times in 3 Posts
Reputation: 13
Default

Now, everything is clear and completely saturated with knowledge on this topic. Credit goes to Ahmed. Hurray!!!!Thanks man!!!
Reply With Quote Quick reply to this message
  #17  
Old 05-25-2015
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 12
Thanked 6 Times in 5 Posts
Reputation: 16
Default

Quote:
Originally Posted by Aumsai View Post
Now, everything is clear and completely saturated with knowledge on this topic. Credit goes to Ahmed. Hurray!!!!Thanks man!!!
Sure

This doubt made me search about this. credit is shared!
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
why increased LH in cryptorchidism? drpisho USMLE Step 1 Forum 1 04-22-2014 01:36 AM
cryptorchidism Dr.valoxib USMLE Step 1 Forum 4 02-14-2014 07:11 AM
Bilateral/Unilateral Cryptorchidism blackychen USMLE Step 1 Forum 0 12-31-2012 05:45 AM
Testosterone levels in cryptorchidism lsumed64 USMLE Step 1 Forum 2 05-12-2012 06:56 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)