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REPRO II Exam 2 > Testicular Neoplasia - Fremont-Smith > Flashcards

Testicular Neoplasia - Fremont-Smith Flashcards

1
Q

germ cell tumors

A

seminomatous

non-seminomatous

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2
Q

sex cord stromal tumors

A

leydig cell tumor

sertoli cell tumor

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3
Q

lymphoma

A

older men

non-hodgkin diffuse B cell lymphoma

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4
Q

seminomatous

A

seminoma - young men

spermatocytic seminoma - older men

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5
Q

non-seminomatous

A

embryonal carcinoma - common
yolk sac tumor
choriocarcinoma
teratoma

often mixed

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6
Q

torsion of testicle

A

breakdown of blood/testicle barrier

  • immune system recognize germ cells/sperm as foreign
  • 10% develop infertility

get immune response against unaffected testicle
-poor sperm quality

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7
Q

cryptorchidism
hypospadius
poor sperm quality

A

testicular dysgenesis syndrome

associated with seminomatous and non-seminomatous germ cell tumors

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8
Q

tunica albuginea

A

surrounding seminiferous tubules

contains the germ cells and sperm

sertoli cell surround germ cell
leydig cells - surrounding fibrosis

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9
Q

sertoli cell

A

surround maturing sperm

-important interaction

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10
Q

germ cell CIS

A

exist before boy is born

  • CIS child born with
  • idiopathic
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11
Q

90% tumors in male

A

germ cell

  • seminoma - majority
  • embryonal - NSGCT
  • mixed - both

malignant

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12
Q

malignant

A

germ cell tumors
yolk sac tumor
teratoma
spermatocytic seminoma

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13
Q

benign

A

sertoli cell tumor
leydig cell tumor
sex cord stromal tumor

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14
Q

i12p

A

genetic marker in germ cell tumors

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15
Q

germ cell tumors

A

good response to chemotherapy

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16
Q

most common neoplasm young adult men

A

germ cell tumors of testis

GCT

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17
Q

risk factors for GCT

A

abnormal testis
fam hx - KT and BAK
white
brothers 8-10x risk

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18
Q

path of GCT

A

precursor malignant cell develops in fetus and is activated at puberty

abnormal chromosome i12p

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19
Q

spermatogonia GCT

A

seminoma

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20
Q

primitive germ cell GCT

A

embryonal carcinoma

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21
Q

mets of GCT

A

periaortic abdominal lymph nodes

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22
Q

painless testicular mass with HCG, LDH, aFP

A

GCT

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23
Q

most common GCT

A

seminoma

slow growing with late spread

LDH and HCG

24
Q

AFP

A

non-seminomatous GCT

25
Q

staging seminoma

A

good - no mets

intermediate - mets

26
Q

tx of seminoma

A

sperm preserved

  • radical orchiectomy
  • node dissection

low risk - no mets - very radiosensitive

intermediate risk - mets - platinum chemo

27
Q

large cell with distinct borders, prominent nucleoli, watery cytoplasm, lymphoid infiltrate, in a nested pattern

A

seminoma histo**

28
Q

spermatocytic seminoma

A

rare tumor men >65yo
slow-growing, non-met

looks like seminoma

29
Q

non-senimonatous GCT

A

mixed germ cell tumor usually

more aggresive and worse prognosis

hematogenous and lymph spread

respond well to chem

30
Q

mixed GCT

A

50-60% of all testicular tumors

31
Q

yolk sac tumor

A

produce AFP

most common GCT in children <3 years old

32
Q

schiller duval bodies

A

yolk sac tumors

33
Q

hemorrhagic, aggressive, HCG

A

choriocarcinoma

hematogenous spread**

prognosis - depend on mets and serum marker levels

tx - radical orchiectomy

34
Q

use of serum markers in NSGCT

A

evaluate masses
staging
assessing tumor burden
response to therapy

35
Q

zones of prostate

A

transition - BPH and obstruction

peripheral - cancers - most posterior** feel with rectal exam

central zone

36
Q

acute prostatitis

A

E. coli gram neg rods, enterococci

reflux of urine

fever, chills, cysuria

tx antibiotics

37
Q

chronic prostatitis

A

recurrent UTIs, dysuria, localized pain

PMNs in urine** diagnosis

38
Q

granulomatous prostatitis

A

most secondary to ruptured acini

39
Q

BPH

A

enlarged prostate transition zone

60-100 g (normal DHT > grwoth factor

40
Q

treatment of BPH

A

alpha blockers - decreased smooth m tone

5 alpha reducatese inhibitor - decreases DHT

tissue destruction

41
Q

5-hydroxy-reductase

A

T > DHT

42
Q

compress urethra into slit-like lumen

A

BPH

glands and stroma proliferate

43
Q

malignant vs. benign prostate gland

A

look for the basal layer (bark) and if cells have invaded from gland

44
Q

imaging of prostate

A

U/S

IVP

45
Q

phenazopyridine

A

drug given if urinary procedure

makes pee dark orange

46
Q

urinary bladder muscle

A

hypertrophies with BPH

to push urine past prostate

47
Q

complications of BPH

A

obstruction - cystitis, pyelonephritis, nephropathy

infection - prostatitis, epididymitis

urosepsis

48
Q

serum Cr level doubles

A

regardless of initial value

indicates serious renal issue

49
Q

adenocarcinoma of prostate

A

posterior wall tissue

2nd leading cause cancer death in men

risk >50yo, AA, fam hx

androgen dependent**

precursor - prostatic intraepithelial neoplasm (PIN)

screening - DRE and PSA

50
Q

predictive value

A

likelihood a positive test respresents disease

51
Q

pararectal US with needle

A

can biopsy prostate mass

52
Q

prominent nucleoli

A

necessary for dx of adenocarcinoma of prostate

53
Q

PSA velocity

A

change of PSA over time

54
Q

PSA

A

organ specific
not cancer specific

more free PSA - more likely benign

55
Q

prostate mets

A

osteoblastic - bone

56
Q

gleason scoring

A

for prostate cancer

57
Q

staging of prostate

A

T3 - through capsule
N1 - node mets present
M1 - distant mets present

REPRO II Exam 2 (21 decks)

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