urogenital pathology Flashcards

1
Q

define nodular hyperplasia or benign prostatic hyperplasia.

A

enlargement of the prostate due to overgrowth of the epithelium and fibromuscluar tissue of the transitional zone and periurethral area.

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2
Q

symptoms of benign prostatic hyperplasia

A

Lower urinary tract infections

Interference with muscular sphincter and by the obstruction of urine flow through pros attic urethra.

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3
Q

4 zones of the prostate.

A

normal prostate=central, transitional, peripheral and periurethral zone.

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4
Q

where does nodular hyperplasia originate from- (which zone of the prostate)

A

most centrally situated glands

this location enables it to produce early urinary obstruction.

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5
Q

3 pathologic changes needed to develop nodular hyperplasia

A

nodule formation
diffuse enlargement of transitional zone and periurethral tissue.
enlargement of the nodules.

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6
Q

what effect on cell proliferation do the androgens which can use benign prosaic hyperplasia have

A

increase cell proliferation and reduce cell death.

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7
Q

in what age group are prosaic cancers most prevalent

A

over 40s

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8
Q

treatment for prostatic cancer

A

Surgery, radiation therapy, and hormonal manipulations (antindrogenic), external beam radiation, prostatectomy.

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9
Q

risk factors of developing benign prostatic hyperplasia

A

age, race, family history, hormone levels, environmental influences.

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10
Q

what hormones play a key role in benign prostatic hyperplasia

A

androgens- maintain growth and survival of prostate cancer cells.

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11
Q

germline mutations in what predispose you to prostate cancer

A

BRAC2

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12
Q

what is the grading system from prostate cancers called

A

Gleason scoring system.

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13
Q

can prostate cancer be screened for

A

Yes- prostate specific antigen.

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14
Q

what is the role of the testes

A

produce sperm and produce androgens.

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15
Q

Testes are made up of what structures

A

tubules lined by spermatogonian (cells which differentiate and form sperm).
support cells- leydig and sertolii

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16
Q

what are the different types of testicular cancer

A
PRIMARY
germ cell
non-germ cell
pure cell
mixed cell
miscellaneous
haematopoietic
teratomas= most common
SECONDARY
metastases
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17
Q

what pre-existing medical conditions have been associated with the development of Testicular germ cell tumours (TGCT)

A

o Prior TGCT in the contralateral testicle
o Cryptorchidism- undescended testes.
o Impaired spermatogenesis
o Inguinal hernia- reduced blood supply to testes
o Hydrocele- reduced blood supply to testes
o Disorders of sex development
o Prior testicular biopsy
o Atopy- genetic tendency to develop allergic diseases
o Testicular atrophy

18
Q

define seminoma

A

cancer, cells are look like spermatogonian cells but they are malignant.

19
Q

define teratoma

A

tumour cells have structure or cells which are not native to the place where the tumour is found.

20
Q

define hamartoma

A

tumour cells are similar to the cells consist of structures which are e.g. breast, ovarian.

21
Q

how are tumours determined in testes

A

age, before puberty is benign, after puberty malignant (it will metastases)

22
Q

define mature teratoma

A

have structures which are similar to other found in the body

23
Q

define immature teratoma

A

cells which don’t look like they come from anywhere else in the body- so invasive.

24
Q

what does the blood film of a acute and chronic epididymoorchitis

A

ghostly outlines of infarcted seminiferous tubules, surrounded by purulent exudate containing neutrophils and other inflammatory cells.

25
Q

define Idiopathic granulomatous orchitis.

A

testis becomes swollen, painful, and tender initially but later may have a residual mass indistinguishable from a neoplasm, prompting orchiectomy.

26
Q

what do blood films of sacrodosis of the testes show

A

non-necrotizing granulomas involving testicular parenchyma. Special stains for fungal organisms and acid-fast bacilli are negative.

27
Q

define malakoplakia of testis.

A

formation of soft yellow, tan, or brown nodules that replace normal testicular parenchyma.
The tubules and interstitium are extensively infiltrated by large histiocytes that have abundant eosinophilic granular cytoplasm (von Hansemann histiocytes)
Body unable to deal with infection

28
Q

define Sperm Granuloma

A

A n exuberant foreign body giant cell reaction to extravasated sperm

29
Q

which parts of the tetses does Tuberculous Orchitis happen

A

epididymis

30
Q

define Tuberculous Orchitis

A

Caseating granulomatous inflammation is prominent, with fibrous thickening and enlargement of the epididymis and adjacent structures

31
Q

define cryptorchidism

A

testicles are missing

32
Q

where are undescended tetses most commonly found.

A

the inguinal canal or upper scrotum

33
Q

2 forms of the cryptorchisdims

A

congential

acquired

34
Q

what causes congenital cryptorchidism

A

anomalies in anatomic development or hormonal mechanisms involved in testicular descent.

35
Q

what causes acquired cyptoorchdism

A

postoperative or spontaneous ascent due to various mechanisms: inability of the spermatic blood vessels to grow adequately, anomalous insertion of the gubernaculum, failure in reabsorption of the vaginal process and failure in postnatal elongation of the spermatic cord.

36
Q

complications of cryptochdism

A

Testicular atrophy, infertility, carcinoma (TGCTs)

37
Q

define hypogonadism

A

testicular failure

38
Q

causes of primary (problem in testes) hypogonadism

A

undescended testis
Klinefelter syndrome, hemochromatosis (iron deposited in tissues)
mumps, orchitis, trauma, cystic fibrosis, testicular torsion (Common in young) and varicocele.

39
Q

causes of secondary hypogonadism

A

pituitary failure (gonadotropin release controlled here), drugs (glucocorticoids, ketoconazole, chemotherapy, and opioids), obesity (due to oestrogen production from fat (dehydosetestostrone is converted to estradiol) and aging (inability to produce dehydosetestostrone)

40
Q

clinical presentation of tubercles orchitis

A

unilateral or bilateral mass, infertility and scrotal fistula.

41
Q

symptoms of sperm granuloma

A

history of pain and swelling of the upper pole of the epididymis, spermatic cord, and, rarely, the testis. Others have a history of trauma, epididymiditis, and orchitis.

42
Q

symptoms in tuberculous orchitis

A

painless scrotal swelling, but other signs and symptoms include unilateral or bilateral mass, infertility, and scrotal fistula.