33 Urogenital pathology Flashcards

1
Q

What is nodular hyperplasia (benign prostatic enlargement)?

A

Benign overgrowth of the epithelium and fibromuscular tissue in the transition zone and periurethral area.

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2
Q

What are the symptoms of benign hyperplasia? (6)

A
Urgency
Diminished stream size and force
Hesitancy
Increased frequency
Incomplete emptying
Nocturia
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3
Q

What are the three pathological changes in nodular hyperplasia? (3)

A

Nodule formation.
Diffuse enlargement of transition zone and periurethral area.
Nodule enlargement.

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4
Q

What is the incidence of carcinoma of the prostate?

A

Rises over 40 years old.

More in African ancestry.

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5
Q

What is the management of prostate carcinoma? (3)

A

Surgery.
Radiation therapy.
Hormonal manipulation.

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6
Q

What are the risk factors for prostate carcinoma? (6)

A
Age.
African ancestry.
High androgen levels.
Family history. 
BRCA2: 20x risk increase.
Increased fat consumption.
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7
Q

How is carcinoma of the prostate graded?

A

Gleason system.

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8
Q

Which medical conditions have been related to the development of testicular germ cell tumours? (9)

A
Previous TCGT in contralateral testicle.
Inguinal hernia.
Impaired spermatogenesis.
Cryptochordism.
Hydrocele.
Disorders of sex development.
Prior testicular biopsy.
Atopy.
Testicular atrophy.
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9
Q

Who gets seminomas vs teratomas?

A

Seminoma: 35-45 year olds.
Teratoma: first and second decades of life.

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10
Q

What are the clinical presentations of seminomas and teratomas?

A

Testicular swelling ± pain.

Rare seminoma: gynecomastia, exophthalmos + infertility.

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11
Q

What does epididymoorchitis cause?

A

Infarcted seminiferous tubules.

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12
Q

Who gets idiopathic granulomatous orchitis and how does it present?

A

Older adults.

Flu-like/UTI presentation. Swollen and painful testis.

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13
Q

Which inflammatory condition of the testis may mimic malignancy?

A

Sarcoidosis.

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14
Q

What is myofibroblastic pseudotumor of testis?

Histology?

A

Benign inflammatory condition of unknown aetiology.

Atypical inflammatory and myofibroblastic reaction with fasciitis-like large cells.

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15
Q

What is a sperm granuloma?

What does it result from?

A

Exuberant foreign body giant cell reaction to extravasated sperm.
Vasectomy/routine autopsy.

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16
Q

How does tuberculosis affect the testis?
Reservoir?
Symptoms? (4)

A

Causes tuberculous orchitis.
Epididymis are reservoir for TB in male genital tract.
Painless swelling with masses, infertility and scrotal fistula.

17
Q

What are the complications of cryptochordism?

A

Testicular atrophy, carcinoma, infertility.

18
Q

What are the primary causes of testicular failure? (9)

A
Undescended testis.
Haemachromatosis.
Kleinfelter syndrome.
Mumps.
Orchitis.
Trauma.
CF.
Testicular torsion, varicocele.
19
Q

What are the secondary causes of testicular failure? (3, 4 drugs)

A

Pituitary failure.
Obesity.
Ageing.
Drugs: glucocorticoids, ketoconazole, chemotherapy, opioids.