Chapter 14 - Male Genital System Flashcards Preview

Pathoma > Chapter 14 - Male Genital System > Flashcards

Flashcards in Chapter 14 - Male Genital System Deck (30)
Loading flashcards...
1
Q

Hypospadias

A

Opening of urethra on inferior surface of penis due to failure of the urethral folds to close

2
Q

Epispadias

A

Opening of urethra on superior surface of penis due to abnormal positioning of the genital tubercle. Can be associated with bladder exstrophy.

3
Q

Lymphogranuloma venereum definition and cause.

A

Necrotizing granulomatous inflammation of the inguinal lymphatics and lymph nodes.

STD caused by Chlamydia trachomatis serotypes L1-L3.

4
Q

Risk factors for Squamous Cell Carcinoma of the Penis?

A
  1. High risk HPV (16, 18, 31, 33)

2. Lack of circumcision.

5
Q

Bowen disease

A

Precursor lesion to SCC of the penis. In situ carcinoma of the penile shaft or scrotum that presents as LEUKOPLAKIA.

6
Q

Erythroplasia of Queyrat

A

Precursor lesion to SCC of the penis. In situ carcinoma of the glans that present as ERYTHROPLAKIA.

7
Q

Bowenoid papulosis

A

Precursor lesion to SCC of the penis. In situ carcinoma that presents as MULTIPLE REDDISH PAPULES. Does not progress to invasive carcinoma.

8
Q

Cryptorchidism

A

Failure of testicle to descend into the scrotal sac. Needs to be corrected by age of 2 or risk of infertility and seminoma

9
Q

Causes of Orchitis (inflammation of testicle) - 4

A
  1. Chlamydia trachomatis (serotypes D-K) or N gonorrhoeae. See in young adults.
  2. E coli and Pseudomonas - see in older adults via UTI
  3. Mumps (teenagers)
  4. Autoimmune orchitis- granulomas involving the seminiferous tubules.
10
Q

Clinical presentation of testicular torsion

A

Sudden testicular pain and absent cremasteric reflex.

11
Q

What side do you commonly see varicocele on and what is it associated with?

A

LEFT SIDE (as drains into left renal vein instead of directly into IVC). Associated with left-sided renal cell carcinoma.

12
Q

Hydrocele

A

Fluid collection within the tunica vaginalis of the scrotum. Associated with incomplete closure of the processus vaginalis (in infants) or blockage of lymphatic drainage (in adults)

13
Q

How do testicular tumors present, and what is done with them to diagnose?

A

Present as firm, painless testicular mass that CANNOT be transilluminated (as opposed to hydrocele).

DO NOT BIOPSY (as risk seeding the scrotum).

14
Q

Types of germ cell tumors in testicles? (5)

A
  1. Seminoma (ala dysgerminoma in the ovary)
  2. Embryonal carcionoma (immature, primative cells that may produce glands)
  3. Yolk sac (endodermal sinus)
  4. Choriocarcionoma
  5. Teratoma
15
Q

Histologic findings of a seminoma (germ cell tumor)

A

Large cells with clear cytoplasm and central nuclei. Form a homogenous mass with no hemorrhage or necrosis. Good prognosis, as respond to radiotherapy.

16
Q

Histologic findings of an embryonal carcinoma (germ cell tumor)

A

Malignant tumor comprised of immature, primitive cells that may produce glands. Forms a hemorrhagic mass with necrosis.

17
Q

Treatment of embryonal carcinoma of the testicle and common serum markers

A

Treat with chemotherapy, but note that it may result in differentiation of the tumor into another type of germ cell tumor (esp. teratoma).

AFP or b-hCG may be elevated.

18
Q

What is the most common testicular tumor in children?

A

Yolk sac (endodermal sinus) germ cell tumor.

19
Q

Characteristic histologic finding of an endodermal sinus (yolk sac) tumor of the testicle and serum markers.

A

Schiller-Duval bodies (glomerulus like structures!). AFP characteristically elevated.

20
Q

What is Choriocarcinoma of the testicle?

A

Malignant tumor of syncytiotrophoblasts and cytotrophoblasts (placenta-like tissue W/O VILLI).

21
Q

What type of tissue makes b-hCG?

A

SYNCYTIOTROPHOBLAST

22
Q

Serum marker found in choriocarcinoma and side effects?

A

b-hCG elevated. May lead to hyperthyroidism or gynecomastia as a-subunit of hCG similar to that of FSH, LH, and TSH.

23
Q

How is a teratoma in males different than in females, and what marker is elevated

A

Malignant in males, benign in females. AFP or b-hCG may be elevated.

24
Q

Histologic findings of Leydig cell tumors (sex cord stromal tumors of testicle)?

A

Produce excess androgen, causing precocious puberty in children or gynecomastia in adults. Reinke crystals seen on histo.

25
Q

What is the most common cause of a testicular mass in males > 60 years of age?

A

Lymphoma (usually bilateral). Often diffuse large B-cell.

26
Q

is there an increased risk for cancer with benign prostatic hyperplasia?

A

NO

27
Q

where does BPH occur?

A

periurethral zone of prostate

28
Q

how to treat BPH?

A

a1-antagonists (eg terazosin) which relax smooth muscle or 5a-reductase inhibitors (take longer to kick in)

29
Q

what is the Gleason grading scale based on?

A

Prostate cancer architecture alone (not nuclear atypia)

30
Q

meds for prostate cancer?

A

Leuprolide (continuos GnRH analog) or Flutamide (competitive inhibitor of androgen receptor).