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gen path final > Genitourinary (AKA "dat dick stuff") > Flashcards

Genitourinary (AKA "dat dick stuff") Flashcards

1
Q

what is a Hypospadias? how prevalent is it?

A
  • an abnormal opening of the urethra along the ventral aspect of the penis
  • occurs in 1/300 live male births
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2
Q

what is the possible complication of a Hypospadias?

A

can be constricted and cause UTI

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3
Q

what is a Epispadias?

A

urethral opening on the dorsal aspect of the penis

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4
Q

which type of urethra malformation can lead to incontinence?

A

Epispadias

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5
Q

_________ disease is a synonym for carcinoma in situ of the penis

A

Bowen

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6
Q

what are the risk factors for developing Penile neoplasms?

A
  • uncircumcised
  • over 40
  • associated with HPV infection types 16 & 18
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7
Q

what do Premalignant Lesions on the penis appear as clinically?

A

Presents as a solitary white and/or red plaque

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8
Q

about __% of premalignant penile lesions will progress to invasive squamous cell carcinoma

A

10%

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9
Q

what is the 5 year survival rate for penis carcinomas?

A

66%

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10
Q

in carcinomas of the penis, local metastasis to what location reduces the 5-yr survival to 27%?

A

inguinal lymph nodes

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11
Q

what is Cryptorchidism?

A

Incomplete descent of the testis from the abdomen to the scrotum

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12
Q

T/F: Scrotum Neoplasms are rare, but most are squamous cell carcinomas

A

true

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13
Q

scrotum carcinomas were first associated with what group?

A

chimney sweeps

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14
Q

what condition leads to a 3 to 5 fold increased risk of testicular cancer?

A

Cryptorchidism

failure of testes to descend

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15
Q

what location/cell type do most testicular cancers arise from?

A

arising in intratubular germ cell neoplasia

within the atrophic tubules

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16
Q

what surgery will reduce risk of sterility and cancer due to cryptochidism?

A

Orchiopexy

surgery to move an undescended testicle down

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17
Q

inflammation in the testes is more common in the ____________ than testis proper (orchitis)

A

epididymis (epididymitis)

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18
Q

___________ refers to inflammation of the testes proper

A

Orchitis

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19
Q

In most cases, inflammation of the testes begins as what?

A

a primary urinary tract infection

with secondary ascending infection of the testes

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20
Q

what conditions can cause orchitis (testicular inflammation)?

A
  • main cause = STD’s

- mumps = effects adults (can cause sterility)

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21
Q

Orchitis is a complication of mumps in ___% of infected adult males

A

20%

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22
Q

______ occurs when the spermatic cord (from which the testicle is suspended) twists

A

Torsion

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23
Q

what is the result of the testicular torsion?

A

obstruction of venous drainage while leaving the thick-walled more resilient arteries patent (open)

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24
Q

_________ torsion occurs either in utero or shortly after birth, without know cause

A

Neonatal

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25
Q

T/F: Intense vascular engorgement and venous infarction follow unless the torsion is relieved

A

true

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26
Q

Adult testicular torsion generally occurs in adolescence secondary to _______________, whereby the testis has increased mobility

A

an anatomic defect

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27
Q

T/F: Testicular torsion is usually not a medical emergency

A

FALSE

Testicular torsion is one of the few urologic emergencies

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28
Q

________ of the testis are the most common causes of firm, painless enlargements of the testis

A

Tumors

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29
Q

where do 95% of testicular tumors arise from?

are these malignant or benign

A

arise from the germ cells

  • germ cell tumors = MALIGNANT

(95% of testicular tumors are malignant)

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30
Q

what age group is at the highest risk for testicular tumors?

A

15-34 years of age

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31
Q

only ___% of patients with testicular germ cell cancer have a history of cryptorchidism

A

only 10%

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32
Q

Germ cell tumors (malignancies) are divided into what 2 categories?

A

1) seminomas

2) nonseminomatous germ cell tumors

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33
Q

what 2 markers can help diagnose testicular cancer?

A

1) α-fetoprotein

2) human chorionic gonadotropin (HCG).

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34
Q

what cell type do seminoma tumors arise from?

A
  • arise from Sertoli or Leydig cells

- make up 5% of all testicular cancers

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35
Q

why are non-seminotomatous tumors likely to metastasize?

A
  • likely to spread early
  • spread thru lymphatics & blood vessels
  • even SMALL malignancies can metastasize
    (opposite of seminomas)
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36
Q

T/F: Seminomas typically respond poorly to treatment, and have a low 5-yr survival rate

A

FALSE

they are one of the most curable cancers

(its the germ cell ones that will get you)

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37
Q

which type of testicular germ cell tumor tends to spread early via lymphatics and blood vessels

A

Non-seminomatous tumors

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38
Q

which tumor markers are associated with Non-seminomatous GERM CELL tumors?

A

1) α-fetoprotein

2) human chorionic gonadotropin (HCG).

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39
Q

what are the 3 main categories of prostate disease?

A

inflammatory lesions (prostatitis)

nodular hyperplasia

carcinoma

40
Q

_________ is clinically apparent inflammation of the prostate which may be acute or chronic

A

Prostatitis

41
Q

Prostatitis is an important cause of what other condition?

A

RECURRENT E. coli urinary tract infection

  • swelling of prostate fucks up normal flow of urine, allows E.coli to invade
42
Q

Both acute and chronic prostatitis present with what symptoms?

A

dysuria
urinary frequency
lower back pain
poorly localized suprapubic or pelvic pain

43
Q

_____________________ refers to hyperplastic enlargement of the prostate, often associated with urinary symptoms

A

Nodular hyperplasia of the prostate

  • AKA “benign prostatic hypertrophy”= BHP
44
Q

Nodular hyperplasia (benign prostatic hypertrophy) Generally affects what region of the prostate?

A

affects the INNER PERIURETHRAL zone of the prostate

  • compresses the prostatic urethra
45
Q

During BHP, Proliferation of stromal & glandular elements in the prostate causes what?

A

enlargement of gland ± urinary obstruction

46
Q

T/F: benign prostatic hypertrophy effects 20% of men at age 40; and 90% of men age 70

A

True

47
Q

In patients with BPH, there is a local increase in what hormone?

A

androgens

48
Q

What is the acronym for the surgery that treats benign prostatic hypertrophy?

A

TURP

Trans urethral resection of the prostate

49
Q

what is the most common cancer of men over age 50 in the U.S ?

A

Adenocarcinoma of the prostate

50
Q

adenocarcinomas of the prostate can metastisize to what locations?

A

lymph nodes and bone

51
Q

Adenocarcinoma of the prostate accounts for ____% of all cancer

A

25% of all cancers

only 9% of these will be fatal

52
Q

the Majority of urinary bladder neoplasms are what type?

A

urothelial carcinoma

53
Q

urothelial carcinomas are most common in what age group? what is the most common clinical sign of it?

A
  • most common in men btw ages 50-80 yrs

- Present with painless hematuria

54
Q

Worldwide, how many new cases of STDs occur annually?

A

15 million

55
Q

what are the 2 most common STD’s?

A

1) genital herpes

2) genital HPV infection

56
Q

Syphilis is a chronic infection caused by what organism?

A

Treponema pallidum

its a spirochete

57
Q

what are the characteristics of primary syphilis?

A

1) Painless CHANCRE forms
- 9-90 days after infection

2) Resolves spontaneously in 4-6 weeks
3) If untreated, ~25% of patients develop secondary syphilis

58
Q

Secondary Syphilis Occurs within 2 months following resolution of what?

A

the primary chancre

59
Q

what types of lesions are found during secondary syphilis?

A

1) maculopapular rash affecting skin (palms and soles)
2) condyloma lata (wart-like lesions on the genitals)
3) mucous patches (may affect oral mucosa)

60
Q

After secondary syphilis spontaneously resolves, it enters a ________ phase

A

latency

61
Q

If secondary syphilis is left untreated, close to ____ of patients develop tertiary syphilis over a period of 5 to 20 years

A

one-third

62
Q

Tertiary syphilis develops after latent period of _____ years

A

5+

63
Q

what are the 3 types of TERTIARY Syphilis?

A

1) Aortitis (80% of patients)
2) Neurosyphilis (10%)
3) Gummas

64
Q

________ is also known as “cardiovascular syphilis”

A

Aortitis

65
Q

what is effected during Neurosyphilis?

A

involvement of the brain, meninges and spinal cord

66
Q

what are “gummas”? (result of tertiary syphilis)

A

focal granulomatous lesions develop in bone, skin, and mucous membranes of the UPPER AIRWAY and MOUTH

67
Q

what are the 3 forms of Congenital Syphilis?

A

1) Stillbirth
2) Infantile syphilis
3) Late congenital syphilis

68
Q

what is “Hutchinson’s Triad”? what form of syphilis is it associated with?

A
  • from Late congenital syphilis

Triad:

1) Hutchinson’s Teeth
2) Interstitial keratitis
3) Eighth cranial nerve deafness

69
Q

“saddle nose deformities” formations are secondary to _______

A

gummas

focal granulomatous lesions

70
Q

up to _____% of infants with congenital syphilis will die

A

40%

71
Q

what 2 SCREENING tests can be used to detect syphilis?

A

RPR (rapid plasma reagin)

VDRL (Venereal Disease Research Laboratory)

72
Q

what SPECIFIC test is used for the detection of syphilis?

A

FTA (Fluorescent Treponemal Antibody)

73
Q

T/F: FTA tests have about 15% false-positive results

A

FALSE

the Screening tests (RPR & VDRL) have a 15% false positive rate

74
Q

what agent causes Gonorrhea? what % of males and females are Asymptomatic?

A
  • caused by Neisseria gonorrhoeae infection

Males: 40% asymptomatic

Females: 80% asymptomatic

75
Q

what type of host reaction is elicited by Gonorrhea?

A

Provokes an intense, suppurative, inflammatory reaction (purulent exudate)

76
Q

Untreated gonorrhea can lead to _____

A

sterility

77
Q

Gonorrhea Ascending infection results in:

what happens in males? females?

A

A) acute prostatitis, epididymitis, or orchitis in MALES

B) inflammation of the uterus, fallopian tubes, and ovaries (acute salpingitis) in FEMALES

C) secondary scarring gives rise to pelvic inflammatory disease

78
Q

what is gonococcal ophthalmia neonatorum?

A

Blindness in infants from gonococcal contamination at birth

79
Q

what are the most common STDs reportable to CDC

A

Nongonococcal Urethritis and Cervicitis

80
Q

a majority of Nongonococcal Urethritis and Cervicitis cases are caused by what?

A

Chlamydia trachomatis

81
Q

Chlamydia trachomatis infections are similar to what other STD?

A

gonorrhea

82
Q

________ tests can be used for the diagnosis of Chlamydia

A

Molecular

83
Q

what is Reactive arthritis (Reiter Syndrome)?

A
  • possible manifestation of Chlamydia
  • immune response to infection
  • combination of urethritis/cervicitis, conjunctivitis, arthritis, and mucocutaneous lesions
84
Q

Genital Herpes Affects how many people in the US? what virus is responsible for most of the cases?

A
  • 50 million people a year

- Most caused by HSV-2 (less commonly HSV-1)

85
Q

name the characteristics of an Initial herpes simplex infection:

A
  • asymptomatic vs painful mucocutaneous eruptions
  • lymphadenopathy and malaise
  • heal 3-6 weeks
86
Q

name the characteristics of a RECURRENT herpes simplex infection:

A
  • small painful vesicles that quickly ulcerate

- heal in 7-10 days

87
Q

HSV are actively shed during what times?

A

periods of clinical lesions (ulcers during recurrent infection)

88
Q

what is the mortality rate for Neonatal herpes?

A

60%

very high

89
Q

what is the “viral cytopathic effect “ on cells infected with HSV?

A
  • ballooning degeneration of epithelial cells

- with large, often multinucleate, purple staining nuclei

90
Q

“_______ cells “ are the cells suffering from viral cytopathic effects associated with a HSV (herpes simplex) infection

A

“Tzanck cells”

91
Q

what is the most common lesion from the Human Papilloma Virus (HPV)?

A

condyloma acuminatum

  • AKA venereal warts
92
Q

condyloma acuminatum is caused by HPV ___ and ___

A

6 and 11

93
Q

name the characteristics of condyloma acuminatum:

A
  • Benign papillary nodules that frequently appear in clusters
  • Occur in anogenital region and oral mucosa
94
Q

T/F: Malignant transformation of genital condyloma acuminatum lesions often occurs

A

FALSE

  • uncommon for genital warts to become malignant
95
Q

what is the Histology AND Treatment for condyloma acuminatum?

A
  • Histology: KOILOCYTIC changes, papillary proliferation of epithelium
  • Treatment: surgical excision, laser treatment, cryotherapy, imiquimod

gen path final (8 decks)

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