Male Genital System Pathology_PATHOMA Flashcards

(42 cards)

1
Q

Testicular SEMINOMA is what ovarian tumor counterpart?

A

OVARIAN DYSGERMINOMA

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2
Q

Classically ELEVATED AFP = what testicular tumor? ELEVATED beta-HCG?

A

AFP - classically yolk sac tumor

b-HCG - classically choriocarcinoma

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3
Q

Schiller-Duval Bodies (glomeruloid-like) structures seen in which tumors? (Male and Female)

A

MALE: Yolk Sac Tumor
FEMALE: Ovarian Tumor

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4
Q

INCREASED AFP testicular tumor Ddx:

A

CLASSICALLY NON-SEMINOMA: YOLK SAC TUMOR, Maybe EMBRYONAL carcinoma, TERATOMA

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5
Q

INCREASED b-HCG testicular tumor Ddx:

A

CLASSICALLY NON-SEMINOMA: CHORIOCARCINOMA, Maybe EMBRYONAL carcinoma, TERATOMA
RARELY SEMINOMA

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6
Q

Which testicular tumor has the poorest prognosis due to early hematogenous spread?

A

NON-SEMINOMA: Embryonal carcinoma has the poorest prognosis

although all non-seminomas generally have a poor prognosis bec of early metastasis relative to seminomas

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7
Q

Which testicular tumor might you also get hyperthyroidism and gynecomastia?

A

CHORIOCARCINOMA
Bec increased beta-HCG and its alpha subunit that is very similar to FSH/LH/TSH -> Increased activation of
FSH/LH - gynceomastia; TSH - hyperthyroidism

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8
Q

What type of masses do you see with a pt who has choriocarcinoma. Be specific with sizes.

A

SMALL NODULE on testicle
LARGE Mass elsewhere (lung, liver)
Exception of normal cancer metastases

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9
Q

Name pertinent lab results of CHORIOCARCINOMA.

A

CLASSICALLY increased beta-HCG,

Possible Increased FSH/LH/TSH due to similarity in structure

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10
Q

What is the most common sex cord tumor? Is it hormonally active or silent? Name the other one.

A

**most common LEYDIG CELL TUMOR - Hormonally ACTIVE

SERTOLI CELL TUMOR - Hormonally SILENT

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11
Q

Pt presents with testicular mass + enlarged fallices + pubic/axillary hair. What is the most likely diagnosis?

A

LEYDIG CELL TUMOR - Hormonally active. Increased androgens and estrogens

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12
Q

Which feature is pathognomonic for Leydig cells? If histology shows this feature, can I safely assume that this pt has a LEYDIG CELL TUMOR?

A

REINKE CRYSTALS

NO - These are present in BOTH normal benign + malignant Leydig cells

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13
Q

Are SEX CORD TESTICULAR TUMORS usually benign or malignant? Are GERM CELL TESTICULAR TUMORS usually benign or malignant?

A

SCT - usually benign; Leydig cell tumors - hormonally active, Sertoli cell tumors - hormonally silent
GCT - usually malignant

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14
Q

Which is the only testicular GCT that is a PAINFUL testicular mass?

A

EMBRYONAL CARCINOMA - coincidently has the POOREST PROGNOSIS

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15
Q

What are the two most common bacterial causes of ACUTE PROSTATIS in younger adults?

A

CHLAMYDIA trachomatis

NEISSERIA GONORRHOEAE

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16
Q

What are the two most common bacterial causes of ACUTE PROSTATIS in older adults?

A

E.COLI

PSEUDOMONAS

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17
Q

What is the clinical presentation of ACUTE PROSTATIS?

A

Dysuria + Fever/Chills

18
Q

How can one confirm ACUTE PROSTATIS on DRE and Culture?

A

DRE: Prostate is TENDER + BOGGY** (highyield)

Prostatic Secretions - WBC, culture show bacteria

19
Q

What is the unique feature of CHRONIC PROSTATIS that distinguishes it from ACUTE PROSTATIS?

A

CHRONIC PROSTATIS - Has pelvic/low back pain + dysuria rather than fever/chill + dysuria

20
Q

What will PROSATATIC SECRETIONS/CULTURE show on CHRONIC prostatis? which are different than ACUTE prostatis

A

CHRONIC:

  1. WBC on prostatic secretions (Same as acute)
  2. NEGATIVE CULTURE (Diff from acute)
21
Q

What penile disorder is the opening of the urethra on the INFERIOR surface of the penis? What is the most common embryological cause?

A

HYPOSPADIAS - Due to failure of urethral folds to close

22
Q

What penile disorder is the opening of the urethra onto the SUPERIOR surface of the penis? What is the most common embryologic cause of this?

A

EPISPADIAS - Due to abnormal positioning of the genital tubercle

23
Q

Which condition is EPISPADIAS associated with?

A

BLADDER EXSTROPHY - opening of the anterior wall of the abdomen at the lower portion above the bladder -> bladder wall is also not formed properly -> complete exposure of the bladder wall

24
Q

RAISINOID NUCLEI = what type of histological change? What is the pathologic condition? What viral infections are they most commonly associated with?

A

KOILOCYTIC CHANGES - Male/Female CONDYLOMA ACUMINATUM

Asssociated with HPV6 or HPV11

25
What is LYMPHOGRANULOMA VENEREUM?
Necrotizing granulomatous inflammation of the INGUINAL lymphatics + lymph nodes
26
What is the most common bacterial organism responsible for LYMPHOGRANULOMA VENEREUM?
CHLAMYDIA TRACHOMATIS L1-L3
27
Does LYMPHOGRANULOMA VENEREUM eventually heal?
YES, with fibrosis
28
What is a possible complication of LYMPHOGRANULOMA VENEREUM?
RECTAL STRICTURE - if there's perianal involvement
29
Which medication is given to a pt with HTN + BPH?
alpha1-antagonist (TERAZOSIN - acts on both alpha1A - prostrate obstruction relief + alpha1B - BV smooth muscle wall)
30
Which medication is given to a pt who is NORMOTENSIVE + BPH
alpha1A-antagonist (TAMULOSIN - only acts on prostate obstruction relief)
31
Which medication directly decreases the production of DHT associated with BPH?
5-alpha reductase INHIBITOR (FINASTERIDE)
32
FINASTERIDE can be administered for which conditions?
BPH + Male pattern baldness
33
What are the disadvantages of FINASTERIDE in terms of pharmacokinetics + side effects?
Takes months to work + Side effects of gynecomastia + sexual dysfunction
34
Which PHOSPHODIESTERASE INHIBITOR is the only one that can be used for BPH?
TALADAFIL
35
What are the 2 risk factors of penile SQUAMOUS CELL CARCINOMA?
HIGH RISK HPV 16/18/31/33 | LACK OF CIRCUMCISION
36
What are the 2 most common bacterial organisms responsible for ORCHITIS in YOUNG, SEXUALLY ACTIVE ADULTS?
Chlamydia trachomatis D-K | Neisseria Gonorrhoeae
37
What are the 2 most common bacterial organisms responsible for ORCHITIS in older adults?
E.coli | Pseudomonas
38
Where is inflammation possible due to MUMPS VIRUS?
**Most classically, PAROTID gland | MUMPS - "MOPP": Meningitis (aseptic) + Orchitis (age >10yo) + Parotitis + Pancreatitis
39
Ddx of granulomas involving the seminiferous tubules: What is a characteristic of the granuloma that differentiates the two?
Autoimmune orchitis - NON-NECROTIZING GRANULOMA | TB - NECROTIZING GRANULOMA, AFB + Stain
40
What is TESTICULAR TORSION? What is the most common cause?
Testicular Torsion = Twisting of the spermatic cord | Most common cause: Failure of the base of the testes to attach to the inner lining of the scrotum
41
What is seen on gross examination and on physical exam to confirm testicular torsion?
1. Gross examination - HEMORRHAGIC INFARCT (Incoming blood supply after tissue died + loosely organized tissue) 2. PE - Absent Cremaster reflex
42
What is the most common association of left spermatic vein varicocele (Dilation due to impaired drainage)?
LEFT RENAL CELL CARCINOMA