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Flashcards in male Path III Deck (55):
1

what testicular tumors are associated with testicular dysgenesis syndrome

the germ cell tumors
seminomatous and non-seminomatous

2

what is the triad of testicular dysgenesis syndrome

cryptorchidms
hypospadius
poor sperm quality

3

what are the seminomatous tumors

seminoma
spermatocytic seminoma

4

what are the non seminomatous germ cell tumors

embryonal Carcinoma
yolk sac tumor
choriocarcinoma
teratoma

5

why do some patients with testicular torsion develop infertility

because once the blood testicle barrier is broken immune bodies recognize no as self and destory both testicles

6

when does the carcinoma in situ cell arise in germ cell tumors

with boy at birth

7

majority germ cell tumors are what

seminomas
embryonal
mixed

8

germ cell tumor chromatin morphology

i12p band

9

risk factors germ cell tumors

cryptorchidism, prior GCT
FMH (KIT and BK)
whites>blacks
brothers increase risk if have it

10

where do germ cells mets to

periaortic abdominal lymph nodes

11

what serume markers can be + in germ cell tumores

hCG LDH and afetalprotein

12

how do germ cell tumors present

painless mass

13

what is the most common GermCellTumor

seminoma

14

serum markers for seminomas

LDH
hCG

15

staging of seminomas

low risk-no mets
intermediate risk-mets

16

what serum marker is never in a pure seminoma

AFP

17

Tx seminoma

radical orchiectomy +/- retroperitoneal lymph node dissection

18

Tx low risk seminoma

radiotherapy

19

Tx intermediate risk seminoma

platinum based chemo

20

gross morphology seminomas

lobular homogenous fleshy tan cut surface

21

how do you prevent seeding of seminoma when cutting testis out

through inguinal canal

22

histo seminoma

large cells with distinct borders, prominent nuclei and watery cytoplasm
lymphoid infiltrate
look like fried eggs

23

schiller duval body

yolk sac tumor

24

what are the pathologies of the prostate

inflammation
nodular hyperplasia (BPH)
adenocarcinoma

25

What are the zones of prostate

central
transitional
peripheral

26

what zone does BPH arise? most CA?

BPH in transitional
CA in peripheral

27

what can cause acute prostatitis

bacteria like acute UTI agents
reflux of urine or iatrogenic

28

presentation acute prostatitis

fever, chills, dysuria

29

Tx acute prostattisi

antibiotics

30

presentation chronic bacterial prostatitis

Hx of recurrent UTIs dysuria and localized pain

31

Dx chronic prostatitis

PMNs in urine and a + culture

32

what causes granulomatous prostatitis

secondary to ruptured acini
commonest cause is BCG

33

what causes BPH

stomal cells make 5 hydroxy reductase that converts T to DHT which increases growth factors

34

signs of BPH

poor flow, incomplete emptying
secondary infection: cystitis, pyelonephritis

35

Tx BPH

alpha blockers
5 alpha reductase inhibitors to dec DHT
tissue destruction: TURP, heat, US, laser

36

corpora amylacea

pink secretions in glandular lumen
BPH

37

signs BPH

enlarged prostate- lose distinction of R and L lobes
can feel median sulcus

38

imaging prostate

rectal US

39

TURP

transurethral prostatectomy

40

phenazopyridine

drug given before urinary procedure
turns urine red

41

complications BPH

obstruction bladder
infection internal genitalia
urosepsis

42

If serum Cr doubles (even in normal range) in a year

bad! put in foley if suspect post renal obstruction

43

most common Dx no non cutaneous malignancy in men

adenocarcinoma of prostate

44

risk factors adenocarcinoma of prostate

age>50 y.o
african american
+FMH

45

pathogenesis adenocarcinoma prostate

androgen dependent
multiplicity of genetic mutations
prostatic intraepithelial neoplasm is precursor lesion

46

screening for adenocarcinoma

DRE
prostatic specific antigen

47

where does adenocarcinoma of prostate arise

posterior wall

48

needle Bx prostate
glands with dark nuclei
prominent nucleoli
dark cytoplasm

Adenocarcinoma

49

basal layer - and racemose + of prostate Bx stains

adenocarcinoma

50

Gleason grades for adenocarcinoma of prostate

1- well differentiated
2- well differentiated
3- moderately differentiated
4- poorly differentiated
5- undifferentiated
commonest and second commenest scores added together

51

T in staging adenocarcinoma of prostate

extracapsular extension
T2 confined
T3 extracapsular
T4 adjacent organs

52

N score in adenocarcinoma of prostate

no longer curable

53

M score in adenocarcinoma of prostate

widespread dissemination
OSTEOBLASTIC
Tx with androgen deprivation

54

perineural invasion in prostate Bx

correlates with extracapsular invasion T3

55

how to detect boney mets from prostate

increase serum alk phosphatase because of increase osteoblast activity