male pathology

Question 1

What is peyronie disease?

Answer 1

abnormal curvature of the penis due to a fibrous plaque in the tunica albuginea - associated with erectile dysfunction

Question 2

How to treat peyronie disease?

Answer 2

surgical repair or treatment wiht collegenase injections (when curvature stabilizes)

Question 3

how does pentoxitylline treat peyronie disease?

Answer 3

its a PDE5 inhibitor that reduces inflammation and prevents collagen depostion

Question 4

What is ischemic priapism ?

Answer 4

erection > 4 hours

Question 5

What disease is ischemic priapism associated with?

Answer 5

sick cell disease - sickled RBCs bloc venous drainage

Question 6

how to treat ischemic priapism

Answer 6

immediate corporal aspiration, intracavernosal phenylephrine, or surgical decompression to prevent ischemia

Question 7

What are the precursor lesions to SCC of the penis?

Answer 7

Bowen disease (on shaft - leukoplakia)
Erythroplasia of Queyrat (on glans -erythroplakia)

Question 8

What is bowenoid papulosis?

Answer 8

carcinoma in situ on the penis of unclear malignant potential that presents as red papultes

Question 9

risk factors for SCC on the penis?

Answer 9

uncircumcised
HPV
smoking

Question 10

What is cryptochidism?

Answer 10

descent failure of one or more testes -> impaired spermatogenesis

Question 11

Cryptochidism increases your risk for what?

Answer 11

germ cell tumours

Question 12

What is a risk factor for cryptorchidism?

Answer 12

prematury

Question 13

What will be the hormone changes in cryptorchidism?

Answer 13

Decreased inhibin B, increased FSH, increased LH, and decreased testosterone if its bilateral cryptochidism

Question 14

Treatment of cryptorchidism?

Answer 14

orchiplexy

Question 15

What deformity may a male with testicular torsion have?

Answer 15

bell clapper deformity

Question 16

how does testicular torsion present?

Answer 16

acute, severe pain, high-riding testis, absent cremasteric reflex

Question 17

What is neonatal testicular torsion?

Answer 17

testicular torsion that occurs within 30 days of birth - tests not attached to scrotum yet

Question 18

treatment of testicular torsion

Answer 18

surgical correction (orchiplexy) within 6 hours, or manual detorsion

Question 19

how do you diagnose a testicular varicocele?

Answer 19

standing clinical exam/valsava maneuver ) or on ultrasound –does not transilluminate

Question 20

Treatment of testicular varicocele?

Answer 20

surgical ligation or embolization

Question 21

What is the nutcracker effect?

Answer 21

when the left renal vein becomes compressed between the aorta and superior mesenteric artery

Question 22

What is a hydrocele?

Answer 22

accumulation of fluid in tunica vaginalis

Question 23

How will a hydrocele appear on U/S?

Answer 23

scrotal swelling that transilluminates

Question 24

What causes a hydrocele in a newborn?

Answer 24

failure of processes vaginalis to close

Question 25

where do extragonadal germ cell tumours arise?

Answer 25

midline locations; retroperitoneum, mediastinum, pineal, suprasellar regions. In children -saccrococcygeal teratomas most common

Question 26

Prognosis of contgenital hydrocele?

Answer 26

most close in one year

Question 27

What causes an aquired hydrocele?

Answer 27

Usually secondary to an infection, trauma or tomour

Question 28

What is a spermatocele?

Answer 28

cyst due to dilated epididymal duct or rate testis

Question 29

What are the testicular germ cell tumours?

Answer 29

``` Seminoma Yolk sac tumour Choriocarcinoma Teratoma Embryonal carcinoma ```

Question 30

Risk factors for germ cell tumours

Answer 30

cryptorchidism and klinefelter syndrome

Question 31

How does a seminoma present?

Answer 31

Painless, homogenous, testicular enlargment

Question 32

Histology of seminoma

Answer 32

large cells in lobules with watery cytoplasm and fried egg appearance

Question 33

Will B-HGC be increased in a seminoma?

Answer 33

yes

Question 34

What is another marker for a seminoma that can be detected in the placenta?

Answer 34

increasedA LP

Question 35

Describe a yolk sack tumour in males

Answer 35

highly aggressive, yellow and mucinous with schiller-duval bodies

Question 36

what will be incrased in a yolk sac tumour?

Answer 36

ALP

Question 37

most common testicular tumour in boys under 3?

Answer 37

yolk sac tumour

Question 38

Will hcg be increased with a choriocarcinoma?

Answer 38

yes

Question 39

where do choriocarcinomas metastasize to in males?

Answer 39

lungs and brain via the blood

Question 40

presentation of choriocarcinoma in males

Answer 40

gynecomastia and possibly hyperthyroidism (from increased hcg)

Question 41

Is a mature teratoma in males malignant?

Answer 41

yes (in adults, not children)

Question 42

Describe an embryonal carcinoma

Answer 42

malignant, hemoorhagic with necrosis Glandular/papillary morphology Commonly mixed

Question 43

which is the only male germ cell tumour that doesn't have increased B-hcg?

Answer 43

teratoma

Question 44

what are the testicular non-germ cell tumours?

Answer 44

leydig cell tumour sertoli cell tumour testicular lymphoma

Question 45

Leydig cell tumour histology/gross

Answer 45

golden brown colour and high in cholesterol Has Reinke crystals (eosinophilic cytoplasmic inclusions) P

Question 46

What does a leydig cell tumour produce?

Answer 46

androgens/estrogens-> gynecomastia or precocious puberty

Question 47

Are most sertoli cell tumours benign or malignant?

Answer 47

benign

Question 48

What is epididymitis?

Answer 48

Inflammation of epididymis

Question 49

how does epididymitis present?

Answer 49

localized pain and tenderness over posterior testis

Question 50

What sign will be present in epididymitis?

Answer 50

+ Prehn sign (pain relief with scrotal elevation)

Question 51

What is orchitis?

Answer 51

inflammation of testis

Question 52

how does orchitis present?

Answer 52

testicular pain, swelling

Question 53

describe the prostate in BPH?

Answer 53

smooth, elastic, firm nodular enlargment

Question 54

where does the enlargment in BPH occur?

Answer 54

periurethral (lateral and middle lobes)

Question 55

Presentation of BPH

Answer 55

increased urination, nocturia, difficulty starting and stopping and dysuria. Can lead to distention and hypertrophy of bladder, hydronephrosis, UTIs and increased PSA

Question 56

treatment of BPH

Answer 56

alpha1-antagonists, 5a-reducaste inhibitors, and PDE-5 inhibitors, surgical resection

Question 57

how does prostatis present?

Answer 57

dysuria, frequency, urgency, low back pain, warm tender enlarged prostate

Question 58

What causes acute prostatitis?

Answer 58

C trachomatis, N gonorrhoeae -young men | E coil -old men

Question 59

What causes orchitis in young men?

Answer 59

C trachomatis and N gonorrhaeae

Question 60

What causes orchitis in older men?

Answer 60

e coli and pseudomonas

Question 61

Other causes of orchitis?

Answer 61

Mumps and autoimmune

Question 62

where does prostatic adenocarcinoma occur?

Answer 62

posterior lobe of prostate

Question 63

tumour markers for prostatic adenocarcinoma?

Answer 63

PAP and PSA

Question 64

which marker may indicate metastasis of prostate adenocarcinoma to the bone?

Answer 64

increased ALP (and PSA)