male pathology Flashcards

1
Q

What is peyronie disease?

A

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

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2
Q

How to treat peyronie disease?

A

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

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3
Q

how does pentoxitylline treat peyronie disease?

A

its a PDE5 inhibitor that reduces inflammation and prevents collagen depostion

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4
Q

What is ischemic priapism ?

A

erection > 4 hours

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5
Q

What disease is ischemic priapism associated with?

A

sick cell disease - sickled RBCs bloc venous drainage

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6
Q

how to treat ischemic priapism

A

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

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7
Q

What are the precursor lesions to SCC of the penis?

A
Bowen disease (on shaft - leukoplakia)
Erythroplasia of Queyrat (on glans -erythroplakia)
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8
Q

What is bowenoid papulosis?

A

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

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9
Q

risk factors for SCC on the penis?

A

uncircumcised
HPV
smoking

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10
Q

What is cryptochidism?

A

descent failure of one or more testes -> impaired spermatogenesis

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11
Q

Cryptochidism increases your risk for what?

A

germ cell tumours

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12
Q

What is a risk factor for cryptorchidism?

A

prematury

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13
Q

What will be the hormone changes in cryptorchidism?

A

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

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14
Q

Treatment of cryptorchidism?

A

orchiplexy

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15
Q

What deformity may a male with testicular torsion have?

A

bell clapper deformity

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16
Q

how does testicular torsion present?

A

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

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17
Q

What is neonatal testicular torsion?

A

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

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18
Q

treatment of testicular torsion

A

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

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19
Q

how do you diagnose a testicular varicocele?

A

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

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20
Q

Treatment of testicular varicocele?

A

surgical ligation or embolization

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21
Q

What is the nutcracker effect?

A

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

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22
Q

What is a hydrocele?

A

accumulation of fluid in tunica vaginalis

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23
Q

How will a hydrocele appear on U/S?

A

scrotal swelling that transilluminates

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24
Q

What causes a hydrocele in a newborn?

A

failure of processes vaginalis to close

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25
Q

where do extragonadal germ cell tumours arise?

A

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

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26
Q

Prognosis of contgenital hydrocele?

A

most close in one year

27
Q

What causes an aquired hydrocele?

A

Usually secondary to an infection, trauma or tomour

28
Q

What is a spermatocele?

A

cyst due to dilated epididymal duct or rate testis

29
Q

What are the testicular germ cell tumours?

A
Seminoma
Yolk sac tumour
Choriocarcinoma
Teratoma
Embryonal carcinoma
30
Q

Risk factors for germ cell tumours

A

cryptorchidism and klinefelter syndrome

31
Q

How does a seminoma present?

A

Painless, homogenous, testicular enlargment

32
Q

Histology of seminoma

A

large cells in lobules with watery cytoplasm and fried egg appearance

33
Q

Will B-HGC be increased in a seminoma?

A

yes

34
Q

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

A

increasedA LP

35
Q

Describe a yolk sack tumour in males

A

highly aggressive, yellow and mucinous with schiller-duval bodies

36
Q

what will be incrased in a yolk sac tumour?

A

ALP

37
Q

most common testicular tumour in boys under 3?

A

yolk sac tumour

38
Q

Will hcg be increased with a choriocarcinoma?

A

yes

39
Q

where do choriocarcinomas metastasize to in males?

A

lungs and brain via the blood

40
Q

presentation of choriocarcinoma in males

A

gynecomastia and possibly hyperthyroidism (from increased hcg)

41
Q

Is a mature teratoma in males malignant?

A

yes (in adults, not children)

42
Q

Describe an embryonal carcinoma

A

malignant, hemoorhagic with necrosis
Glandular/papillary morphology
Commonly mixed

43
Q

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

A

teratoma

44
Q

what are the testicular non-germ cell tumours?

A

leydig cell tumour
sertoli cell tumour
testicular lymphoma

45
Q

Leydig cell tumour histology/gross

A

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

46
Q

What does a leydig cell tumour produce?

A

androgens/estrogens-> gynecomastia or precocious puberty

47
Q

Are most sertoli cell tumours benign or malignant?

A

benign

48
Q

What is epididymitis?

A

Inflammation of epididymis

49
Q

how does epididymitis present?

A

localized pain and tenderness over posterior testis

50
Q

What sign will be present in epididymitis?

A

+ Prehn sign (pain relief with scrotal elevation)

51
Q

What is orchitis?

A

inflammation of testis

52
Q

how does orchitis present?

A

testicular pain, swelling

53
Q

describe the prostate in BPH?

A

smooth, elastic, firm nodular enlargment

54
Q

where does the enlargment in BPH occur?

A

periurethral (lateral and middle lobes)

55
Q

Presentation of BPH

A

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

56
Q

treatment of BPH

A

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

57
Q

how does prostatis present?

A

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

58
Q

What causes acute prostatitis?

A

C trachomatis, N gonorrhoeae -young men

E coil -old men

59
Q

What causes orchitis in young men?

A

C trachomatis and N gonorrhaeae

60
Q

What causes orchitis in older men?

A

e coli and pseudomonas

61
Q

Other causes of orchitis?

A

Mumps and autoimmune

62
Q

where does prostatic adenocarcinoma occur?

A

posterior lobe of prostate

63
Q

tumour markers for prostatic adenocarcinoma?

A

PAP and PSA

64
Q

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

A

increased ALP (and PSA)