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Flashcards in male reproductive pathology Deck (47)
1

what symptoms might present with male reproductive pathology

vomiting
penile pain
penile ulceration
scrotal swelling
urinary frequency
haematuria
acute/chronic abdominal pain
abdominal swelling
rectal pain
testicular pain
incontinence
urinary retention

2

what is benign prostatic hyperplasia

common
associated with hormonal imbalance
hyperplasia of glands and stroma
not premalignant
obstructs urine flow
associated with infection
treatable
may be acute or chronic

3

how might BPH present compared with prostatic carcinoma

BPH commonly presents with urinary symptoms
by the time carcinoma is found the patient may already have metastatic disease or local invasion

4

what might a prostatic carcinoma feel like on rectal exam

loss of median sulchus
hardy, rocky prostate
rather that smooth and elastic
subcapsular invasion
asymmetry

5

what problems do clinicians have with prostatic cancer

hard to tell whether it is indolent or aggressive so hard to know how to treat
tend to underestimate the extent of the disease with needle biopsy
false positives and negatives with PSA

6

what is the biggest risk factor for testicular cancer

cryptorchidism, 10 x risk

7

what is a common cause of orchitis

mumps

8

what age group tend to get testicular cancer

under 35s and old men

9

what are the two types of germ cell testicular tumour

teratoma(always malignant features in males) and seminoma (most common)

10

what are the features of seminoma

cells look like spermatagonia
low level of necrosis usually
peak age approx 40
lumpy and white

11

what are the features of male teratomas

germ cell origin
more agressive than seminoma
may be differentiated, undifferentiated or trophoblastic (placenta like)
may secrete hCG- tumour marker

12

what chemical is an important cancer biomarker

Alpha fetoprotein (AFP)

13

what are the histological features of BPH

transitional zone of prostate plus peri urethral glands (glands around the urethra)
nodules of glands and stroma
compression and elongation of urethra
interferes with urethral sphincter
palpable median groove

14

what are the complications of BPH

Bilateral hydronephrosis
hydroureter
pyelonephritis
calculi
septicaemia
bladder:diverticulum, hypertrophy, trabeculation, urethral compression
nodular enlargement
acute or chronic urinary retention

15

what is the precursor to prostate cancer

prostatic intraepithelial neoplasia

16

what age group usually get prostate adenocarcinoma

over 50 years

17

what are the features of prostate cancer

adenocarcinoma often metastasises to bone

latent carcinoma: microscopic, common in old age, dormant lesions, 30% rate of metastases after 10 years

18

what is the gleason score

way of measuring differentiation in prostate cancer -1 to5 score

19

what does prostate cancer present with

urinary symptoms
incidental findings on rectal exam
bone metastases
lymph node metastases

20

how is prostate cancer diagnosed

imaging, cytology, biochemistry(PSA), haematology, bone marrow involvement, biopsy

21

how is prostate cancer treated

oestrogens, gnrh analogues, orchidectomy, radiotherapy, radical prostatectomy

22

what is hypospadias and epispadias

hypo- urethral opening on inferior aspect
epi- opening on superior aspect and often accompanied by bladder malformations

23

what is phimosis

a congenital narrowing of the opening of the foreskin so that it cannot be retracted

24

what is a paraphimosis

foreskin becomes trapped behind the glans penis and cannot be reduced

25

what is Bowen's disease

early form of skin cancer which is easily treatable
may affect the penis
persistent red scaly patch on the skin , may be sore and red
intraepithelial carcinoma
keratotic surface

26

what skin diseases can affect the penis and scrotum

Bowen's disease and squamous cell carcinoma

27

what is Peyronie's disease

bent penis and pain when errect due to scar tissue
may occur with Dupytren's

28

what can cause invasive squamous cell carcinomas of the penis

HPV

29

what are the features of SCC of the penis

glans penis or prepuce
nodule or plaque
metastasises to inguinal lymph nodes

30

what is fournier gangrene

a type of necrotising fasciitis or gangrene that affects the perineum

31

what is balantitis

inflammation of the head of the penis

32

what is scrotal carcinoma

nodular ulcerated mass
spreads to inguinal nodes

33

what might causes urethral obstruction

rupture
stricture
congenital valves

34

what might causes urethritis

gonorrhoea
non gonococcal

35

what can gonococcal urethritis cause

urethral stricture
epididymitis
prostatitis

36

what is a haematocele

collection of blood in the tunica vaginalis usually caused by trauma

37

what testicular cancers affect which age groups

teratoma- 30 yrs
seminoma- 40 yrs
lymphoma- 70yrs

38

what are the symptoms of testicular tumours

painless unilateral enlargement
hydrocele
metastatic disease
gynaecomastia

39

name some other germ cell tumours

intratubular germ cell neoplasia
yolk sac tumour (children)
combined germ cell tumour

40

name some non germ cell tumours

malignant lymphoma
leydig cell tumour
sertoli cell
metastatic tumour

41

what is stage 1 testicular tumour

confined to testes and coverings

42

what is stage 2 testicular tumour

testis and para aortic lymph nodes

43

what is stage 3 testicular cancer

lymph nodes in mediastinum and/ or supraclavicular region

44

what is stage 4 testicular cancer

visceral metastases

45

what can cause male infertility

endocrine
gnrh deficiency
oestrogen excess
cryptorchidism
abnormal spermatogenesis
obstruction of efferent ducts

46

what can affect the epididymis and spermatic cord

 Congenital abnormalities
 Epididymal cysts and spermatocoeles
 Varicocoele
 Torsion of the spermatic cord and
testis
 Inflammatory lesions
– Epididymo-orchitis
 Tumours - rare

47

what marker might a teratoma secrete

hCG