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Flashcards in Male Reproductive System Deck (20):
1

What is cryptorchidism, and how does it present clinically?

Incomplete descent of the testes

In 3-4%, the inguinal canal remains open, therefore the cremaster muscle pulls the testes back into the abdominal cavity

10x greater risk for malignant transformation
(surgical correction decreases, but does not eliminate)

2

Explain the pathogenesis of infections, such as balanitis, urethritis, prostatitis, eppididymitis, and orchitis.

Balanitis: inflammation of glans

- HSV = vesicles, shallow ulcers

- syphilis = ulcers

Urethritis: urethra

- Gonorrhea = purulent exudate

- mycoplasma = no exudate

- chlamydia = urethritis, uveitis, arthritis (Reiter's)

Prostatitis: stagnation of urine

- gram negatives = pain, urgency, fever

Epididymitis: ascending infection

- young = gonorrhea, chlamydia

- old = obstruction, surgery

Orchitis: isolated or complication of epididymitis

 

3

Compare genital herpes simplex infection and gonorrhea with nongonococcal urethritis.

HSV2 >> blisters >> travel along axons of peripheral nerves >> ganglia >> reactivation

Gonorrhea >> purulent urethritis

Chlamydial >> most common cause of bacterial urethritis in men >> urethral pain, NO discharge

4

What are the pathologic and clinical features of primary, secondary, and tertiary syphilis?

Primary

- 1 to 12 weeks after exposure, painless indurated ulcer

- chancre heals spontaneously 4-6 weeks

Secondary

- 2mo to 2yrs

- systemic fever, malais, macular rash, lymphadenopathy

- papules (condyloma latum)

Tertiary

- granulomas (gummas)

- aneurysms

- tabes dorsalis

- tertiary is incurable

5

How common are testicular tumors and in which age group are they most often encountered?

90% occur 25-45 years

90% are germ cell

90% are malignant

90% curable

6

Classify testicular germ cell tumors.

Seminoma

Nonseminomatous

embryonal carcinoma

teratocarcinoma

choriocarcinoma

yolk sac carcinoma

7

What is the difference between teratoma and teratocarcinoma?

Teratoma = ALL the embryonic cells differentiate into mature tissue

Teratocarcinoma = EC cells and somatic tissues

8

Which serologic tumor markers are useful for diagnosing testicular tumors?

hCG is secreted by trophoblasts; strong indicator of a germ cell tumor

AFP is secreted by yolk sac

9

How are testicular germ cell tumors treated, and what is the usual outcome of such treatment?

10

What is the difference between seminoma and nonseminomatous germ cell tumors?

Nonseminomatous have EC cells . . .

11

Compare Leydig cell tumors and sertoli cell tumors.

Leydig: produce testosterone or estrogen

Sertoli: benign, secrete inhibin and sex hormones

12

What is BPH and what are its causes?

Reactive enlargement of the periurethral portion of the prostate and median lobe.

13

Correlate pathologic and clinical findings in benign prostatic hyperplasia.

Hyperplastic glands surrounded by an increased amount of fibromuscular stroma.

 

14

How common is carcinoma of the prostate?

Most common cancer in males

3rd most common cause of cancer related deaths

15

Discuss the possible role of hormones in the pathogenesis of prostatic carcinoma.

Testosterone receptors have been found; however, testosterone levels are not elevated

Antitestosterone drugs retard tumor growth

16

Correlate the pathologic and clinical findings of prostatic carcinoma.

Most are adenocarcinoma

Symptoms begin when tumor enlarges >> pain (nerve invasion), dysuria, hematuria, constipation, intestinal obstruction

17

What is the value of prostate-specific antigen in the diagnosis of prostatic carcinoma?

Prostate cancer and normal cells produce

-nl = 4 ng/mL

-cx typically >10ng/mL

**Alk phosphatase may elevate (osteoblasts) with metastases

18

What is the outcome of treatment of prostatic carcinoma?

Surgical resection

(extensive + radiation)

5 year survival with tumor limited to prostate = 75%

Spread = 35-50%

19

On what does the prognosis of prostatic carcinoma depend?

Histology grade

Most significant = extent of tumor

20

Correlate the pathologic and clinical features of carcinoma of the penis.

smegma = produce of penile coronal glands, admixed to desquamated cells and bacteria >> carcinogenic influence

Almost all are located on the glans