Pathology of Male Reproductive System

Question 1

What is Hypospadias

Answer 1

congenital anomaly - ventral location of the urethral opening
-androgen mediated
urethral groove forms inappropriately and does not close completely

Question 2

what does hypospadias lead to

Answer 2

abnormal or poor stream
increased bed wetting, incomplete voiding
spraying of stream

Question 3

what is Epispadias

Answer 3

urethral opening on the dorsal side of the penis
can lead to incontinence, reflux, UTI

Question 4

what is phimosis

Answer 4

inability to retract the foreskin

Question 5

what is paraphimosis

Answer 5

urologic emergency
entrapment of foreskin in the retracted position

Question 6

what can paraphimosis lead to

Answer 6

tourniquet effect with necrosis of the glans

Question 7

what is the presentation of paraphimosis

Answer 7

presents with pain, edematous pepuce
shaft will be flaccid

Question 8

where are the stimulation for eerections

Answer 8

neurally, may be stimulated leading to reflex arc at S2, S4
centrally in hypothalamus (paraventricular nucleus, autonomic control area) - T11, L2

Question 9

what increases when ach acts directly on vasculature for erections

Answer 9

Nitrous oxide

Question 10

what is the reason we give men with ED PDE-5 meds

Answer 10

issues with Nitric Oxide - decrease vascular pressure - inhability to compress venous structures
-atherosclerosis
-DM

Question 11

what is ED a warning sign of

Answer 11

CVD

Question 12

What is a fibrous deposition within the tunica albuginea of the shaft of the penis

Answer 12

peyronie’s disease

Question 13

what is an erection lasting longer than 4 hours

Answer 13

priapism

Question 14

what are causes of priapism

Answer 14

idiopathic
spinal cord trauma
sick cell disease
tumors
infection
trauma
cocaine
medications (trazadone)

Question 15

is priapism a emergency

Answer 15

yes

Question 16

what are low flow causes of priapism

Answer 16

decreased venous return
elevated pressure may lead to ischemia (compartment syndrome)
meds, sickle cell

Question 17

what are high flow causes of priapism

Answer 17

less common
associated with increase arterial inflow not balanced by venous outflow
associated with trauma
less painful

Question 18

what is the treatment of priapism

Answer 18

phenalepherine after the lido/bicarb block

Question 19

What is required for growth of prostate

Answer 19

dihydrotesterone (DHT) - metabolite of testosterone

Question 20

what does BPH increase the risk of

Answer 20

hematuria
UTI
Pyelonephritis
hydroureter
hydronephrosis

Question 21

what is inflammation of the prostate

Answer 21

prostatitis

Question 22

what is the most common cause of prostatitis

Answer 22

E. coli - ascending infection

Question 23

what is the presentation of acute bacterial prostatitis

Answer 23

presents with sxs of enlarged prostate and infection
fever, perineal pain, dysuria, urinary retention, nocturia, dysorgasmia,
can be bacteremia

Question 24

what is fluid between the parietal layer of tunica vaginalis and visceral layer of tunica vaginalis

Answer 24

hydrocele

Question 25

what envelops the testsis

Answer 25

tunica vaginalis

Question 26

what population is hydrocele common in

Answer 26

newborns

Question 27

what is secondary hydrocele associated with

Answer 27

infection or trauma

Question 28

what is dilation of pampiniform plexus vessels

Answer 28

varicocele

Question 29

how is varicocele described

Answer 29

bag of worms

Question 30

what is the cause of varicocele

Answer 30

poorly functioning valves so that venous back flow is not prevented - pooling

Question 31

What is inflammation of the epididymis

Answer 31

epididymitis

Question 32

what is epididymitis most commonly associated

Answer 32

STI - N.gonorrhoeae - C. trachomatis

Question 33

what is the most common pathogen associated with epididymitis in MSM

Answer 33

E.coli, H. flu, TB

Question 34

what is the presentation of epididymitis

Answer 34

present with scrotal pain/inflammation typically acute discomfort +/- pyuria swelling of epididymis (starts with trail and ascends) urinary obstruction

Question 35

what are risks with epididymitis

Answer 35

abscess, infertility, infarction scarring can leave lasting problems

Question 36

what is orchitis

Answer 36

inflammation of testes

Question 37

what is orchitis associated with

Answer 37

bacteremia or direct spread up the urethrae - through prostate - up vas deferens - through eipididymis - testes

Question 38

what is orchitis classically associated with

Answer 38

mumps

Question 39

when does orchitis begin after parotitis

Answer 39

3-4 days after

Question 40

What is testicular torsion

Answer 40

twisting of the testes resulting in rotation and cessation of blood flow from the spermatic cord urologic emergency

Question 41

what is lost with testicular torsion

Answer 41

cremasteric reflex

Question 42

what is the blue dot sign

Answer 42

as testes becomes necrotic, the testicular appendage will necrose - become cyanotic