Prostatic Neoplasia - Fremont-Smith

Question 1

condyloma accuminata

Answer 1

benign
-STD - HPV type 6 and 11

most often - coronal sulcus and inner prepuce - under foreskin

Question 2

bowen disease

Answer 2

CIS
-variant high risk HPV - 16

red or gray plaque on shaft

Question 3

bowenoid papulosis

Answer 3

CIS
-variant high risk HPV - 16

multple red-tan papules in young adults

-doesnt go to SCC**

Question 4

erythroplasia of querat

Answer 4

CIS
-variant high risk HPV - 16

shiny red soft red plaque on glans and foreskin

Question 5

high risk HPV

Answer 5

incorporates into host DIA

viral E6 oncoprotein inactivates p53 and E7 inactivates pRB (retinoblastoma)

Question 6

male HPV infection

Answer 6

often don’t see anything

acetowhite - look for tiny lesions

Question 7

remove a lesion

Answer 7

not removing a virus**

still HPV on skin surface
-is the immune system that removes virus

Question 8

condyloma

Answer 8

koilocytic change

Question 9

does not invade to SCC

Answer 9

bowenoid papulosis

Question 10

perakeratosis

Answer 10

nuclei in keratin layer - indicate rapid turnover

whiteness and red lesions

Question 11

CIS

Answer 11

need excised

but not bowenoid papulosis - bc does not invade

Question 12

invasive SCC of penis

Answer 12

rare

risk fx - lack of circumcision, HPV 16/18, age 40-70yo, smoking

slow growing painless tumor

Question 13

prognosis of penile SCC

Answer 13

depends on spread to nodes

no inguinal - 66% 5 year
yes inguinal - 27% 5 years

Question 14

keratin pearl

Answer 14

SCC

Question 15

pearly penile papules

Answer 15

variant of normal**

papillary growth around corona of glans

not sex transmission

will go away after time

Question 16

appendix testes

Answer 16

on a stalk

stalk can become torsioned - ischemic/pain

common issue young boys

see dusky blue through scrotal sac

“the blue dot”

Question 17

tunica albuginea

Answer 17

covers seminiferous tubules

Question 18

pyocele, hydrocele, hematocele

Answer 18

around testicle

Question 19

early testicular descent

Answer 19

mullerian inhibiting substance

Question 20

late testicular descent

Answer 20

androgen dependent

Question 21

cryptorchidism

Answer 21

improper testicle descent

Question 22

testicle descent

Answer 22

two phases:
1 - transabdominal 6 weeks - due to MIS - from sertoli cells

2 - inguinal scrotal - androgen driven - gubernaculum guides testes

Question 23

risk with cryptorchidism

Answer 23

testicular ca
trauma
torsion
infertility

Question 24

orchiopexy

Answer 24

surgical correction of cryptorchidism

Question 25

B/L cryptorchidism

Answer 25

25% klinefelters premature birth fam hx

Question 26

leydig cells

Answer 26

in stroma

Question 27

sertoli cells

Answer 27

mixed in with germ cells required for spermatogenesis -source of MIS - for initial descent phase of testicle

Question 28

intraabdominal testicle

Answer 28

needs to be corrected | -remove or bring down to scrotum

Question 29

cryptorchid testis histo

Answer 29

leydig hyperplasia peritubular fibrosis only sertoli in tubules

Question 30

prune belly syndrome

Answer 30

bilateral cryptorchidism aka eagle-barret syndrome absence of abdominal muscles**

Question 31

torsion

Answer 31

twisting of spermatic cord 2/3 medially** 1/3 laterally due to dissociation of tunica vaginalis - this keeps it from torsioning 12 hours to save testicle

Question 32

tunica vaginalis

Answer 32

hydrocele space partial envelopes testicle involved in torsion

Question 33

attachment to tunica vaginalis

Answer 33

stops torsion not completely developed until 1-2 yrs old

Question 34

in utero torsion

Answer 34

testicle present in scrotum - no pain - hard, discoloration of scrotum - may be absent see fibrosis and hemosiderin

Question 35

torsion after birth

Answer 35

acute pain | -swelling and color changes to scrotum

Question 36

bell clapper deformity

Answer 36

testicle lateral not up and down orientation

Question 37

testicular torsion diagnosis

Answer 37

color doppler blood flow also nuclear scan - looking for blood flow

Question 38

epididymis

Answer 38

bacteria - gonorrhea, chlamydia old men - e. coli from UTI - reflux of bacteria up vas need to culture urine** also TB

Question 39

syphilis

Answer 39

testis affected first and may spare epididymis

Question 40

mumps

Answer 40

pressure atrophy due to tunica albuginea | -unusual in kids

Question 41

granulomatous orchitis

Answer 41

man has vasectomy - sperm to surrounding tissue - form granuloma most common - secondary to BCG for transitional cell carcinoma of bladder -introduce BCG to bladder - granulomatous change - can get into urine to testicle**