Flashcards in Repro - Pathology (Male Reproductive pathology) Deck (72)
What are 4 symptoms of prostatitis?
Prostatitis - (1) Dysuria (2) Frequency (3) Urgency (4) Low back pain
What is (are) the causes of acute versus chronic prostatitis? Which is most common?
ACUTE: bacterial (e.g., E. coli); CHRONIC: bacterial or abacterial (most common)
In what patient population is benign prostatic hyperplasia common?
Common in men > 50 years old.
Define the physiological change benign prostatic hyperplasia.
Hyperplasia (not hypertrophy) of the prostate gland
What physical findings characterize benign prostatic hyperplasia? Is it a premalignancy?
Characterized by a smooth, elastic, firm nodular enlargement of the periurethral (lateral and middle) lobes, which compress the urethra into a vertical slit. Not considered a premalignant lesion.
What are 4 signs/symptoms with which benign prostatic hyperplasia often presents?
Often presents with (1) increased frequency of urination, (2) nocturia, (3) difficulty starting and stopping the stream of urine, and (4) dysuria.
What are 3 conditions/complications that may result from benign prostatic hyperplasia?
May lead to (1) distention and hypertrophy of the bladder, (2) hydronephrosis, and (3) UTIs.
What key lab finding is associated with benign prostatic hyperplasia?
Increased free prostate specific antigen (PSA)
What are the treatment options for benign prostatic hyperplasia? What is the mechanism behind these treatments?
Treatment: alpha-1 antagonists (terazosin, tamsulosin), which cause relaxation of smooth muscle; Finasteride (5alpha-reductase inhibitor)
Draw a visual of the prostate, including and labeling the following: (1) Anterior lobe (2) Benign prostatic hyperplasia (boundaries) (3) Lateral lobe (4) Middle lobe (5) Posterior lobe (6) Prostate cancer (7) Urethra.
See p. 586 in First Aid 2014 for visual at bottom right of page
In what patient population is prostatic adenocarcinoma common? What other reproductive pathology is also notable for being common in this patient population?
Common in men > 50 years old; Benign prostatic hyperplasia
From where in the prostate gland does prostatic adenocarcinoma most often arise? How is it most frequently diagnosed?
Arises most often from the posterior lobe (peripheral zone) of the prostate gland and is most frequently diagnosed by increased PSA and subsequent needle core biopsies.
What are 2 useful tumor markers for prostatic adenocarcinoma?
Prostatic acid phosphatase (PAP) and PSA are useful tumor markers (increase total PSA, with decreased fraction of free PSA).
What complication may develop in late stages of prostatic adenocarcinoma? What 3 symptoms/signs indicate this?
Osteoblastic metastases in bone may develop in late stages, as indicated by lower back pain and an increase in serum ALP and PSA.
What histological finding(s) characterize(s) Prostatic adenocarcinoma?
Note the small neoplastic glands with prominent nucleoli amid normal prostate stroma
What is cryptorchidism?
Undescended testis (one or both)
What effect does cryptorchidism have on spermatogenesis and testosterone levels, and why?
Impaired spermatogenesis (since sperm develop best at temperatures < 37 C); can have normal testosterone levels (Leydig cells are unaffected by temperature)
Of what other pathology does cryptorchidism increase the risk?
Associated with increased risk of germ cell tumors
What increases the risk of cryptorchidism?
Prematurity increased the risk of cryptorchidism
What are the key hormonal changes in cryptorchidism? Which hormone level varies, and according to what?
Decreased inhibin, Increased FSH, and Increased LH; Testosterone decreases in bilateral cryptorchidism, normal in unilateral
What is Varicocele, and what causes it?
Dilated veins in pampiniform plexus as a result of increased venous pressure
What is the most common cause of scrotal enlargement in adult males?
On what side does varicocele most often occur, and why?
Most often on the left side because of increased resistance to flow from left gonadal vein drainage into the left renal vein
What effect can varicocele have on fertility, and why?
Can cause infertility because of increased temperature
How does varicocele appear?
"Bag of worms" appearance
How is varicocele diagnosed?
Diagnosed by ultrasound with Doppler
What are the treatment options for Varicocele?
Treatment: Varicocelectomy, Embolization by interventional radiologist
What percentage of testicular tumors are germ cell versus non-germ cell tumors?
Germ cell: ~95% of all testicular tumors; Non-germ cell: ~5% of all testicular tumors.
In what patient population do testicular germ cell tumors most often occur?
Most often occur in young men