Reproductive - Male Pathology Flashcards Preview

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Flashcards in Reproductive - Male Pathology Deck (73)
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1

Hypospadias: Mechanism and Presentation

Failure of urethral folds to close leading to opening of urethra on inferior surface of penis

May be associated with androgen dysfunction

2

What is the most common malformation of urethral grove?

Hypospadias

3

Why treat hypospadias?

Prevent UTI

4

Epispadias: Mechanism and Presentation

Opening of urethra on superior surface of penis
Due to faulty positioning of genital tubercle

5

What is episapdias associated with?

Extrophy of bladder

6

Condyloma acuminatum: Mechanism and Cause

Benign warty growth on genital skin
Due to HPV type 6, 11; koilocytic changes

7

Lymphogranuloma venereum: Presentation

Necrotizing granulomatous inflammation of inguinal lymphatics and lymph nodes (Chlamydia L1-L3)

Heals with fibrosis; perianal involvement may result in rectal stricture

8

Squamous Cell Carcinoma of Penis: Risk factors

high risk HPV, lack of circumcision

9

Squamous Cell Carcinoma of Penis: Epidemiology

More common in Asia, Africa, South American

10

What are the precursor lesions of Squamous Cell Carcinoma of Penis?

Bowen disease
Erythroplasia of Queryrat
Bowenoid papulosis (not precursor)

11

Bowen disease

In situ carcinoma of penile shaft or scrotum with leukoplakia

12

Erythroplasia of Queyrat

In situa carcinoma on glans that presents as erythroplakia

13

Bowenoid papulosis

In situa carcinoma with multiple reddish papules in younger patients (40s)

Does not progress to invasive carcinoma

14

Peyronie's disease

Bent penis due to acquired fibrous tissue formation

15

Priapism

Painful sustained erection not associated with sexual stimulation or desire

16

Priapism: Causes

trauma

sickle-cell disease (sickled RBCs trapped in vascular channels)

medications (anticoagulants, PDE5 inhibitors, antidepressants, alpha-blockers, cocaine)

17

Cryptorchidism

Failure to testicle to descend into scrotal sac

If not resolve spontaneously, orchipexy before age 2

18

Cryptorchidism: Complications

testicular atrophy with infertility (impaired spermatogenesis); increased risk of seminoma

19

Cryptorchidism: Levels of sex hormones

Normal testosterone level (Leydig cells unaffected by temperature)

High FSH, LH, low inhibin
Low testosterone if bilateral

20

Cryptorchidism: Risk factor

Prematurity

21

What is the most common congenital male reproductive abnormality? (1%)

Cryptorchidism

22

Orchitis

Inflammation of testicle
increased risk of sterility but libido unaffected

23

Orchitis: Causes

Young adults: chlamydia trachomatis (DK) or Neisseria gonorrhoeae

Older adults: E. coli and pseudomonas (UTI pathogens)

Mumps virus (teenage): infertility - not seen in < 10 yo

Autoimmune orchitis: granulomas involving seminiferous tubules

24

Testicular torsion: Presentation and Mechanism

Adolescent with sudden testicular pain and absent cremasteric reflex
(Congenital failure of testes to attach to inner lining of scrotum)

Twisting of spermatic cord; thin-walled veins obstructed -> congestion and hemorrhagic infarction

25

Varicocele: Presentation

Left-sided scrotal swelling with "bag of worms" appearance"

26

Varicocele: Mechanism

Dilation of veins in pampiniform plexus due to impaired drainage (increased venous pressure)
Left side affected - drains into left renal vein

27

What is left-sided varicocele associated with?

Left sided renal cell carcinoma (RCC invades renal vein)

28

Varicocele: Complications

Infertility (increased temperature)

29

Varicocele: Diagnosis and Treatment

Diagnosis: ultrasound
Treatment: Varicocelectomy, ebolization

30

Hydrocele: Presentation and Mechansim

Scrotal swelling that can be transilluminated

Fluid collection within tunica vaginalis (serous membrane that covers testicles and internal surface of scrotum)