Flashcards in The Lower UT and Male Repro System Deck (43)
What causes Exstrophy of the bladder
Incomplete resorption of the anterior cloacal membrane which is nomrlaly replaced by smooth muscle in embryogenesis
What can failiure of the urachus to involute lead to ?
Vesicle-umbilical fistula or urachal diverticulum
What cancer is likely to develop from exstrophy of the bladder?
Squamous Carcinoma (from squamous metaplasia of exposed bladder mucosa)
What complications result form Nodular Prostatic Hyperplasia?
UTI from retention of urine in the bladder
Bladder stones from retained urine in a diverticulum becoming infected
Bladder Infection Risk is increased with what?
Bladder Outlet Obstruction
Prior instrumentation or catheterization
What microscopical findings are associated with acute cystitis?
Neutrophlic infiltrate of variable intensity
What is typical presentation of urothelial cell carcinoma?
less frequently, Dysuria
What is typical presentation of chronic cystitis?
Dysuria (pain when urinating)
Excessive urinary frequency
Lower abdominal or pelvic discomfort
Microscopic: Predominance of lymphocytes and fibrosis of the lamina propria
Describe an Exophytic Papilloma
Papillary fronds that are lined by urothelial epithelium (indistinguishable from normal urothelium)
Usually a single lesion 2-5 cm in diameter, although multiple papillomas are not unusual
UROTHELIAL CELL CARCINOMA IN SITUE
RED VELVETY FLAT PATCHES (close to expohytic papillary urothelial cell carcinoma)
What are the most important risk factors for bladder cancer?
Industrial Exposure to Azo Dyes
Infection with Schistosoma Haematobium
Drugs (Cyclophosphamide and analgesics)
Radiation Therapy (prostate, cervical, rectal cancer)
What is hydrocele associated with in infants? adults?
Infants- Inguinal Hernia
Adults0 Infection, Tumor, or Trauma
What can cause Hematocele?
Can develop into hydrocele
What does "field effect" refer to in regards to urotthelial cell carcinoma?
The etiologic factors associated with epithelial tumors of the renal pelvis and ureter are similar to those observed in bladder cancer
How does Rhabdomyosarcoma typically of the embryonal type manifest?
Mostly in children as SARCOMA BUTYROIDES
These are edematous, mucosal, polypoid masses that resemble a "cluster of grapes"
What are Urethral Caruncles? Which patients are affected
Polylpoid inflammatory lesions containing acutely and choronically inflamed granulation tissue, ulceration, and hyperplasia of urothelial or squamous epithelium.
The lesion is usually near the urethral meatus and produces pain and bleeding
The polypoid mass is exophytic, often ulcerated
This is mostly seen in women, mostly after menopause
How is the pronosis of squamous cell carcinoma of the bladder?
Poor- almost all patients with this tumor demonstrate invasion of the bladder wall at the time of initial presentation
What lesions develop from HPB?
Wart-like lesions- referred to as VERRUCAE and CONDYLOMATA
Lesion shows epidermal hyperkeratosis, parakeratosis, acanthosis, papillomatosis
What causes Balanoposthitis?
It is caused by bacterial infection, but in immunosuppressed persons and in diabeetics, it can also be caused by fungi. It is a typically a consequence of poor hygiene in uncircumcised men.
What are complications of Balanoposthitis?
- Stricture of the meauts, phimosis, and paraphimosis
What is Phimosis? Paraphimosis?
The orifices of the prepuce may be too narrow to allow retraction over the glans penis.
When the narrow prepuce is forcefully retracted, it may strangulate the glans and impede the outflow of venous blood.
What are is the pathogenesis of BPH?
Mostly due to age0related changes in circulatingl evels of testosterone and dihyrotestosterone.
approximately 75% of men 80yo + have some degree of BPH
What is the typical presentation of Epididymitis?
Intrascrotal pain and tenderness, with or without associated fever
What is associated with Female Pseudohermaphroditism?
Virilization of the external genital organs
Virilization of Vulva: Fusion into scrotal folds and is associated with clitoromegaly (most often seen in adrenogenital syndrome caused by 21-OHase deficiency- also adrenal hyperplasia and ambiguous genitalia is seen with this deficiency)
What characterizes Male Psuedohermaphroditism? When does this normally occur?
- A normal 46, XY karyotype
- Gonads are cryptorchid testes, but the external genital organs appear feminine or ambiguously female, with signs of virilization
Most often encountered in androgen-insensitivity syndromes due to a congenital deficiency of the androgen receptor, also known as testicular feminization syndrome.
What is most common testicular tumor in the first 4 years of life? 4-12 yrs of life? Adults?
60yo): Malignant Lymphoma
What is the microscopic appearance of a Yolk sac tumor?
- Interlacing strands of epithelial cells surrounded by loose connective stroma
- Lobular arrangement of cells, surrounded by empty spaces, leads to the formation of glomeruloid structures referred to as Schiller-Duval bodies
What cancer secretes hCG?
Describe a Seminoma on gross exam? micro?
Gross: Solid, rubbery-firm masses
Micro: Neoplastic cells arranged as nests or sheets that are separated by fibrous septae and infiltrated with chronic inflammatory cells (lymphocytes, plasma cells, and macrophages)