Urogenital Pathology Flashcards Preview

Clinical Pathology > Urogenital Pathology > Flashcards

Flashcards in Urogenital Pathology Deck (29):
1

What is BPH?

Benign prostatic hyperplasia - enlargement of epithelial and fibromuscular tissue in prostate

2

Where does BPH usually occur?

TRANSITION ZONE and PERIURETHRAL ZONE - more central so compresses urethra

3

What are the symptoms of BPH? (LOWER URINARY TRACT SYMPTOMS)

-Increased urgency/frequency

-Problems starting urination/emptying bladder

-Nocturia

- Diminished stream size and force ('not hitting wall')

4

Where do most carcinomas of the prostate arise?

Peripheral zone - symptoms of BPH do not arise until very advanced

5

What is the pathogenesis of BPH? What is predominant in older men? (*)

Nodule formation*

Enlargement of transitional and periurethral zone

Enlargement of nodules*

6

What is the cause of BPH?

Impaired cell death resulting accumulation of senescent (old) cells in prostate

Hormone imbalance e,g, testosterone (DHT)

7

What is the main type of prostate cancer?

Prostatic adenocarcinoma

8

What is the treat for prostatic adenocarcinoma?

- Surgery - radical prostatectomy

-Radiotherapy

- Hormonal manipulations

9

What are the risk factors for prostatic cancer?

Age, race, family history, environmental (increased consumption of fats)

Androgen exposure - reduced androgen exposure (with castration/anti-androgens) is associated with disease regression

BRCA2

10

What grading system is used for prostatic carcinoma?

Gleason grade

TMN stage

11

Why is there no screening programme for prostatic cancer?

Prostatic specific antigen - associated with false negatives/positives

Complications of treatment e.g. importance, incontinence

Unnecessary treatments/limited benefits

12

What are the two functions of the testes?

Sperm production

Androgen production

13

What are the major aetiological causes of germ cell tumours?

-Prior germ cell tumour in contralateral testicle

-Cryptochordism (absence of testicle(s) in scrotum - e.g undescended)

- Inguinal hernia/hydrocele (anything impairing blood flow to testicle)

- Disorder spermatogenesis

- Testicular atrophy

14

What age group do seminomas most likely effect?

35-45 yr olds (rare >50 yrs)

15

What are the clinical presentations of seminomas?

Pain
Testicular enlargement
Asymptomatic
Metastases
Infertility
Gynecomastia - male breasts

16

What serum markers are associated with seminoma?

PLAP
hCG - cause of gynecomastia

17

When do teratomas most commonly arise?

10-20yrs old

18

If the patient is pre-pubescent, what is a mature teratoma considered?

Benign

19

If the patient is post-pubescent, what is a mature teratoma considered

Malignant

20

What serum tumour markers do teratomas secrete?

none

21

What is the definition of orchitis?

Any inflammatory condition of the testes

22

What are the clinical features and causes for epididymoorchitis?

Infective inflammation of epididymus

Fever, malaise, pain, warm, enlarged

Neutrophil invasion and inflammation

UTI (non-specific)/gonococcal infection

23

What are the clinical features of an idiopathic granulomatous orchitis?

Older people (idiopathic = unknown cause)

Symptoms of UTI, trauma or flu-like lines

Testis = swollen painful and tender

24

What is sarcoidosis of the tests?

Granulomas in the testes

25

What is the pathogenesis and clinical characteristics of a sperm granuloma?

Extraversion of sperm into interstitium, resulting in inflammatory reaction (histiocytes/polymorphs) and fibrosis

Results in swelling in epididymis. Can result from result vasectomy

26

What presents with bilateral/unilateral painless scrotal swelling, infertility and scrotal fistula. Prominent caseating granulomatous inflammation fibrous thickening and enlargement of epididymis and other structures?

TB orchitis

27

What is cryptorchordisn? What is its complications?

Failure of testes to defend into scrotum - acquired or congenital causes

Results in testicular ischaemia and hypoxia -> testicular atrophy -> infertility/testicular cancer

28

Name some primary causes of testicular failure (hypogonadism)

Cryptochoridism
Klinefelter syndrome
Mumps
Orchitis
CF
testicular torsion

29

Name some secondary causes of gonadal failure (hypogonadism)

Pituitary failure
Acing
Obesity
Steroids

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