XVIII - The Male Genital System Flashcards Preview

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Flashcards in XVIII - The Male Genital System Deck (111)
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91

Biomarker elevated in choriocarcinoma

Serum HCG(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 979

92

Its most common presenting feature is testicular swelling; may manifest with gynecomastia and sexual precocity due to elaboration of androgens, and even corticosteroids.

Leydig Cell Tumors (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980

93

It has a distinctive golden brown homogeneous cut surface. Histologically, cells are large and have round, polygonal cell outlines, abundant granular eosinophilic cytoplasm, and round central nucleus. Cytoplasm contains lipid droplets, vacuoles, lipofuscon, or crystalloid of Reinke.

Leydig Cell Tumors (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980

94

Presents as a testicular mass. These neoplasm appear as firm, small nodules with a homogeneous gray-white to yellow cut surface. Tumor cell are arranged in distinctive trabeculae and form cordlike structures and tubules.

Sertoli cell tumors(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980

95

It is characterized by formation of large, fairly discrete nodules in the periurethral region of the prostate. The most common benign prostatic disease in men older than age 50 years.

Benign Prostatic Hyperplasia or Nodular Hyperplasia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 982

96

Major clinical problem in BPH

Urinary obstruction(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 983

97

The most common form of cancer in men.

Adenocarcinoma of the prostate(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 983

98

DRE was performed in a patient and demonstrated a gritty and firm prostate. PSA was 6 ng/ml. Biopsy of prostate was done and showed crowded glands lined by a single uniform layer of cuboidal epithelium, lack branching and papillary infolding, and absent outer basal cell layer. What is the diagnosis?

Prostate adenocarcinoma(TOPNOTCH)

99

Most common location of prostate cancer

Posterior location, peripheral zone of the gland(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 985

100

The most common tumor to secondarily involve the prostate

Urothelial cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 990

101

Which of the following has been implicated in the development of squamous cell carcinoma of the penis? (A) smegma (B) smoking (C) HPV infection (D) all of the above

all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

102

A 3 year old male presents with only one palpable testicle. Imaging showed an undescended right testis. Which of the following is true? (A) his left testis has an increased risk for developing cancer (B) surgical placement of his right testis into his scrotum before puberty eliminates the risk of cancer (C) surgical placement of his right testis into his scrotum after puberty eliminates the risk of cancer (D) all of the above are true

his right testis has an increased risk for developing cancer (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689

103

A 25 year old develops bilateral parotitis and fever. He was never vaccinated with MMR. A few days later, he develops bilateral testicular pain and swelling. This complication (A) is more common in children (B) occurs in 80% of adult males (C) consists of a predominantly lymphoplasmacytic inflammatory infiltrate (D) all of the above are true

consists of a predominantly lymphoplasmacytic infiltrate (A- rare in children, B - 20% in adults) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690

104

Which of the following confers an increased risk of testicular cancer? (A) intersex syndromes (B) a brother who has testicular cancer (C) cancer in the contralateral testis (D) all of the above

all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690

105

A 44 year old cyclist presents with a unilateral painless testicular mass. Serum HCG is slightly elevated, while serum AFP is normal. Orchiectomy is performed, and the mass is fairly circumscribed, pale, and fleshy. Microscopic examination showed large, uniform cells with distinct borders, clear glycogen-rich cytoplasm, and conspicuous nucleoli. The stroma has a lymphocytic infiltrate. His tumor (A) is exquisitely radiosensitive (B)may be associated with foci of intratubular germ cell neoplasia elsewhere in the testis (C) is histologically identical to ovarian dysrgerminoma (D) all of the above

all of the above (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691

106

A 2 year old boy presents with marked right testicular enlargment. Serum HCG is slightly elevated, while serum AFP is markedly elevated. Orchiectomy is performed, and on microscopic examination, the tumor is composed of low cuboidal to columnar epithelial ccells forming microcysts, sheets, glands, and papillae, with eosinophilic hyaline globules. This tumor (A) is rare in this age group (B) may harbor structures resembling primitive glomeruli (C) has a more benign behavior than seminomas (D) all of the above are true

may harbor structures resembling primitive glomeruli (Schiller Duvall bodies) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

107

A 55 year old man complains of urinary frequency, intermittency, and weak stream. A digital rectal exam showed a diffusely enlarged, doughy prostate. Serum PSA is 2 ng/L. He undergoes TURP. Histopathology will likely show (A) glands with inner columnar cells and outer flattened cells, some areas thrown into folds, admixed with fibrous stroma (B) small crowded round glands, some coalescing, with cells containing prominent nucleoli (C) nests and sheets of cells with amphophilic cytoplasm and prominent nucleoli (D) glands forming glomeruloid structures

glands with inner columnar cells and outer flattened cells, some areas thrown into folds, admixed with fibrous stroma (nodular prostatic hyperplasia) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 696-697

108

In nodular prostatic hyperplasia, (A) epithelial cells have prominent nucleoli (B) the pathology usually arises in the peripheral zone (C) circulating systemic androgens are consistently elevated (D) clinical symptoms are seen in 10% of patients

clinical symptoms are seen in 10% of patients (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 697-698

109

A 28 year old male sex worker presents with multiple maculopapular lesions of the palms and soles and generalized lymphadenopathy. His oral cavity also shows similar lesions. He reports that two months ago, he noticed a painless ulcer with indurated margins on the shaft of his penis, which has now disappeared. Which of the following is accurate? (A) if a biopsy of his penile ulcer and his present lesions were done, they would both show proliferative endarteritis with lymphoplasmacytic infiltrate (B) his present lesions are not infectious (C) if he is left untreated, the commonest tertiary form of his disease are gummas in the bone and skin (D) he is likely negative for antitreponemal antibody at his present stage

if a biopsy of his penile ulcer and his present lesions were done, they would both show proliferative endarteritis with lymphoplasmacytic infiltrate (B - present lesions are infectious; (C) commonest tertiary is cardiovascular (D) positive in virtually all 2ndary syphilis) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 701-703

110

A 19 year old college student consults for penile discharge. He discloses a history of unprotected sex. A gram stain of the smear of the discharge shows numerous neutrophils, some of which harbor gram negative cocci in pairs in the cytoplasm. The likely etiologic agent is (A) Trichomonas (B) Chlamydia (C) Treponema (D) Neisseria

Neisseria (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 705

111

A 31 year old male with multiple sexual partners presents with several painless verrucous papules around the coronal sulcus of his penis. Excision is done, and microscopic examination showed stratified squamous epithelium in a papillary architecture. Some of the squamous cells have irregular, hyperchromatic nuclei surrounded by a perinuclear halo. His lesions are caused by (A) HSV-2 (B) HPV (C) Calymmatobacterium granulomatis (D) Haemophilus ducreyi

HPV (TOPNOTCH)Robbins Basic Pathology, 8th ed., p709