XVIII - The Male Genital System Flashcards Preview

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Flashcards in XVIII - The Male Genital System Deck (109):
1

An abnormal opening of the urethra along the ventral aspect of the penis.

Hypospadias. SEE SLIDE 18.1 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 687

2

An abnormal opening of the urethra along the dorsal aspect of the penis.

Epispadias. SEE SLIDE 18.1 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 687

3

A congenital malformation of the bladder associated with epispadias.

Bladder extrophy. SEE SLIDE 18.2 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

4

A condition in which the prepuce cannot be retracted easily over the glans penis

Phimosis. SEE SLIDE 18.1 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

5

Appears grossly as a solitary, plaquelike lesion on the shaft of the penis. Histologic examination reveals morphologically malignant cells throughout the epidermis with no invasion of the underlying stroma. Has potential for malignant transformation.

Bowen disease. SEE SLIDE 18.3 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

6

Bowen disease which presents as an erythematous patch on the glans penis.

Erythroplasia of Queyrat. SEE SLIDE 18.3 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

7

Occurs in young, sexually active males, histologically identical to Bowen disease. Presents with multiple reddish brown papules on the glans and is most often transient, with rare progression to carcinoma in immunocompetent patients.

Bowenoid papulosis. SEE SLIDE 18.4 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

8

Appears as a gray, crusted, papular lesion, most commonly on the glans penis or prepuce, which infiltrates the underlying connective tissue to produce an indurated, ulcerated lesion with irregular margins.

Squamous cell carcinoma of the penis. SEE SLIDE 18.4 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689

9

A variant of squamous cell carcinoma characterized by a papillary architecture, less striking cytologic atypia, and rounded, pushing deep margins.

Verrucous carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689

10

Most common cause of scrotal enlargement, which is an accumulation of serous fluid within the tunica vaginalis usually secondary to infection or malignancy.

Hydrocele(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689

11

Represents failure of testicular descent into the scrotum which involves the right testis more commonly than the left. Causes increased risk of sterility and development of testicular cancer.

Cryptorchidism(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690

12

Most important cause of firm, painless enlargement of the testis.

Testicular neoplasms(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690

13

Composed of sheets of large, uniform cells with distinct cell borders, clear, glycogen-rich cytoplasm, and round nuclei with conspicuous nucleoli. The cells are often arrayed in small lobules with intervening fibrous septa. SEE SLIDE 18.5.

Seminomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691

14

These tumors contain a mixture of medium-sized cells, large uninucleate or multinucleate tumor cells, and small cells with round nuclei that are reminiscent of secondary spermatocytes.

Spermatocytic seminoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691

15

Large and primitive-looking with indistinct cell borders, large nuclei, and basophilic cytoplasm. SEE SLIDE 18.6

Embryonal carcinoma of the testis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

16

Most common primary testicular neoplasm in children younger than 3 years of age.

Yolk sac tumors/endodermal sinus tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

17

Low cuboidal to columnar epithelial cells forming microcysts, sheets, glands, and papillae, often associated with eosinophilic hyaline globules. (+) Schiller-Duval bodies. SEE SLIDE 18.7

Yolk sac tumors/endodermal sinus tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

18

Structures resembling primitive glomeruli, seen in yolk sac tumors.

Schiller-Duval bodies. SEE SLIDE 18.7 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

19

Cytotrophoblast and syncytiotrophoblast without villus formation. SEE SLIDE 18.8

Choriocarcinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

20

Tissues from all three germ-cell layers with varying degrees of differentiation

Teratomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

21

Teratoma which contain fully differentiated tissues from one or more germ cell layers (e.g., neural tissue, cartilage, adipose tissue, bone, epithelium) in a haphazard array.

Mature teratomas. SEE SLIDE 18.9 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

22

Teratoma which contain immature somatic elements reminiscent of those in developing fetal tissue.

Immature teratomas. SEE SLIDE 18.9 (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

23

Characterized by the presence of an acute, neutrophilic inflammatory infiltrate, congestion, and stromal edema of the prostate.

Acute prostatitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 695

24

Characterized by variable amount of lymphoid infiltrate, evidence of glandular injury, and, frequently, concomitant acute inflammatory changes of the prostate.

Chronic prostatitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 695

25

Nodular hyperplasia is usually more pronounced in what part/s of the prostate?

Inner (central and transitional) region of the prostate(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 696

26

Composed of proliferating prostatic glandular elements and fibromuscular stroma. The glandular lumina often contain inspissated, proteinaceous secretory material, termed corpora amylacea. SEE SLIDE 18.10

Nodular Hyperplasia of the Prostate (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 697

27

Major hormonal stimulus for proliferation in nodular hyperplasia of the prostate.

DHT (Dihydrotestosterone)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 698

28

Most common area of the prostate affected by prostatic carcinoma.

Outer (peripheral) glands (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 698

29

Concentration of this biochemical marker is of great value in monitoring patients after treatment for prostate cancer.

Prostate specific antigen (PSA)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 700

30

A commonly used method for grading prostatic carcinoma, which is based on features such as the degree of glandular differentiation, the architecture of the neoplastic glands, nuclear anaplasia, and mitotic activity.

Gleason system(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 700

31

A chronic venereal infection caused by the spirochete Treponema pallidum, whose fundamental microscopic lesion is a proliferative endarteritis and an accompanying inflammatory infiltrate rich in plasma cells.

Syphilis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

32

An irregular, firm mass of necrotic tissue surrounded by resilient connective tissue. Contains a central zone of coagulation necrosis surrounded by a mixed inflammatory infiltrate composed of lymphocytes, plasma cells, epithelioid cells, giant cells, and a peripheral zone of dense fibrous tissue. Seen in tertiary syphilis.

Gumma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

33

This stage of syphilis is characterized by the presence of an indurated chancre at the site of initial inoculation, associated with painless regional lymphadenopathy.

Primary Syphilis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

34

Both nontreponemal and antitreponemal antibody tests are strongly positive in virtually all cases of this stage of syphilis.

Secondary syphilis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

35

In males this is manifested most often as a purulent urethral discharge, associated with an edematous, congested urethral meatus. Gram stain of urethral discharge, demonstrates the characteristic gram-negative, intracellular diplococci.

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

36

A gram-negative intracellular bacterium that causes a disease that is clinically indistinguishable from gonorrhea in both men and in women.

Chlamydia trachomatis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707

37

C. trachomatis infection causing a triad of reactive arthritis, conjunctivitis and generalized mucocutaneous lesions. Seen in patients who are HLA-B27 positive.

Reiter syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707

38

This STD is a chronic, ulcerative disease caused by certain strains of C. trachomatis, which presents with nonspecific urethritis, papular or ulcerative lesions involving the lower genitalia, regional adenopathy, or an anorectal syndrome.

Lymphogranuloma venereum (LGV) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707

39

This STD is an acute, ulcerative infection caused by Haemophilus ducreyi, a small, gram-negative coccobacillus. The lesion is an irregular ulcer (single or multiple), whose base is covered by a shaggy, yellow-gray exudate. Regional lymph nodes are enlarged and tender.

Chancroid ulcer caused by H. ducreyi (TOPNOTCH)Robbins Basic Pathology, 9th ed., p 677

40

A chronic inflammatory disease caused by Calymmatobacterium granulomatis. The organisms are demonstrable in Giemsa-stained smears of the exudate as minute coccobacilli within vacuoles in macrophages (Donovan bodies). Regional lymph nodes are typically spared.

Granuloma Inguinale (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 708

41

The initial lesions of this infection are painful, erythematous vesicles on the mucosa or skin of the lower genitalia and adjacent extra-genital sites. Cowdry type A inclusions appear as light purple, homogeneous intranuclear structures surrounded by a clear halo.

HSV 2(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 708

42

Caused by HPV types 6 and 11. Lesions vary from small, sessile lesions to large, papillary proliferations measuring several centimeters in diameter.

Condylomata acuminata (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 709

43

What is the most common cause of hydronephrosis in infants and children?

Ureteropelvic junction obstruction (TOPNOTCH)

44

Fiery red appearance of the cervix is associated with what type of infection?

Strawberry cervix is associated with T. vaginalis infection (TOPNOTCH)

45

Approximately 70% of prostate carcinoma will arise in what zone of the gland?

Peripheral zone ( posterior location) (TOPNOTCH)

46

Morphology: hallmark is nodularity due to glandular proliferation or dilation and to fibrous or muscular proliferation of the stroma

BPH (TOPNOTCH)

47

Morphology: tumor cells are arranged in distinctive trabeculae with a tendency to form cordlike structures resembling immature seminiferous tubules. SEE SLIDE 18.11.

Sertoli Cell Tumors or Androblastoma (TOPNOTCH)

48

Morphology: Rod shaped crystalloids of Reinke. SEE SLIDE 18.12

Leydig/Interstitial Cell Tumors (TOPNOTCH)

49

What is the most common form of testicular neoplasm in men over the age of 60?

Testicular Lymphoma (TOPNOTCH)

50

Within how many hours should the testes be explored surgically and untwisted manually so the testes will be viable after a testicular torsion?

Within 6 hours(TOPNOTCH)

51

Morphology: Clear vacuolization of the prickle cells. SEE SLIDE 18.13

Condylomata acuminatum (koilocytosis) (TOPNOTCH)

52

What HPV DNA type is found in approximately 80% of Bowen Disease and bowenoid papulosis?

HPV Type 16 (TOPNOTCH)

53

What type of bladder cancer is associated with long standing schistosomiasis?

Squamous cell carcinoma (TOPNOTCH)

54

In bladder carcinoma, the major decrease in survival is associated with tumor invading what layer of the bladder?

Muscularis propria (detrussor muscle) (TOPNOTCH)

55

Umbrella cells with abundant cytoplasm, cells with oval nuclei often with nuclear grooves can be seen in what type of epithelium?

Urothelium(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 959

56

Most common primary malignant tumor of the ureter

Urothelial carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 960

57

Ureteral narrowing or obstruction characterized by fibrotic proliferative inflammatory process encasing retroperitoneal structures and causing hydronephrosis

Sclerosing Retroperitotneal Fibrosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p 961

58

Primary or idiopathic retroperitoneal fibrosis is also called___.

Ormond Disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p 961

59

Most common and serious congenital anomaly of the urinary bladder

Vesicoureteral reflux(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 961

60

Most common cause of acute cystitis

E. coli (TOPNOTCH)Robbins Basic Pathology, 9th ed, p. 962

61

Laminated mineralized concretions resulting from deposition of calcium in enlarged lysosomes, present within the macrophages; seen in Malakoplakia. SEE SLIDE 18.14

Michaelis-Gutmann bodies(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 963

62

Most common precursor lesions to invasive urothelial carcinoma

Non-invasive papillary tumors(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 964

63

Most important risk factor for bladder carcinoma

Cigarette smoking(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 964

64

True or False. Patients with exstrophy of the bladder have an increased risk of adenocarcinoma.

True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 962

65

A newborn baby was noted to pass out out urine through a small opening at the area of the umbilicus. This is due to :

A patent urachus(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 962

66

True or False. Patients with urachal cyst are are risk for carcinoma.

True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 962

67

Most common bladder tumors

Urothelial tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 964

68

Dominant and sometimes only clinical manifestation of bladder cancer

Painless hematuria(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 967

69

Urothelial carcinoma associated with loss of the TP53 and RB tumor suppressor genes and frequently progresses to muscle-invasive disease.

Non-invasive high grade urothelial carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 968

70

Urothelial carcinoma associated with gain of function FGFR3 and HRAS mutation.

Non-invasive low-grade urothelial carcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 968

71

Most common cause of bladder obstruction in males

BPH (TOPNOTCH)

72

Inflammatory lesion that presents as a small, red, painful mass about the external urethral meatus, consisting of inflamed granulation tissue covered by friable mucosa which may ulcerate and bleed with the slightest trauma, typically in older females.

Urethral caruncle(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 969

73

Characterized by arrested germ cell development associated with marked hyalinization and thickening of the basement membrane of the spermatic tubules.

Cryptorchidism(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 972

74

Most frequent causes of epididymitis in sexually active men younger than age 35 years.

C. trachomatis and N. gonorrhoea(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 974

75

Most frequent causes of epididymitis in men older than age 35 years.

E. Coli and Pseudomonas(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 974

76

Most common benign paratesticular tumor

Adenomatoid tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975

77

Most common malignant paratesticular tumors in children

Rhabdomyosarcroma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975

78

Most common malignant paratesticular tumors in adults

Liposarcoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975

79

The most common testicular tumor in men agest 15-34 years old

Germ Cell tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975

80

Syndrome composed of cryptorchidims, hypospadias, and poor sperm quality; also associated with germ cell tumors

Testicular dysgenesis syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 975

81

Most common type of germ cell tumor

Seminoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 976

82

Most common testicular tumor in infants and children up to 3 years of age

Yolk sac tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 976

83

Lymphatic spread is common to all forms of testicular tumors. Which group of nodes are initially involved?

Retroperitoneal para-aortic nodes(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 979

84

Most aggressive nonseminomatous germ cell tumors

Pure choriocarcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 979

85

Biomarker elevated in yolk sac tumor

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

86

Biomarker elevated in choriocarcinoma

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

87

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

88

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. SEE SLIDE 18.12 (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980

89

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. SEE SLIDE 18.11 (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 980

90

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

91

Major clinical problem in BPH

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

92

The most common form of cancer in men.

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

93

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. SEE SLIDE 18.15. What is the diagnosis?

Prostate adenocarcinoma(TOPNOTCH)

94

Most common location of prostate cancer

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

95

The most common tumor to secondarily involve the prostate

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

96

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

97

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

98

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

99

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

100

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

101

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

102

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

103

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

104

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

105

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

106

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

107

Most important prognostic factor in urothelial cancer

Extent of invasion and spread at time of initial diagnosis (TOPNOTCH)Robbins Basic Pathology, 9th ed., p670

108

Flat, raised lesions that may be seen in secondary syphilis

Condyloma lata (TOPNOTCH)Robbins Basic Pathology, 9th ed., p674

109

In this STD, lesions contain a mixed granulomatous and neutrophilic inflammatory response. Lymph node involvement is prominent, with assocaited stellate abscesses that eventually fibrose, causing lymphedema.

Lymphogranuloma venerueum caused by certain strains of Chlamydia (TOPNOTCH)Robbins Basic Pathology, 9th ed., p676