Male Reproductive Pathology Flashcards

1
Q

where do most cases of BPH occur?

A

Transitional Zone!!!

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2
Q

where do most cases of carcinomas occur? and why?

A

Peripheral zone! 70% of gland mass

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3
Q

what types of bacteria cause acute prostatitis?

A

mostly Gram-negative rods (same organisms as UTIs: Proteus and E.coli)

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4
Q

what digital rectal exam finding do you find in acute bacterial prostatitis? what clinical symptoms are present?

A

extremely tender and boggy. fever, chills, dysuria, very painful

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5
Q

what is the clinical presentation for chronic bacterial prostatitis?

A

non-specific: low back pain, dysuria, perineal pain.

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6
Q

what is the most common form of prostatitis today? what does it consist of?

A

chronic Abacterial. STD organisms have been implicated (Chlamydia, mycoplasma, ureaplasma)

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7
Q

when should you really use PSA testing?

A

male w/ strong family history

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8
Q

is BPH pre-malignant?

A

NO. nodular proliferation of both glands and stroma.

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9
Q

clinical features of BPH?

A

nocturia**

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10
Q

BPH treatment?

A

5-alpha reductase inhibitory (finasteride) testoterone>DHT. multiply PSAx2.3 if taking 1mg/d >4yrs

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11
Q

why is vericocele great on the left?

A

because drainage has to go through renal vein first before IVC on the LEFT.

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12
Q

where does testicular cancer metastize?

A

nodes

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13
Q

what is phase 1 (transabdominal) of testicular descent controlled by?

A

mullerian-inhibiting substance

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14
Q

what is phase 2 (inguinoscrotal: descends through inguinal canal into scrotum) of testicular descent controlled by?

A

androgen dependent.

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15
Q

Cryptorchid testis cases are 75% ____ (unilateral or bilateral)

A

unilateral.

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16
Q

what happens if cryptorchid testis is bilateral and left uncorrected?

A

sterility!

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17
Q

what type of tumors are you at an increased risk for with Cryptorchid testis?

A

5-10x increase in germ cell tumors! WHILE, 5-10% of testicular germ cell tumors occur in cryptorchid testes

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18
Q

what is the treatment for cryptorchid testis?

A

orchiopexy (stitch down to prevent movement). before 2yrs old for fertility, 10 yrs for neoplasm. deficient spermatogenesis still in 10-60% even WHEN corrected & still SOME increased risk of cancer REMAINS

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19
Q

what are examples of chromosomal abnormalities leading to testicular infertility?

A

Klinefelter’s syndrome (47 XXY- sterility is the defining feature). Down’s syndrome (trisomy 21).

20
Q

what are the causes of bacterial Epididymo-orchitis in patients under 35 yrs old?

A

most are sexually transmitted: N. gonorrheae, Chlamydia, Mycoplasma, Treponema Pallidum (primary syphillis)

21
Q

a male patient noticed his left testicle looking like a ‘bag of worms’. name that disorder! what is it a cause of? is this painless or painful?

A

Varicocele. Infertility (relative HYPERthermia). painLESS.

22
Q

what are the two main types of testicular neoplasms? what are their subcategories?

A

Germ cell tumors & Sex cord stromal tumors.
Germ cell: Seminoma, nonseminoma (Embryonal carcinoma, yolk sac tumor, choriocarcinoma).
Sex cord stromal: Sertoli cell, Leydig cell tumor, ganulosa cell tumor, mixed.

23
Q

Are Nonseminoma Germ Cell Tumors benign or metastatic? what about sex cord stromal tumors??

A

Nonseminoma: metastatic.

Sex cord stromal: rare, benign, small.

24
Q

What is the most common type of testicular tumor (solid)? PATHOMA

A

Germ Cell Tumors (95% of cases)

25
Q

_____ (of the Germ Cell Tumors) are highly responsive to radiotherapy, metastasize late and have an excellent prognosis? PATHOMA

A

seminomas

26
Q

___ (of Germ Cell Tumors) often metastasize early? PATHOMA

A

NONseminomas

27
Q

what is the most common testicular tumor in children? what is characteristically elevated? PATHOMA

A

Yolk Sac (endodermal sinus) tumor is a malignant tumor. Schiller-Duval bodies seen on histology. AFP is characteristically elevated

28
Q

what is the most common cause of a testicular mass in males > 60 yrs, often bilateral? PATHOMA

A

Lymphoma (usually diffuse large B-cell type)

29
Q

what is referred to as the ‘fish flesh tumor’? large, fleshy, homogenous that encompasses entire testicle and has NO hemorrhage or necrosis.

A

Seminoma. non-caseating granuloma

30
Q

what type of tumor is a malignant tumor comprised of immature, primitive cells that may produce glands; forms HEMORRHAGIC mass with necrosis? what is the usual age group? PATHOMA

A

Embryonal carcinoma. 20-30 yrs. more aggressive than Seminoma.

31
Q

what is a malignant tumor of syncytiotrophoblasts and cytotrophoblasts? what is characteristically elevated?

A

Choriocarcinoma. beta-hCG

32
Q

_____ is a tumor composed of mature fetal tissue derived from two or more embryonic layers?

A

teratoma

33
Q

teratoma: is it malignant or benign in males? females?

A

malignant in males, benign in females.

34
Q

where does hematogenous spread lead to?

A

lung, brain, liver

35
Q

T or F: Seminomatous component of mixed tumors usually does not metastasize?

A

He said TRUE. however, that’s confusing since PATHOMA says seminomatous tumor is malignant but metastasizes LATE

36
Q

A patient gets diagnosed with a testicular cancer and it is confined to the testis. What stage is it?

A

Ia. Ib: spread to adnexa. Ic: spread to scrotum (rare bc tunixa holds tumor in)

37
Q

what stage involves the retroperitoneal lymphatics in testicular cancer?

A

Stage II.

38
Q

T or F: Seminoma will often remain localized?

A

True. 70% stage I.

39
Q

what is the least favorable non-seminomatous element?

A

choriocarcinoma

40
Q

are you more likely to have mortality in a seminoma or non-seminoma category?

A

non-seminoma (more aggressive and spreads faster and is hemorrhagic and necrotic). seminoma- does spread, but very LATE and is nonhemorrhagic and does not show necrosis.

41
Q

what elevation are you looking for in choriocarcinoma or syncitiotrophoblast?

A

hCG

42
Q

____ are exquisitely radiosensitive?

A

Seminomas

43
Q

_____ tumor is comprised of tubules and is usually clinically silent. what is it associated with?

A

Sertoli cell tumor. Gynecomastia

44
Q

what do Leydig cell tumors cause ((1) in children (2) in adults) due to elaborate production of androgens and/or estrogens?

A

causing precocious puberty in children or gynecomastia in adults.

45
Q

what are the most common primary sites of metastatic tumors in older males ?

A

lung and prostate

46
Q

what is a hydrocele due to?

A

failure to obliterate the inguinal canal. filling of fluid in tunica vaginalis. associated with incomplete closure of processus vaginalis