all things male Flashcards by Becky Koscik

abnormal curvature of penis

peyronie disease

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what causes peyronie disease

fibrous plaque in the tunica albuginea

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what is a consequence of peyronie disease

erectile dysfunction

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when to consider peryonie dsiease surfical repair

once curvature stabilizes

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what is penile fracture

rupture of corpora cavernosa due to forced bending

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what is priapism

painful sustained erection for more than 4 hours

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sickle cell disease
trauma
sildenafil
trazodone

priapism

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how does sickle cell disease cause priapism

sickled rbcs get trapped in vascular channels

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treatment for priapism

immediate corporal aspiration
inravascernosal phenylephrine
surfical decompression
to prevent ischaemia

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what penile pathology is more common in asia
africa
sourth america

squamosu cell carcinoma

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what are the predisposign penile lesions that can lead to sqamous cell carcinoma

bowens

erythroplasia fo queyrat

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presentation of bowens

leukoplakia on shaft

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presentation of erythroplasia ofqueyrat

eyrhtroplakia on glans and mucous of prepuce

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presentation of bowenodi papulosis

reddish papules

unclear maligi potential

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what is associated withe penile squamous cell carcioma

HPV

lack of circuncision

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what is cryptochidisim

undescended testes

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describe the descent of the testes

transabdominal by MIH

inguinoscrola by androgesn adn hCG – think androgen sensitivity syndrome

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what happens to cyrptorchidims testes

impaired spermatogenesis - icnreased temp affects sertoli, best at < 37
testosterone okay bc leydigs not affected byt emp

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what si cryptorchidism associated with

germ cell tumors

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what causes increased risk of cyrptochidism

prematurity

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when does testosterone decreased in cryptorchidosim

normal if unilateral

decreased if bilateral

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hormone changes seen in cyrptochidism

decreased testosterone if bilateral
normal testosterone if unilateral
decreased inhibition
increased FSH
increased LH

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what is a varicocele

dilated veins in pampiniform plexus due to increased venous pressure

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what is the most common cause of scrotal enlargement in adult males

varicocele

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when do varicoceles usually presetn

15-25 years old

which side and why varicoceles

left; increased rsistance to flow from left gonadal veins into left renal veine

why can vaircocele cause infertility

increase temp

how does varicocele present

aching pain ins crotum dragging sensation in testicle visbile bag of worms

how to diagnose varicocele

ultrasound dopplller

does varicocele transilluminate

treatment of varicocele

caricocelectomy | embolization by internventialn radiolotis

smoker | sudden onset left varicocele

renal cell carcinoma invading left renal vein

where do extragonal derm cell tumors arise

midlein lcoatiosn

here are extragondal germ cell tumors in adultes

retroperitoneam mediateinum pineal suprasellar regions

where do extragonadal germ cell tumors show up in munchkins

sacrococcygeal teratomas most comolny

cause of epididymitis in 35

< 35 - chlamydia and gonorrhoea | > 35 - ecoli and pseudomonase

distinguishing physical test for epididymitis

elevation of scrotum decreases pain

when to suspect torsino of the testical

12-18 years old vilent moemvent or physical trauma cryptochoid testes atrophy of teste

what is distinguidhing phys test for testicular torsion

no cremasteric reflues | sudden pain onset

what differentiates a scotal mass vrs a testicular tumor

benign scrotal lesions can be transilluminated

what is a congenital hydrocele

common cause of scrotal swelling in munchkins | due to incomplete obilteration of processus vaginalis

what is an acquired hydroele

benign scrotla fluid collection suually due to infection trauma or tumor bloody - hematocele

what is a spermatocele

cyst due to dilated epififymal duct or rete testes

paratesticular fluctuant nodule

spermatocele

transilluminating sweeling in munchkin

congenital hydrocele

what accounts fo 95% of testicular tumors

germ cell tumors

who most commonly gets testicualr germ cell tumors

young men | white > black

what ar ethe risk factors for germ cell testicular tumors

MOSt COMMON - cyrptochidism | klinefelter

what is the differential for testicular mass that does not transilluminate

cancer.

give tumor of age group, testicular a) 30-35, > 65 b) < 4 yo c) 20-30 yo d) all ages e) 20-25 yo

a) 30-35, > 65 = seminoma b) < 4 yo = yolk sac/endodermal sinus tumor c) 20-30 yo = choriocarcinoma d) all ages = teratoma e) 20-25 = embryonal tumor

describe a seminoma

malignant painless homogenosu testicular enlargement NEVER IN FANCEY

histopathos of seminoma

large cells in obules with watery sytoplasm fried eff appearance ~ dysgerminoma

marker of seminoma

increased placental ALP

treatment of seminoma

radiosensitive

mets and prog of seminoma

late mets and excellent prognosis

painless homongenous testicular enlargment

seminoma

large cells in obules with watery cytoplasm and fired egg apeprance icnreased ALP

seminoma

yellow mucinous tumor

yolk sac

schiller duval bodes

glomuerli | yolk sacr

icnreased AFP

yolk sacr

what is the most common testicular tumor in boys > 3 yo

yolk sac

maligi potential of yold sac

aggressively

increased hCG

choriocarcinoma

histopathos of choriocarcinoma

syncytiotrophoblastic and cytotrophoblastic elements

how does choriocarcinoma spread

hematogenous met ot lung and brain

how can choriocarcinoma present

hemorrhagic stroke due to bleeding of mets

``` hyperthyroidism symptoms gynecomastia hemorrhagic stroke mass in testes non transillumination high hCG ```

choriocarcinoma

femal ovarioan tumor = hypethyroidosim

dermoid/mature teratoma

teratome in adult male vrs female vrs boys

maligi at males benign at females benign at boys

increased hCG and or AFP

teratoma

what is an embryonal carcinoma

hemorrhagic mass with necrosis paiful glanular and papillary morpho usually mixed

increased hCG and normal AFP when pruie, increased AFP when mixed

embryonal

malig potentail of embryonal carcinoma

maligi yes.

histopathos of embryonal carcinoma

glandular and papillary morphology

general characteristics of non germ cell testicular tumors

5% fo all | mostly benign

reinke cyrostals | androgen production

leydig cell non germ cell testicular tumor

golden brown with reinke cyrtsals

leydig cell non germ cell testicular tumour

genecomastia in men precosious puberty in boys bening testicular mass that doesnt transilluminate

leydig cell tumor

androblastmoa from sex cor stroma

sertoli cell testicualr non germ cell tumor

what is the most common testicular cancer in older men

testicualr lymphoma

what is a testicular lymphoma

not primary arises from emts lymphoma to testes AGGRESSIVE

where would mets form testicular tumors occur

paraaortic LNs

name the tumor a) icnreased placental ALP b) increased AFP c) increased hCG d) increased hCG and of AFP e) icnreased hcG and AFP if mied

a) increased ALP - seminoma b) icnreased AFP - yold sac c) increased hCG - choriocarcinoma d) increased hCG and or AFP - teratoma e) icnreased hCG and AFP if mixed - embryonal

common patholgoy in men over fifty

bph

describe bph

smooth, elastic, firm nodular enlargement HYPERPLASIa not hypertophy or periuretral (lateral and middle ) lobes taht compress the urethra into a critcal slit

increased frequency of un=rination nocturia difficulty starting and stopping urine stream dysuria

obstructive symptoms | more commolny BPH than carcinoma bc BPH at the periuretral lobes ie lateral and middle

increased free PSA

BPH

increased bound PSA

prostatic adenocarcinoma

what are complications of bph

may lead to distension and hypertrophy of bladder | hydroneprhosis and UTI

treat bph

alpha 1 antags = terazosin, tamsulosin = relaxation fo smooth muscle 5 alpha reducatse inhibtiors - inasteride PDE5 inhibitiors

dysuria frequency urgency low back pain

prostat

causes of acute prostatits

E coli if > 35 | chlam an dgon if < 35

causes of chronic prostatitis

abacterial mostly

diagnosis acute prostattiso

3r and 4th part of urin (proastat and massage) will ahve imcreased wbc and bacteria

where does prostatic adenocarcinoma arise from

posterior lobe/peripheral zone

how is prostatic adenocarcinoma diagnoseied

increasd PDA and biopsy

how are prostatic acid phosphatase and PSA useful tumoru markers

icnreased total psa with decreased free fraction of psa change of psa >0.75 /year psa / total volume shorter doublign time of PSA

lower back pain and icnreased serum PSA and ALP

osteoBlastic met to bones

histopathos of prostatic adenocarcinoma

small neoplastic glands wtih prominent nucleuio amid normal prsate stroma