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Disease Mechanisms > Ch 21: Lower Urinary Tract & Male Genital System > Flashcards

Ch 21: Lower Urinary Tract & Male Genital System Flashcards

1
Q

which two things are the descent of the testicles reliant on

A

mullerian inhibiting substances and androgens

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2
Q

what are the two main functions of the testes

A

spermatogenesis and making testosterone

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3
Q

what are the two cell types of the seminiferous tubules

A

spermatogenic and sustentacular cells

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4
Q

what do speramtogenic cells do

A

form sperm

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5
Q

what do sustenacular (nurse/sertoli) cells do

A

produce androgen-binding protein (ABP) and inhibin
support sperm production

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6
Q

what do the interstitial (leydig) cells do and where are they found

A

found between the seminiferous tubules
produce and secrete androgens like testosterone

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7
Q

explain how testosterone is made

A

hypothalamus releases GnRH
anterior pituitary releases FSH and LH
LH causes testosterone production; FSH causes ABP production
ABP binds to testosterone
testosterone stimulates spermatogenesis and development of male charactersistics

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8
Q

what is the negative feedback for testosterone

A

inhibin - inhibits FSH release from anterior pituitary

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9
Q

what is the most common condition of the testis

A

tumors

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10
Q

what is cryptorchidism

A

failure of testicles to descend which leads to absense of one or both tests

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11
Q

what is synorchism

A

fusion of testis

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12
Q

what are the most common conditions of the epididymis

A

inflammatory diseases

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13
Q

which two diseases cause inflammation of the epididymis

A

tuberculosis and gonorrhea

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14
Q

where is the most common location for testicles to get stuck along their descent

A

inguinal canal

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15
Q

what three things can cryptorchidism cause

A

tubular atrophy, sterility, and testicular cancer

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16
Q

where can cancer develop in a male with unilateral cryptorchidism

A

develops in the descended testis - suggests intrinsic defect in gonadal development

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17
Q

what is an orchiopexy

A

procedure to bring the undescended testicle back into the scrotum
does not completely eliminate the risk of sterility and cancer

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18
Q

what is epididymitis

A

UTI that reached the epididymis through the lymphatics or vas deferens

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19
Q

what causes epididymitis in children

A

congenital abnormalities with gram negative rods

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20
Q

what causes epididymis in those under 35

A

STI - either chlamydia or gonorrhea

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21
Q

what causes epididymitis in those older than 35

A

infections with E. coli or pseudomonas

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22
Q

what can gonorrhea do to the epididymis

A

can cause abscess formation which leads to destruction, scarring, and possibly inflammation of the testis

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23
Q

what is orchitis

A

a UTI that spreads to the testis via the vas deferens or lymphatic system

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24
Q

what are the three types of orchitis

A

granulomatous (autoimmune)
mumps
syphilis

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25
Q

what is granulomatous orchitis

A

an autoimmune type of orchitis - no actual infection
idiopathic
most common in middle aged men
causes testicular mass and sometimes a fever

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26
Q

what is mumps orchitis

A

systemic viral disease that leads to orchitis one week after onset of swelling of the parotid gland

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27
Q

who is most at risk for mumps orchitis

A

post-pubertal males

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28
Q

what is syphilis orchitis

A

a bacterial infection that is acquired or congenital
first affects the testes but can spread to the epididymis

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29
Q

what is a testicular torsion

A

twisting of the testicle that cuts off venous drainage but no arterial
leads to vascular engorgement and a hemorrhagic infarction

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30
Q

what is a neonatal torsion

A

a testicular torsion that occurs in utero or soon after birth

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31
Q

what is an orchiectomy

A

removal of testicle in cases of adolescence testicular torsion for example

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32
Q

what is adult torsion

A

testicular torsion resulting from a bilateral anatomic defect that increases mobility of testes, making them more susceptible to twisting
treatment is contralateral (same side) orchiopexy

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33
Q

what are the four categories of testicular tumors

A

germ cell tumors derived from germ cell neoplasia in situ
germ cell tumors unrelated to germ cell neoplasia in situ
sex cord-stromal tumors
tumor containing both germ cell and sex cord-stromal elements

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34
Q

what are the two main categories of testicular tumors

A

germ cell tumors
sex cord-stromal tumors

35
Q

what is the most common type of testicular tumors

A

germ cell tumors

36
Q

what are the two types of germ cell tumors in males

A

seminomas
non-seminomas

37
Q

what is the most common type of germ cell testicular tumor in males

A

seminomas

38
Q

what are the two types of sex cord-stromal tumors in males

A

leydig cell tumors
Sertoli cell tumors

39
Q

what type of cells do germ cell tumors comes from in males

A

reproductive cells - most are malignant

40
Q

what are the three main risk factors of germ cell tumors in males

A

cryptorchidism
genetic factors
testicular dysgenesis syndrome (TDS)

41
Q

what is the risk of germ cell tumors in someone with cryptorchidism

A

3-5 fold increase in undescended testis

42
Q

what is the risk of germ cell tumors in brothers with certain genetic factors

A

8-10 fold increase

43
Q

what are the three disorders under the umbrella of testicular dysgenesis syndrome (TDS)

A

cryptorchidism
hypospadias (opening of urethra is not at tip of penis)
poor sperm quality

44
Q

which genetic factor is a risk factor for germ cell tumors

A

KIT gene

45
Q

where do most germ cell tumors arise from in males

A

germ cell neoplasia in situ - need an environmental factor and a inherited/acquired genetic abnormality

46
Q

what is a seminoma

A

most common type of germ cell tumor
resembles primordial germ cells or gonocytes
single cell type derived from germ cell neoplasia in situ

47
Q

who is most at risk for a seminoma in males

A

a male in their 40’s

48
Q

what is a non-seminoma in males

A

type of germ cell tumor
made of undifferentiated cells derived from germ cell neoplasia in situ

49
Q

what are the four main types of non-seminomas in males

A

embryonal carcinoma
yolk sac tumor
teratoma
choriocarcinoma

50
Q

who is most at risk for an embryonal carcinoma in males

A

20-30 year old males

51
Q

who is most at risk for a yolk sac tumor in males

A

1-3 year old males

52
Q

who is most at risk for a choriocarcinoma in males

A

20-30 year old males

53
Q

which type of non-seminoma is most aggressive and most rare in males

A

choriocarcinoma

54
Q

who is most at risk for leydig cell tumors in males

A

20-60 year olds

55
Q

what is a leydig cell tumor in males

A

a type of sex cord-stromal tumor made of leydig cells
these tumors produce androgens, estrogens, and corticosteroids
90% are benign

56
Q

what is a Sertoli cell tumor in males

A

a type of sex cord-stromal tumor made of Sertoli cells
hormonally silent, just present as a testicular mass
90% are benign

57
Q

what is a hydrocele

A

type of tunica vaginalis lesion
processus vaginalis accumulates with serous fluid
leads to a enlargement of scrotal sac

58
Q

what is a hematocele

A

type of tunica vaginalis
accumulation of blood in tunica vaginalis due to bleeding or trauma

59
Q

what is a spermatocele

A

type of tunica vaginalis
cystic accumulation of semen in dilated efferent ductus or rete testes

60
Q

what is a variocele

A

type of tunica vaginalis
dilation of veins in the pampiniform plexus

61
Q

is the prostate retroperitoneal

A

yes but does not have true capsule

62
Q

what are prostate glands lined by

A

basal epithelium and columnar secretory cells

63
Q

which hormone is the growth of the prostate reliant on

A

testosterone

64
Q

what are the four zones of the prostate

A

peripheral
central
transitional
periurethral

65
Q

which zone of the prostate is the origin of most carcinomas

A

peripheral zone

66
Q

which zone of the prostate is where most hyperplasia arises

A

transitional

67
Q

what are the three main pathologic processes that affect the prostate

A

prostatitis (inflammation)
benign prostatic hyperplasia (BPH)
tumors

68
Q

what is acute bacterial prostatitis

A

bacterial infection that causes inflammation of the prostate

69
Q

what is chronic bacterial prostatitis (CBP)

A

recurrent bacterial infection that causes inflammation of the prostate

70
Q

what is chronic abacterial prostatitis

A

chronic inflammation of the prostate with no history of recurrent UTI as well as a negative culture

71
Q

what is the most common type of prostatitis

A

chronic abacterial prostatitis

72
Q

what is granulomatous prostatitis

A

inflammation of the prostate caused by an infectious agent like a fungus or a non-infectious agent like secretions from ruptured ducts and acini

73
Q

what are two other forms of prostatitis

A

adenoviral
IgG4 associated autoimmune prostatitis

74
Q

what is benign prostatic hyperplasia (BPH)

A

non-malignant hyperplasia of prostate due to impaired cell death
leads to an accumulation of epithelial cells in the prostate

75
Q

what are the two secondary effects of benign prostatic hyperplasia (BPH)

A

compression of the urethra which leads to difficulty in urination
retention of urine which an lead to cystitis and renal infection

76
Q

who is most affected by benign prostatic hyperplasia (BPH)

A

men above 50 years of age

77
Q

what is the second cause of cancer related death in men over 50

A

adenocarcinoma of prostate

78
Q

what is the most common form of prostate cancer

A

adenocarcinoma

79
Q

where does adenocarcinoma of the prostate most commonly arise within the prostate

A

peripheral zone - found on rectal exam

80
Q

what is the most common genetic alteration that can lead to adenocarcinoma of the prostate

A

chromosomal rearrangement that places the ETS gene (ERG or ETV1) next to TMPRSS2 promotor
leads to over-expression

81
Q

how is adenocarcinoma of the prostate monitored after treatment

A

serum PSA levels

82
Q

what are the two most common sites of metastasis of adenocarcinoma of the prostate

A

lymph nodes and bone

83
Q

what is the most common bony metastases of adenocarcinoma of the prostate

A

osteoblastic carcinoma

Disease Mechanisms (19 decks)

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