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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
what is granulomatous orchitis
an autoimmune type of orchitis - no actual infection idiopathic most common in middle aged men causes testicular mass and sometimes a fever
26
what is mumps orchitis
systemic viral disease that leads to orchitis one week after onset of swelling of the parotid gland
27
who is most at risk for mumps orchitis
post-pubertal males
28
what is syphilis orchitis
a bacterial infection that is acquired or congenital first affects the testes but can spread to the epididymis
29
what is a testicular torsion
twisting of the testicle that cuts off venous drainage but no arterial leads to vascular engorgement and a hemorrhagic infarction
30
what is a neonatal torsion
a testicular torsion that occurs in utero or soon after birth
31
what is an orchiectomy
removal of testicle in cases of adolescence testicular torsion for example
32
what is adult torsion
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
33
what are the four categories of testicular tumors
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
34
what are the two main categories of testicular tumors
germ cell tumors sex cord-stromal tumors
35
what is the most common type of testicular tumors
germ cell tumors
36
what are the two types of germ cell tumors in males
seminomas non-seminomas
37
what is the most common type of germ cell testicular tumor in males
seminomas
38
what are the two types of sex cord-stromal tumors in males
leydig cell tumors Sertoli cell tumors
39
what type of cells do germ cell tumors comes from in males
reproductive cells - most are malignant
40
what are the three main risk factors of germ cell tumors in males
cryptorchidism genetic factors testicular dysgenesis syndrome (TDS)
41
what is the risk of germ cell tumors in someone with cryptorchidism
3-5 fold increase in undescended testis
42
what is the risk of germ cell tumors in brothers with certain genetic factors
8-10 fold increase
43
what are the three disorders under the umbrella of testicular dysgenesis syndrome (TDS)
cryptorchidism hypospadias (opening of urethra is not at tip of penis) poor sperm quality
44
which genetic factor is a risk factor for germ cell tumors
KIT gene
45
where do most germ cell tumors arise from in males
germ cell neoplasia in situ - need an environmental factor and a inherited/acquired genetic abnormality
46
what is a seminoma
most common type of germ cell tumor resembles primordial germ cells or gonocytes single cell type derived from germ cell neoplasia in situ
47
who is most at risk for a seminoma in males
a male in their 40's
48
what is a non-seminoma in males
type of germ cell tumor made of undifferentiated cells derived from germ cell neoplasia in situ
49
what are the four main types of non-seminomas in males
embryonal carcinoma yolk sac tumor teratoma choriocarcinoma
50
who is most at risk for an embryonal carcinoma in males
20-30 year old males
51
who is most at risk for a yolk sac tumor in males
1-3 year old males
52
who is most at risk for a choriocarcinoma in males
20-30 year old males
53
which type of non-seminoma is most aggressive and most rare in males
choriocarcinoma
54
who is most at risk for leydig cell tumors in males
20-60 year olds
55
what is a leydig cell tumor in males
a type of sex cord-stromal tumor made of leydig cells these tumors produce androgens, estrogens, and corticosteroids 90% are benign
56
what is a Sertoli cell tumor in males
a type of sex cord-stromal tumor made of Sertoli cells hormonally silent, just present as a testicular mass 90% are benign
57
what is a hydrocele
type of tunica vaginalis lesion processus vaginalis accumulates with serous fluid leads to a enlargement of scrotal sac
58
what is a hematocele
type of tunica vaginalis accumulation of blood in tunica vaginalis due to bleeding or trauma
59
what is a spermatocele
type of tunica vaginalis cystic accumulation of semen in dilated efferent ductus or rete testes
60
what is a variocele
type of tunica vaginalis dilation of veins in the pampiniform plexus
61
is the prostate retroperitoneal
yes but does not have true capsule
62
what are prostate glands lined by
basal epithelium and columnar secretory cells
63
which hormone is the growth of the prostate reliant on
testosterone
64
what are the four zones of the prostate
peripheral central transitional periurethral
65
which zone of the prostate is the origin of most carcinomas
peripheral zone
66
which zone of the prostate is where most hyperplasia arises
transitional
67
what are the three main pathologic processes that affect the prostate
prostatitis (inflammation) benign prostatic hyperplasia (BPH) tumors
68
what is acute bacterial prostatitis
bacterial infection that causes inflammation of the prostate
69
what is chronic bacterial prostatitis (CBP)
recurrent bacterial infection that causes inflammation of the prostate
70
what is chronic abacterial prostatitis
chronic inflammation of the prostate with no history of recurrent UTI as well as a negative culture
71
what is the most common type of prostatitis
chronic abacterial prostatitis
72
what is granulomatous prostatitis
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
what are two other forms of prostatitis
adenoviral IgG4 associated autoimmune prostatitis
74
what is benign prostatic hyperplasia (BPH)
non-malignant hyperplasia of prostate due to impaired cell death leads to an accumulation of epithelial cells in the prostate
75
what are the two secondary effects of benign prostatic hyperplasia (BPH)
compression of the urethra which leads to difficulty in urination retention of urine which an lead to cystitis and renal infection
76
who is most affected by benign prostatic hyperplasia (BPH)
men above 50 years of age
77
what is the second cause of cancer related death in men over 50
adenocarcinoma of prostate
78
what is the most common form of prostate cancer
adenocarcinoma
79
where does adenocarcinoma of the prostate most commonly arise within the prostate
peripheral zone - found on rectal exam
80
what is the most common genetic alteration that can lead to adenocarcinoma of the prostate
chromosomal rearrangement that places the ETS gene (ERG or ETV1) next to TMPRSS2 promotor leads to over-expression
81
how is adenocarcinoma of the prostate monitored after treatment
serum PSA levels
82
what are the two most common sites of metastasis of adenocarcinoma of the prostate
lymph nodes and bone
83
what is the most common bony metastases of adenocarcinoma of the prostate
osteoblastic carcinoma

Disease Mechanisms (19 decks)

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