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Patho 2 > Chap 21- Lower urinary tract and male genital system > Flashcards

Chap 21- Lower urinary tract and male genital system Flashcards

1
Q

urothelium

A
  • aka transitional epithelium
  • lines ureters, bladder, and urethra (except terminal portion)
  • changes shape when stretched
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2
Q

possible complications in female lower urinary tract

A
  • ureter lies close to uterine a and vulnerable to injury during operations
  • genital tract lose to bladder and makes it possible for disease to spread from one tract to another
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3
Q

bifid ureter

A
  • congenital
  • two ureters arising from one kidney
  • often associated with kidney malformations
  • ureters can remain seperate or join together
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4
Q

ureteropelvic junction obstruction

A
  • congenital or acquired
  • most common cause of hydronephrosis in infants and children
  • causes stagnation of urine
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5
Q

diverticula of ureter

A
  • congenital or aquired
  • dilation, elongation or tortuosity of ureter
  • aquired may be due to calculi, pelvic neoplasm, or pressure on ureter
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6
Q

what are the common causes of cystitis

A
  • e. coli
  • proteus
  • klebsiella
  • enterobacter
  • women more likely than men
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7
Q

cysitis

A
  • either acute or chronic

- bacterial pyelonephritis is frequently preceeded by infection of bladder with retrograde spread

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8
Q

predisposing factors for cystitis

A
  • DM
  • instrumentation
  • immune deficiency
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9
Q

triad of sx of cystitis

A
  • frequency
  • lower abdominal pain
  • dysuria
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10
Q

diseases resulting in cystitis as a secondary complication

A
  • prostatic enlargement
  • cystocele of bladder
  • calculi
  • tumors
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11
Q

bladder and urothelial neoplasms

A
  • most common in bladder
  • highest in men between 50- 80 y/o
  • not familial
  • acquired mutations -> GF receptor signaling cascades
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12
Q

risk factors for bladder cancer

A
  • cigarette smoking**
  • chemical carcinogens
  • long term exposure to analgesics
  • heavy long term exposure to cyclophosphamide
  • irradiation
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13
Q

symptoms of bladder cancer

A
  • painless hematuria**
  • frequency
  • urgency
  • dysuria
  • pyelonephritis or hydronephrosis
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14
Q

morphological patterns of bladder cancer

A
  • papilloma
  • invasive papillary carcinoma
  • flat non-invasive carcinoma
  • flat invasive carcinoma
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15
Q

urethritis classifications

A
  • gonococcal

- non-gonococcal- chlamydia or mycoplasma

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16
Q

urethritis

A
  • often accompanied by cystitis in women and prostatitis in men
  • gonococcal urethritis is first manifestation of venereal disease
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17
Q

sx of urethritis

A
  • pain
  • itching
  • frequency
  • usually warns of more serious disease at higher levels of UGT
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18
Q

seminiferous tubules

A
  • site of germination, maturation, and transportation of sperm cells
  • located within testes
  • surrounded by epithelium called sertoli cells
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19
Q

sertoli cells

A
  • surround seminiferous tubules

- provide protection and nourishment to germ cells

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20
Q

function of testes

A
  • produce sperm and male sex steroids
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21
Q

function of epididymides

A
  • store sperm
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22
Q

function of vas deferens

A

conduct sperm to urethra

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23
Q

function of male sex accessory glands

A

produce seminal fluid that nourishes sperm

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24
Q

function of urethra

A

conduct sperm to outside the male body

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25
Q

function of scrotum

A

provides proper temperature for testes

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26
Q

erectile tissue of the penis

A
  • corpus spongiosum

- two corpora cavernosa

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27
Q

smegma

A
  • oily secretion produced by glans combined with shed skin cells
  • accumulates under foreskin
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28
Q

when does spermatogenesis develop in males

A
  • usually by age 16

- involves HPG axis

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29
Q

adrenarche

A
  • onset of androgen dependent body changes

- causes growth of axillary and pubic hair, body oder, acne

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30
Q

gonadarche

A
  • earliest gonadal changes of puberty

- i.e. testicular enlargement

31
Q

testosterone

A
  • gives males their secondary sex characteristics and sex drive
  • regulates metabolism and protein anabolism
  • inhibits pituitary secretion of gonadotropins
  • promotes K excretion and Na reabsorption
  • male pattern baldness
  • acne
32
Q

semen

A

sperm and ejaculatory fluid from seminal vesicles

33
Q

prostate gland secretion

A
  • secretes fluid that mixes the semen and decreases acidity
  • increases sperm motility
  • prolongs sperm life
34
Q

bulbourethral gland

A
  • aka cowpers gland

- secretes alkaline fluid in urethra to neutralize acidity caused by urine transport

35
Q

phimosis

A
  • foreskin cannot be retracted from glans penis
  • d/t poor hygiene, infections, and carcinoma
  • can lead to urinary obstruction and pain
36
Q

paraphimosis

A
  • foreskin is retracted and cannot be returned over glans penis
  • penis becomes constricted and edematous
  • medical emergency
  • can cause gangrene
37
Q

hypospadias and epispadias

A
  • abnormal urethral opening
  • d/t malformation of urethral groove and urethral canal
  • may be associated with failure of abnormal descent of testes and other malformations of urinary tract
  • causes urinart tract obstruction and UTI
  • cause of sterility
38
Q

hypospodias location

A

opening on ventral surface of penis

39
Q

epispadias

A

opening on dorsal surface of penis

40
Q

varicocele

A
  • dilation of veins in spermatic cord

- d/t inadequate or absent valves in spermatic veins

41
Q

hydrocele

A
  • scrotal swelling d/t collection of fluid in tunica vaginalis
  • imbalance between fluid secretion and reabsorption
42
Q

tunica vaginalis

A

serous membrane that covers testes

43
Q

spermatocele

A
  • painless diverticulum of epididymis located between head of epididymis and testis
  • contains milky fluid with sperm
44
Q

what types of conditions are associated with the epididymis

A

inflammatory diseases

45
Q

cryptorchidism

A
  • complete or partial failure of intra-abdominal testes to descend into scrotal sac
  • assoc with testicular dysfunction and cancer
  • should be completely descended by end of 1st year
46
Q

risk factors for cryptorchidism

A
  • prematurity and low birth weight
  • familial history of genital dev
  • maternal alcohol use or cigarette smoking during pregnancy
  • exposure to second hand smoke during pregnancy
47
Q

phases of testicular descent

A
  • transabdominal phase
  • inguinoscrotal phase
  • testes can get stuck in either phase in cryptorchidism
48
Q

complications of crytorchidism

A
  • sterility

- testicular cancer

49
Q

testicular torsion

A
  • twisting of spermatic cord
  • cuts off venous drainage of testes
  • surgical emergency because can cause testicular infarction
  • sudden onset of testicular pain
50
Q

cause of testicular torsion

A
  • bell clapper abnormality- bilateral anatomic defect that leads to increased mobility of testes
  • testes don’t get attached to posterior wall of scrotum
51
Q

testicular tumor classifications

A
  • germ cell tumors (majority)
  • sex- chord stromal tumors
  • germ cell tumors further divided into seminomas or non-seminomas
52
Q

seminomas

A
  • most common type of germ cell tumor
53
Q

causes of testicular tumors

A
  • environmental factors

- genetic factors

54
Q

dysgerminoma

A

he ovarian tumor that is similar to testicular tumors

55
Q

what is the peak incidence of testicular tumors

A
  • usually in men 15-34
  • peak in third decade
  • cause 10% of all cancer deaths
56
Q

pathogenesis of testicular tumors

A
  • originate from intratubular germ cell neoplasia (ITGCN)
  • retain expression of transcription factors OCT3/4 and NANOG
  • biologic markers= hCG, AFP, LDH
57
Q

what do OCT3/4 and NANOG normally do

A

maintain pluripotent stem cells

58
Q

clinical features of testicular tumors

A
  • painless enlargement of testis

- any solid testicular mass should be considered neoplastic until proven otherwise

59
Q

how does testicular cancer spread

A
  • lymphatic spread to retroperitoneal and para-aortic nodes -> mediastinal and supraclavicular nodes
  • then hematogenous to lungs
60
Q

zones of the prostate

A
  • peripheral zone
  • central zone
  • transitional zone
  • periurethral zone
61
Q

where do most prostatic hyperplasias occur

A

transitional zone

62
Q

where doe most prostatic carcinomas occur

A

peripheral zone

63
Q

BPH

A
  • most common benign prostatic disease in men >50

- nodular hyperplasia in periurethral region -> partial or complete urethral obstruction

64
Q

pathogenesis of BPH

A
  • testosterone converted to DHT by 5 alpha reductase
  • binds to androgen receptors in stromal and epithelial cells
  • binding -> growth and proliferative pathway activation
65
Q

clinical features of BPH

A
  • urinary obstruction, bladder hypertrophy and distention
  • frequency, noturia
  • difficulty in starting and stopping urine stream
  • overflow dribbling
  • dysuria
  • increased UTI risk
66
Q

treatment for mild cases of BPH

A
  • decrease fluid intake esp before bedtime
  • moderating intake of alcohol and caffeine
  • timed voiding schedules
67
Q

prostate cancer

A
  • adenocarcinoma is most common form of cancer in men
  • tied with colorectal cancer mortality
  • occurs in 20% of men in 50s
  • occurs in 70% of men 70- 80 y/o
68
Q

pathogenesis of prostate cancer

A
  • largely unknown
  • associated with androgen levels, age, and race
  • african americans have higher risk
  • environmental factors like charred red meat are associated
  • family history
  • increased fat consumption
69
Q

what are protective factors against prostate cancer

A
  • soy

- vit D

70
Q

mutations associated with prostate cancer

A
  • short CAG repeats
  • BRACA2
  • hypermethylation of glutathione S- transferase gene
71
Q

what is the prostatic cancer precursor lesion

A
  • prostatic intraepithelial neoplasia (PIN)
72
Q

clinical course of prostate cancer

A
  • if localized is asymptomatic
  • discovered based on rectal exam or elevated PSA
  • arise in periphery so urinary sx occur late
73
Q

PSA

A
  • prostate specific antigen
  • used to dx and manage prostate cancer
  • estimates pt treatment response

Patho 2 (15 decks)

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