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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
function of scrotum
provides proper temperature for testes
26
erectile tissue of the penis
- corpus spongiosum | - two corpora cavernosa
27
smegma
- oily secretion produced by glans combined with shed skin cells - accumulates under foreskin
28
when does spermatogenesis develop in males
- usually by age 16 | - involves HPG axis
29
adrenarche
- onset of androgen dependent body changes | - causes growth of axillary and pubic hair, body oder, acne
30
gonadarche
- earliest gonadal changes of puberty | - i.e. testicular enlargement
31
testosterone
- 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
semen
sperm and ejaculatory fluid from seminal vesicles
33
prostate gland secretion
- secretes fluid that mixes the semen and decreases acidity - increases sperm motility - prolongs sperm life
34
bulbourethral gland
- aka cowpers gland | - secretes alkaline fluid in urethra to neutralize acidity caused by urine transport
35
phimosis
- foreskin cannot be retracted from glans penis - d/t poor hygiene, infections, and carcinoma - can lead to urinary obstruction and pain
36
paraphimosis
- foreskin is retracted and cannot be returned over glans penis - penis becomes constricted and edematous - medical emergency - can cause gangrene
37
hypospadias and epispadias
- 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
hypospodias location
opening on ventral surface of penis
39
epispadias
opening on dorsal surface of penis
40
varicocele
- dilation of veins in spermatic cord | - d/t inadequate or absent valves in spermatic veins
41
hydrocele
- scrotal swelling d/t collection of fluid in tunica vaginalis - imbalance between fluid secretion and reabsorption
42
tunica vaginalis
serous membrane that covers testes
43
spermatocele
- painless diverticulum of epididymis located between head of epididymis and testis - contains milky fluid with sperm
44
what types of conditions are associated with the epididymis
inflammatory diseases
45
cryptorchidism
- 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
risk factors for cryptorchidism
- 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
phases of testicular descent
- transabdominal phase - inguinoscrotal phase - testes can get stuck in either phase in cryptorchidism
48
complications of crytorchidism
- sterility | - testicular cancer
49
testicular torsion
- twisting of spermatic cord - cuts off venous drainage of testes - surgical emergency because can cause testicular infarction - sudden onset of testicular pain
50
cause of testicular torsion
- bell clapper abnormality- bilateral anatomic defect that leads to increased mobility of testes - testes don't get attached to posterior wall of scrotum
51
testicular tumor classifications
- germ cell tumors (majority) - sex- chord stromal tumors - germ cell tumors further divided into seminomas or non-seminomas
52
seminomas
- most common type of germ cell tumor
53
causes of testicular tumors
- environmental factors | - genetic factors
54
dysgerminoma
he ovarian tumor that is similar to testicular tumors
55
what is the peak incidence of testicular tumors
- usually in men 15-34 - peak in third decade - cause 10% of all cancer deaths
56
pathogenesis of testicular tumors
- originate from intratubular germ cell neoplasia (ITGCN) - retain expression of transcription factors OCT3/4 and NANOG - biologic markers= hCG, AFP, LDH
57
what do OCT3/4 and NANOG normally do
maintain pluripotent stem cells
58
clinical features of testicular tumors
- painless enlargement of testis | - any solid testicular mass should be considered neoplastic until proven otherwise
59
how does testicular cancer spread
- lymphatic spread to retroperitoneal and para-aortic nodes -> mediastinal and supraclavicular nodes - then hematogenous to lungs
60
zones of the prostate
- peripheral zone - central zone - transitional zone - periurethral zone
61
where do most prostatic hyperplasias occur
transitional zone
62
where doe most prostatic carcinomas occur
peripheral zone
63
BPH
- most common benign prostatic disease in men >50 | - nodular hyperplasia in periurethral region -> partial or complete urethral obstruction
64
pathogenesis of BPH
- testosterone converted to DHT by 5 alpha reductase - binds to androgen receptors in stromal and epithelial cells - binding -> growth and proliferative pathway activation
65
clinical features of BPH
- urinary obstruction, bladder hypertrophy and distention - frequency, noturia - difficulty in starting and stopping urine stream - overflow dribbling - dysuria - increased UTI risk
66
treatment for mild cases of BPH
- decrease fluid intake esp before bedtime - moderating intake of alcohol and caffeine - timed voiding schedules
67
prostate cancer
- 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
pathogenesis of prostate cancer
- 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
what are protective factors against prostate cancer
- soy | - vit D
70
mutations associated with prostate cancer
- short CAG repeats - BRACA2 - hypermethylation of glutathione S- transferase gene
71
what is the prostatic cancer precursor lesion
- prostatic intraepithelial neoplasia (PIN)
72
clinical course of prostate cancer
- if localized is asymptomatic - discovered based on rectal exam or elevated PSA - arise in periphery so urinary sx occur late
73
PSA
- prostate specific antigen - used to dx and manage prostate cancer - estimates pt treatment response

Patho 2 (15 decks)

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