CP33 - UROGENITAL PATHOLOGY

Question 1

what are other names for enlargement of the prostate?

Answer 1

nodular hyperpleasia

benign prostatic hyperplasia

Question 2

what enlargement of the prostate consist?

Answer 2

consists of overgrowth of the epithelium and fibromuscular tissue of the transition zone and periuretheral area

Question 3

what are known as LUTS?

Answer 3

Lower Urinary Tract Symptoms - symptoms caused by interfering with muscular sphincteric function and by obstruction of urine flow through prostatic urethra

Question 4

what are some examples of LUTS?

Answer 4

urgency, difficulty in starting urination, diminished stream size and force, increased frequency, incomplete bladder emptying, and nocturia.

Question 5

what is nocturia

Answer 5

excessive urination during the night

Question 6

what are the different zones of prostate?

Answer 6

central, peripherial, transitional and periurethral zone

Question 7

what are the 3 pathologic stages of nodular hyperplasia?

Answer 7

nodule formation

diffuse enlargement of transition zone and periurethral tissue

enlargement of nodules

Question 8

what is the aetiology of nodular hyperplasia

Answer 8

It is believed that the main component of the “hyperplastic” process is impaired cell death. It has been proposed that there is an overall reduction of the rate of cell death, resulting in the accumulation of senescent cells in the prostate.

In keeping with this androgens (mainly DHT) which are required for the development of BPH, can not only increase cellular proliferation, but also inhibit cell death.

Question 9

what are some risk factors for prostate carcinoma

Answer 9

> 40 yrs 
african
FH
hormone levels
environmental influences (increased consumptions of fats) 

androgens - important role

Question 10

what are the treatment for prostatic cancer?

Answer 10

surgery, radiation therapy and hormonal manipulations

radial prostatectomy

external-beam radiation therapy, interstitial radition therapy

Question 11

what does androgens do in prostate cancer?

Answer 11

maintaining the growth and survival of prostate cancer cells

Question 12

which genes have a 20-fold increased risk of prostate cancer?

Answer 12

BRCA2

Question 13

which race has the highest risk?

Answer 13

Northern european and lowest in asian and african descent

Question 14

what are the aetiology of testicular germ cell tumours?

Answer 14

Prior TGCT in the contralateral testicle

Cryptorchidism

Impaired spermatogenesis

Inguinal hernia

Hydrocele

Disorders of sex development

Prior testicular biopsy

Testicular atrophy

Question 15

what are the difference between seminoma and teratoma in terms of occurrence period

Answer 15

seminoma - 35-45

teratoma - 1st and 2nd decades of life

Question 16

what are the difference between seminoma and teratoma in terms of presentation

Answer 16

seminoma - testicular enlargement, presence of tumour markers

teratoma - gradual enlargement, pure form does not secrete tumour markers

Question 17

what is the name for inflammation of testis

Answer 17

epididymoorchitis

Question 18

what is idiopathic granulomatous orchitis

Answer 18

Typically in older adults, often with associated symptoms of UTI, trauma, or flu-like illness

testis becomes swollen, painful, and tender initially but later may have a residual mass indistinguishable from a neoplasm, prompting orchiectomy.

Question 19

how does sarcoidosis present in the testis?

Answer 19

Sarcoidosis can affect the testis, and can mimic malignancy, particularly if accompanied by radiologic pulmonary abnormalities

Question 20

how does Malakoplakia of testis present in the testis?

Answer 20

Malakoplakia may affect only the testis, or less commonly, both testis and epididymis, resulting in formation of soft yellow, tan, or brown nodules that replace normal testicular parenchyma

Question 21

how does myofibroblastic pseufotumour of testis present in the testis?

Answer 21

An atypical inflammatory and myofibroblastic reaction with fasciitis-like large cells.

Question 22

how does Sperm Granuloma present in the testis?

Answer 22

An exuberant foreign body giant cell reaction to extravasated sperm, and occurs in up to 42% of patients after vasectomy and 2.5% of routine autopsies. Patients may have no symptoms, but often present with a history of pain and swelling of the upper pole of the epididymis, spermatic cord, and, rarely, the testis.

Question 23

how does tuberculous orchitis present in the testis?

Answer 23

Patients usually present with painless scrotal swelling, but other signs and symptoms include unilateral or bilateral mass, infertility, and scrotal fistula.

Caseating granulomatous inflammation is prominent, with fibrous thickening and enlargement of the epididymis and adjacent structures.

Question 24

what is cryptorchidism

Answer 24

abscess of one or both testis from the scrotum

Question 25

how does cryptorchidism present

Answer 25

These testes most frequently are found in the inguinal canal or upper scrotum; arrest within the abdomen is less frequent.

Congenital: caused by anomalies in anatomic development or hormonal mechanisms involved in testicular descent.

Complications: Testicular atrophy, infertility, carcinoma (TGCTs)