Diseases of the Prostate, Testis, and Penis

Question 1

The seminiferous tubules are ____________ of each other.

Answer 1

independent

Question 2

The ______________ can fill up with fluid after an injury.

Answer 2

tunica vaginalis

Question 3

The center of the sperm’s flagellum is _______________.

Answer 3

microtubule (hence why Kartagener’s leads to infertility)

Question 4

The “fried egg cells” at the periphery of the seminiferous tubules are _______________.

Answer 4

spermatogonia

Question 5

The most common spot that undescended testes get stuck is ________________.

Answer 5

the superficial inguinal canal

Question 6

Cryptorchidism is most often _____-lateral.

Answer 6

uni

Question 7

What adverse effects may result from cryptorchidism?

Answer 7

Germ cell tumors and testicular atrophy

Note: the risk of germ cell tumor remains elevated after surgical correction of cryptorchidism, but it does go down.

Question 8

Most of the acquired forms of testicular atrophy will display ________________ on histologic examination.

Answer 8

lack of stratification of the spermatogonia with widening lumen

Question 9

End-stage testicular atrophy will show _______________ on microscopy.

Answer 9

“Sertoli-only” syndrome

Question 10

In addition to sclerosis, those with Klinefelter’s will have __________________ in their testes.

Answer 10

no elastic fibers and Leydig cell hyperplasia

Question 11

Part of what makes testicular torsion so painful is ___________________.

Answer 11

that the veins get occluded first and arterial blood still pumps in, raising testicular pressure

Question 12

Epididymitis and orchitis usually result from _______________.

Answer 12

UTIs

Question 13

True or false: mumps orchitis is most often bilateral.

Answer 13

False. 70% of the time it is unilateral.

Question 14

Differentiate orchitis from TB and orchitis from syphilis.

Answer 14

TB: usually affects the epididymis first and then the testes
Syphilis: usually affects the testes first and then the epididymis

Question 15

_______________ causes obliterative arteritis and coagulative of the testes.

Answer 15

Syphilis

Question 16

TB causes ______________ of the testes.

Answer 16

caseating granulomas

Question 17

The vast majority of testicular tumors are ______________.

Answer 17

germ cell tumors (which includes many subtypes)

Question 18

What is the most common presentation of testicular neoplasia?

Answer 18

Painless testicular enlargement

Question 19

If a germ cell tumor fails to develop, it is referred to as ______________.

Answer 19

a seminoma

Question 20

If a germ cell tumor develops, then it can either _________________.

Answer 20

become embryonic (a teratoma) or extra-embryonic (yolk sac)

Question 21

List some features of the most common testicular tumor.

Answer 21

Testis seminoma:

• good prognosis (radiosensitive and chemosensitive)
• fourth decade of life
• serum markers negative

Question 22

Seminomas display what on microscopy?

Answer 22

“Emptying” of the seminiferous tubules with new blood vessels cuffed with lymphocytes

Question 23

Developed testicular tumors (i.e., embryonal) are more often _________________.

Answer 23

mixed with seminoma

Question 24

On gross examination, embryonal tumors will display ________________.

Answer 24

variegation: divets, bumps, heterogeneity

Question 25

Describe how seminomas and embryonal tumors will look under the microscope.

Answer 25

Seminomas: "fried-egg look" | Embryonal tumors: high N:C ratio, crowded, occasional rosettes (because they're trying to form a tubule)

Question 26

_______________ tend to have a cystic appearance.

Answer 26

Teratomas (because teratomas have more mature cells that can form ducts and epithelial lining)

Question 27

Which tumor can make different mature tissues?

Answer 27

Teratomas

Question 28

The most common testicular tumor in children is ______________.

Answer 28

yolk sac tumor

Question 29

Yolk sac tumors make ________________.

Answer 29

alpha-feto protein

Question 30

The most aggressive type of testicular tumor is _____________.

Answer 30

choriocarcinoma (frequent metastasis)

Question 31

A pregnancy test will be positive in a man who has ________________.

Answer 31

choriocarcinoma

Question 32

The most common testicular tumor in men over 60 is _____________.

Answer 32

lymphoma

Question 33

Most Leydig cell tumors are _______________.

Answer 33

benign (although some can have masculinization or feminization)

Question 34

The most common penile malignancy is _________________.

Answer 34

squamous cell carcinoma (of the skin)

Question 35

Normally, the prostate is about the size of a __________.

Answer 35

walnut

Question 36

BPH only occurs in the ________________.

Answer 36

transition zone (in the central prostate)

Question 37

Once again, the seminal vesicles are _____________ to the ducturs deferencs.

Answer 37

lateral

Question 38

What is prostate sand?

Answer 38

Secretions that get trapped in the prostate ducts and calcify (normal with aging)

Question 39

There are two forms of acute and chronic prostatitis: _______________.

Answer 39

bacterial and abacterial

Question 40

The most common etiology of acute prostatitis is _________________.

Answer 40

Escherichia coli from UTI

Question 41

What can cause chronic prostatitis?

Answer 41

Unclear etiology: - diet (amines from cooked red meat) - occult infection

Question 42

BPH presents with enlargement of two of kinds of tissue: _________________.

Answer 42

glandular and stromal

Question 43

How does BPH lead to renal failure?

Answer 43

Post-renal hydrostatic pressure can increase to the point where glomerular filtration is impaired.

Question 44

What are the three leading causes of cancer death in men?

Answer 44

Lung Prostate Colon

Question 45

Prostate cancer most strongly correlates with _____________.

Answer 45

Race (more common in blacks and whites) Age (more common with age) Genetics

Question 46

The gold standard for diagnosing prostate cancer is _______________.

Answer 46

blind, random biopsies (only 50% sensitive)

Question 47

Prostate cancer is multi-_______________.

Answer 47

focal; in fact, some prostate cancers start as multifocal but coalesce together and display molecular heterogeneity

Question 48

Some prostate cancers start as ______________.

Answer 48

intraepithelial neoplasia

Question 49

How is Gleeson scoring done?

Answer 49

You take the highest grade plus the second highest grade and add them together – so the lowest score possible is 2 and the highest is 10.

Question 50

What embryonic tissue gives rise to the prostate?

Answer 50

Posterior urogenital sinus

Question 51

Describe the two layers of epithelium in the prostate.

Answer 51

Basal cuboidal layer and glandular columnar layer

Question 52

How common is BPH?

Answer 52

Very! Roughly 50% of men in their 50s, 60% of men in their 60s, etc.

Question 53

True or false: mumps frequently leads to infertility in males.

Answer 53

False.

Question 54

Which germ cell tumor is more common in older men?

Answer 54

Spermatocytic seminoma (less aggressive)

Question 55

The testicular tumor that has a maze-like network secretes what?

Answer 55

Alpha-fetoprotein (being yolk sac tumor)

Question 56

The transitional zone of the prostate is on the __________ side.

Answer 56

anterior

Question 57

The central zone of the prostate surrounds the ___________.

Answer 57

ejaculatory ducts

Question 58

Importantly, the bone lesions found in prostate cancer are _____________.

Answer 58

osteoblastic, meaning they will be extra dense (as opposed to most other cancers which have osteoclastic/osteolytic bone lesions)

Question 59

Mumps orchitis usually presents _________ after parotid involvement.

Answer 59

1 week

Question 60

Which inflammatory cell types often appear in syphilis?

Answer 60

Plasma cells

Question 61

Testis seminoma is most common in the __________ decade of life.

Answer 61

fourth

Question 62

Which testicular tumor is most common in the third decade of life?

Answer 62

Embryonal

Question 63

The two most common types of testicular tumors in children are ________________.

Answer 63

teratomas and yolk sac tumors

Question 64

How is testicular cancer staged?

Answer 64

I: confined to testis II: spread to retroperitoneal nodes III: spread beyond retroperitoneal nodes