Exam 2: Males Flashcards
Abnormal urethral orifice risk for
Risk for obstruction or UTI
Abnormal urethral orifice affects
1 in 300
Hypospadias
Ventral (MC)
Epispadias
Dorsal
Epispadias is less common but more
Severe
Epispadias is associated with
Bladder exstrophy
Smegma combined with poor hygiene can lead to
Inflammation
Pain
Infection
Phimosis
Inability to retract prepuce
Balanoposthitis
Prepuce inflammation
Balanitis
Glans penis inflammation
Paraphimosis
Entrapment behind coronal sulcus
Most penile neoplasms are
Squamous cell carcinoma
Risks for penile neoplasms
>40 yo Uncircumcised Smoking Poor hygiene HPV16 and 18 AIDS
Bowen disease
In situ SCC
Solitary
10% invasive
Invasive SCC
Gray Crusted Hardened Irregular boarders Raised or ulcerated
Prognosis of invasive SCC
Lymphatic Mets
<30% 5 year survival
Scrotum cancer is ___, but MC is
Rare
SCC
Hydrocele
Increase serous fluid in tunica vaginalis
MC cause of scrotal enlargement
Hydrocele
Chylocele
Increase in lymph, due to filariasis
Hematocele
Increase in blood
Carriers of W. Bancrofti
Flies
Mosquitoes
Arthropoda
Cryptorchidism
Failure of testicle to descend
MC idiopathic
MC position for cryptorchidism
High scrotal
Cryptorchidism can cause __ and __ by age 5 years old
Atrophy and sterility
___ is a 3-5X risk for testicular cancer
Cryptorchidism
Testicular atrophy can be from
Ischemia Trauma High estrogens Irradiation Chemo therapy
Inflammation of testis
Orchitis
Inflammation of epididymis
Epididymitis
MC unilateral
Diagnosis of cryptorchidism
1 year after birth
___ causes 20% of orchitis in adults
Mumps
Inflammation of testes and epididymis commonly begins as __ and spreads via
UTI
Vas deferens or lymphatics
Testicular torsion
Spermatic cord twisting, obstructing venous drainage
___ is urologic emergency
Testicular torsion
Testicular torsion MC in
Ages 12-18
Bell-clapper deformity
1/3 of testicular torsion ___, but some may need surgical repair if
Spontaneously resolve
Unresolved within 6 hours
Varicocele
Enlarged pampiniform venous plexus of scrotum
Testicular torsion is usually ___ and can lead to ischemia
Unilateral
Varicocele is considered a ___, which can indicate
Malignancy
Testicular or renal cell carcinoma
Testicular neoplasms MC cancer in what group
Males 15-35
Lethality of testicular ca
5% lethal
Risks for testicular ca
Family history
Cryptorchidism
Caucasians
Gonadal dysgenesis
Brother with testicular ca increases your risk by
8-10X
Cancer in contralateral testicle
10% of cases of cryptorchidism progress to
Testicular ca
When serous fluid accumulates in tunica vaginalis
Hydrocele
Who is most likely to develop testicular torsion
Adolescents
Sex cord-stromal tumors
Benign
From serotoli or Leydig cells
Leydig cells produce ___
Testosterone
Germ cell tumors are __ and are from ___
Malignant
Intratubular germ cell neoplasia (in situ)
95% of postpubertal testicular tumors
Germ cell tumors
2 main types of testicular germ cell tumors
Seminomas
Nonseminomatous
Peak patient ages for seminoma
30-40
10% of patients with seminoma have elevated
HCG
2 most aggressive testicular GCT
Embryonal carcinoma
Choriocarcinoma
Teratomas are different in that they affect what age?
All ages
100% of patients with choriocarcinoma have elevated
HCG
90% of patients with yolk sac tumor have elevated
AFP
Peak patient age for yolk sac tumor
3
50% of all GCTs
Seminomas
Soft, gray-white, well demarcated mass with large and uniform cells and round nuclei
Seminomas
4 types of nonseminomatous GCTs
- Embryonal carcinoma
- Choriocarcinoma
- Yolk sac tumor
- Teratoma
Invasive, anaplastic, indistinct borders with no tumor marker
Embryonal carcinoma
Seminomas Mets via
Lymphatics (late mets)
Nonseminomatous GCTs mets via ___ or ___ to what locations?
Lymphatics or hematogenous mets
To liver or lungs
Features of testicular cancer
Painless testicular mass
Non-translucent
Blood in semen
Dull achy pain in groin/abdomen
Urologist specializes in
Male and female urinary tract
Reproductive system of males
Carcinomas of prostate MC found in
Peripheral zone
Hyperplasia of prostate MC found in
Transitional zone
10% of prostatitis is due to
Bacterial infection
MC uropathogen to cause prostatitis
E. coli
Symptoms of prostatitis
LBP Pelvic pain Dysuria Fever Chills Tender DRE
Most prostatitis due to
Chronic non bacterial
Aka prostatodynia or chronic pelvic pain syndrome
Prostatitis can be from infections of what type/location
Blood
Lymph
Urethral/bladder
Rectum
Benign Prostatic Hyperplasia occurs in what location
Transitional zone
BPH is idiopathic, but growth may be dependent on what
Androgen-dependent growth (dihydrotestosteorne)
Onset of BPH
> 40 yo
90% of males are >70 yo
10% of BPH cases are symptomatic, which include
Lower UT
Increase frequency to urinate
Nocturia
Nodules are well-circumscribed in
BPH
Potential consequences of TURP
Incontinence
ED
1/3 of all male cancer diagnoses
Prostate carcinoma
2nd MC cause of cancer-related death in males
Prostate carcinoma
Prostate cancer is a form of
Adenocarcinoma
Risk factors for prostate carcinoma
> 50 yo (MC age 65-75)
High androgens
Caucasian
African Americans
Cancer of prostate is MC to develop at which location
Peripheral zone
Osteoblasts mets to spine describes
Prostate cancer
Malignancies that mets to bone, MC the spine
Breast Lung Thyroid Kidney Prostate
(BLT Kosher Pickle)
Hydronephrosis
Dilation of renal pelvis/calyces
- blocks urine
- atrophy and decrease in function
Acquired hydronephrosis due to
Stone
BPH
Prostate ca
Renal calculus aka
Kidney stone
Renal calculus MC made of
Calcium oxalate
All men ages 55-69 should be screened for prostate cancer via PSA test
False
Congenital hydronephrosis is MC and due to ___ and MC in ___
Atresia
Male infants
Risks for kidney stones
Males Family history Dehydration UTIs Low vitamin A Gout
Staghorn calculus
Upper urinary tract stone
Renal calculus causes __ pain
Flank (refers to groin)
Staghorn calculi made up of
Magnesium ammonium phosphate
Renal colic
Usually unilateral intense pain due to kidney stone slowly traveling down ureter
Deficiency in vitamin A
Kidney stones
Bitot spots
Vitamin A toxicity
Vomiting Weight loss Arthritis HA Dizziness Diplopia
Urinary bladder diverticulum
Invagination of bladder wall
MC acquired
MC small and asymptomatic
Infection risk
Urinary bladder cystitis
Inflammation of urinary bladder due to E. coli (MC)
Suprapubic pain, dysuria, painful sea
Freq of bladder cancer
7% men
3% all cancer-related death
90% of bladder cancer
Urothelial carcinoma
5% bladder cancer
SCC (due to schistosomiasis infections)
Risks for bladder cancer
Age 50-80 Bladder irritation Smoking Urban environments Occupational carcinogens
Risks for cystitis
E. Coli infection Female Sex Reduced outflow Dementia
Bladder cancer is NOT ___ but involves acquired ___ or __ mutations
Familial
TP53 or RB mutations
2 types of urothelial carcinoma in situ
Papillon papillary carcinoma
Flat noninvasive carcinoma
2 types of invasive urothelial carcinoma
Invasive papillary carcinoma
Flat invasive carcinoma
____ decreases risk of progression and recurrence of bladder cancer
Smoking cessation