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GM System Path 2 > Exam 2 - Men > Flashcards

Exam 2 - Men Flashcards

1
Q

If a patient comes in with an abnormal urethral orifice on the underside of the penis what is it

A

Hypospadias

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2
Q

If a patient comes in with an abnormal urethral orifice on the dorsal side of the penis what is it called

A

Epispadias

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3
Q

What other problem can result from an abnormal urethral orifice

A

Risk for obstruction or UTi

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4
Q

What is more common hypospadias or epispadias, and which is more severe

A

Hypospadias is mc and epispadias is more sever

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5
Q

How do you treat abnormal urethral orifice

A

Reconstruction

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6
Q

If a patient comes in with an accumulation of dead skin and moisture that causes penile inflamation what is this

A

Poor hygeine causing smegma

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7
Q

What can produce smegma

A

Trauma and infections

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8
Q

A patient comes in with penile inflammation of the glans what is it called

A

Balanitis

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9
Q

A patient comes in with penile inflammation of the prepuce (foreskin) what is the dx name

A

Balanoposthitis

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10
Q

Patient comes in with an inability to retract the foreskin what is this condition called

A

Phimosis

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11
Q

How does a patient usually get phimosis

A

Mc its acquired, rarely congenital

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12
Q

Where is the likely location of paraphimosis

A

Entrapped/retracted foreskin behind the coronal sulcus

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13
Q

What are the symptoms of paraphimosis

A

Erythema, pain, odor

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14
Q

What are the risks that come along with balanitis or phimosis

A

Poor hygiene, no circumcision

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15
Q

What type of penile neoplasm is most common

A

Squamos cell carcinoma

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16
Q

Who is most likely to get a penile neoplasm

A

> 40 years, uncircumcised, poor hygeine, HPV 16/18, AIDS, smoking

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17
Q

Patient comes in with penile neoplasm SCC “in situ” (does not penetrate BM) which is solitary and on the shaft what is the condition

A

Bowen disease

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18
Q

Where does the penile neoplasm that is invasive SCC most likely located

A

Glans or prepuce

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19
Q

Patient comes in with an apparent neoplasm (irregular borders) on the glans/prepuce that is gray/crusted and raised/ulcerated

A

Invasive SCC penile neoplasm

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20
Q

Which penile neoplasm has lymphatic mets with <30% 5 year survival

A

Invasive SCC

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21
Q

What is the removal of invasive penile SCC called

A

Penectomy, perineal urethrostomy

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22
Q

What is the usual cause of inflammation of the scrotum

A

Fungal infex or dermatoses

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23
Q

What is the most common form of scrotum neoplasia

A

Rare but SCC is MC

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24
Q

Patient comes in with an increase in serous fluid in tunica vaginalis what is the condition

A

Hydrocele of the scrotum

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25
Q

What is the mc cause of scrotal enlargement

A

Hydrocele (increase in serous fluid in tunica vaginalis)

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26
Q

What are common causes of hydrocele of scrotum

A

Infx, tumor, idiopathic

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27
Q

How does one dx scrotum hydrocele

A

Transluminescence

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28
Q

What is the condition of blood in the scrotum

A

Hematocele

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29
Q

What is the condition of increased lymph in the scrotum

A

Chylocele

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30
Q

What is elephatiasis of the scrotum

A

Filariasis

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31
Q

How would one get filariasis of the scrotum

A

Flies, mosquitos, arthropods

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32
Q

What is the causitive organism of filariasis

A

Filariodea spp. (Round worms) = wuchereria bancroftii

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33
Q

A patient has a failure of a testicle to descend what is the condition

A

Cryptorchidism

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34
Q

Where is cryptorchidism mc

A

Mc in high scrotum and decreases liklihood up inguinal canal/abadomen

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35
Q

When is cryptorchidism liikley dx

A

At age 1 year

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36
Q

Is cryptorchidism likely to be bilateral

A

No only 10%

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37
Q

By age 5 what are consequences of cryptorchidism

A

Atrophy and sterility

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38
Q

What is tx of cryptorchidism

A

Repositioning (orchipexy) to decrease CA risk

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39
Q

What is CA risk of cryptorchidism

A

Risk for testicular CA = 3-5x risk

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40
Q

Why does cryptorchidism cause testicular atrophy

A

Ischemia, trauma, increased estrogen along with chemo/irradiation

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41
Q

What is inflammation of the testis called

A

Orchitis

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42
Q

What is inflammation of the epidiymis

A

Epididymitis

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43
Q

What can happen with orchitis

A

Pain, bloody ejaculation, edema

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44
Q

What is a consequence of epididymis

A

Pain, fever, mc unilateral

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45
Q

How does inflammation of the testis/epididymis usually begin

A

Usually as UTI

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46
Q

A patient comes in complaining of testicular inflammation and mentions that a few days ago he had a UTI what happened

A

The UTI spread via vas deferens/lymphatics causing acute onset of neutrophils, edema, tender

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47
Q

What else can cause inflamm of testis/epididymis

A

STD’s, mumps, TB, autoimmune

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48
Q

What type of orchitis can cause necrosis and eventually sterility

A

Mumps virus in adults

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49
Q

What does TB do to testi/epididymis inflamm

A

Caseous granulomas

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50
Q

A patient comes in and you realize that there is engorgement, pain caused by spermatic cord twisting what is the condition

A

Testicular torsion

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51
Q

What condition can obstruct venous damage, has a risk for infarction and must be untwisted within 6 hours

A

Testicular torsion

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52
Q

What type of testicular torsion takes place in utero or perinatally

A

Neonatal testicular torsion

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53
Q

What effect anatomically does neonatal testicular torsion have

A

No anatomical defect

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54
Q

What type of testicular torsion is mc

A

Adult

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55
Q

What type of testicular torsion happens around age 12-18

A

Adult testicular orsion

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56
Q

What deformity comes as a result of adult testicular torsion

A

Bell clapper deformity

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57
Q

What is varicocele within the scrotum

A

Enlarged pampiniform venous plexus of the scrotum

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58
Q

What can cause a varicocele of the scrotum

A

Abdominal malignancy mc is renal cell carcinoma

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59
Q

Who is most likely impacted by testicular neoplasia

A

Ages 15-34 caucasians with family hx

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60
Q

What are other testicular neoplasia risks besides age 15-34, caucasian, family hx

A

Gonadal dysgenesis/androgen insensitivity, cryptorchidism in 10% of cases

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61
Q

Which testicular neoplasia is benign and is from sertoli and leydig cells

A

Sex cord stromal tumors

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62
Q

What is 95% of postpubertal testicular tumors

A

Germ cell tumors (GCT’s)

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63
Q

What type of testicular neoplasia is malignant and from intratubular germ cell neoplasia (in situ)

A

Germ cell tumors

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64
Q

What are two types of GCT’s

A

Seminomas, nonseminomatous GCT’s

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65
Q

What is the peak patient age of those with seminoma tumor

A

30-40 yrs

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66
Q

What type of GCT is 50% of all with a more favorable prognosis

A

Seminomas

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67
Q

Which GCT has 10% increase of hCG which is a tumor marker

A

Seminomas

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68
Q

What are the characteristics of seminomas mass

A

Soft, well demarcated, gray/white

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69
Q

What are characteristics of seminomas cells

A

Large, uniform, round nuclei, few lymphocytes

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70
Q

What type of testicular neoplasia is described as having large round cells, mass has distinct borders

71
Q

What are types of nonseminomatous GCT’s

A

Embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma

72
Q

What type of nonseminomatous GCT is invasive, anaplastic with indistinct borders affecting ages 20-30 with no tumor marker

A

Embryonal carcinoma

73
Q

3 year old Patient comes in with a large anaplastic mass that a doctor says is favorable what is it

A

Nonseminomatous GCT yolk sac tumor

74
Q

What nonseminomatous GCT is a small mass and affects those from 20-30 with increased hCG

A

Choriocarcinoma

75
Q

What type of GCT is a firm mass of all germ cell layers of all ages

A

Nonseminomatous Teratoma

76
Q

What type of GCT is hemorrhagic

A

Nonseminomatous GCT (embryonal carcinoma) with undifferentiated indistinct borders

77
Q

What type of testicular cancer is large and palpable indicated a well contained mass

78
Q

What testicular cancer has late lymph mets and is radiosensitive

79
Q

What type of testicular cancer is small and less palpable

A

Nonseminomatous GCT

80
Q

What type of testicular cancer has a lymph/hemtaogenous mets and earlier mets of liver/lungs

A

Nonseminomatous GCT

81
Q

What are features of testicular cancer

A

Painless mass, non translucent, blood in semen, dull achy pain in groin/abdomen

82
Q

What is the treatment of testicular cancer

A

Radical orchiectomy, assumed malignancy

83
Q

What pathology is usually located in the peripheral zone of a prostate

A

Carcinomas

84
Q

What pathology is usually located in the transitional zone of the prostate

A

Hyperplasia = BPH

85
Q

What is the examination technique for the prostate

A

Digital rectal examination

86
Q

What type of prostatis is infection with common uropathogens

A

Bacterial prostatitis

87
Q

What are symmptoms of bacterial prostatis

A

LBP, dysuria, pyrexia/chills, tender DRE

88
Q

What prostatis is 90-95% of the tme

A

Chronic nonbacterial aka chronic pelvic pain syndrome/ prostatodynia

89
Q

What type of prostatis is evaluated with DRE, sequential specimens, NIH outcome measures

A

Chronic non bacterial

90
Q

What type of prostatis is of unknown prevalence that has leukocytes in prostatic secretions

A

Asymptomatic

91
Q

Patient comes in complaining of prostate issues and its said they have andorgen dependent growth what is it

A

Benign prostatic hyperplasia

92
Q

Who is likely to get BPH

A

> 40 years old, 90% are .70 years old

93
Q

What are the possible BPH symptoms within the 10% symptomatic ones

A

Urethral obstruction, difficulty starting/maintaining stream, increase frequency/urgency, nocturia

94
Q

Patient comes in with glandular hyperplasia and nodules that are well circumscribed

A

BPH (more advanced)

95
Q

What are common treatments of BPH

A

Watchful waiting (MC), DHT inhibition, smooth muscle relaxants, TURP

96
Q

What treatment of BPH is abbreviated TURP

A

Transurethral resection of prostate

97
Q

What does TURP used for

A

Incontinence, erectile dysfunx

98
Q

What is nearly 1/3 of all male CA diagnosies

A

Carcinoma of the prostate

99
Q

What is the 2nd MC cause of CA related death in males

A

Carcinoma of prostate

100
Q

What is the carcinoma of the prostate that is a firm mass with ill defined borders and may/maynot be palpable

A

Adenocarcinoma

101
Q

What are the risk factors for carcinoma of the prostate

A

> 50 (mc 65-75), increased androgens, AA or asian descent

102
Q

What is the aggressiveness like of carcinomas in the prostate

A

Mc indolent

103
Q

Where are most carcinomas of the prostate located

A

80% in peripheral zone

104
Q

Where can carcinoma of the prostate mets to

A

Spine and is osteoblastic

105
Q

What is an indicator of carcinoma of the prostate

A

Increase PSA

106
Q

What info is needed for online risk assessment for prostate ca

A

> 55 years old, no past prostate CA, DRE and PSA results of past year

107
Q

What condition is a dilation of the renal pelvis/calyces

A

Hydronephrosis

108
Q

What causes the dilation of hydronephrosis

A

Obstruction blocks the urine =dilation = decrease funx, possible atrophy

109
Q

What type of hydronephrosis is mc and is atresia in male infants

A

Congenital

110
Q

What type of hydronephrosis has stones, BPH, prostate ca

111
Q

Is a unilateral obstruction of hydronephrosis significant

112
Q

What does bilateral obstruction of ureters mean

A

Polyuria (incomplete) or anuria (complete)

113
Q

What is the mc cause of renal calculus

A

Calcium oxalate

114
Q

What are symptoms of renal calculus

A

Ureter pain = flank pain to groin that is intermittent and severe

115
Q

Who is at risk for renal calculus

A

Male, fam hx, dehydration, uti’s, gout

116
Q

A decrease in what vitamin can be a risk for renal calculus

A

Decrease in vitamin A

117
Q

How long does a renal calculus take to pass

A

Within 2 weeks

118
Q

What is an upper urinary tract stone that is massive and cast of renal pelvis

A

Staghorn calculus

119
Q

What is staghorn calculi mc from

A

Mc from recurrent uti’s

120
Q

What stones make up staghorn calculi

A

Magnesium ammonium phosphate

121
Q

What does a vitamin A deficiency produce

A

Kidney stones and bitot spots

122
Q

What condition has a blind ended pouch in the bladder wall that is usually small and asymptomatic but carries an infection risk

A

Diverticulum

123
Q

How does one get urinary bladder diverticulum

A

Mc obstruction from Urethral obstruction

124
Q

What condition is inflammation of the urinary bladder caused by bacterial infx (ecoli), chemo

125
Q

What are symptoms of cystitis

A

Suprapubic pain, urinary frequency, painful sex

126
Q

What bladder cancer is mc urothelial carcinoma or squamos cell carcinoma

A

Urothelial carcinoma (90%)

127
Q

What bladder cancer is common in egypt

A

Schistosoma infections of squamos cell carcinoma

128
Q

What are risks of bladder cancer

A

Male 50-80, chronic infx, smoke, urban environments, occupational carcinogens

129
Q

What mutation is associated with bladder cancer

A

Acquired tP53 mutation, not familial

130
Q

What condition of the bladder has a high recurrence and painless hematuria

A

Bladder ca

131
Q

How do you dx bladder cancer

132
Q

What can decrease the risk of progression/recurrence of bladder cancer

A

Smoking cessation

133
Q

What is the mc std within us

A
  1. Genital herpes and 2. Hpv (do not require CDC notification)
134
Q

What std is caused by treponema pallidium

135
Q

What happens in someone that has syphilis about 9-90 days after contact

A

Chancre (stage 1)

136
Q

What are the risks of syphilis

A

AA, homosexual males

137
Q

What happens in tertiary syphilis

A

Neurosyphilis

138
Q

How long does syphilis take to resolve

139
Q

What is a skin symptom of secondry syphilis

A

Mucocutaneous lesions

140
Q

What part of syphilis has coagulative necrosis, leukocytes and impact bones, skin, airways

141
Q

How does a baby get congential syphilis

A

Crosses placenta

142
Q

If left untreated what happens with congenital syphilis

A

40% lethality in utero

143
Q

What congenital syphilis has skeletal deformation, hepatomegaly, pancreatic fibrosis, pneumonitis, spirochetes in all tissues

A

Stillbirth

144
Q

What congenital syphilis impacts cutaneous, visceral and skeletal

145
Q

What congenital syphilis impacts facial, dental, skeletal/periosteal

146
Q

What deformities are common with congenital syphilis

A

Saddle nose deformity, periostitis (saber shin)

147
Q

What teeth deformities is associated with congenital syphilis

A

Hutchinson’s teeth, mulberry molars

148
Q

What is the 2nd mc reportable std

149
Q

What organism causes gonorrhea

A

Neisseria gonnorhoeae

150
Q

When does gonorrhea take hold

A

2-7 days post infx

151
Q

What are symptoms of gonorrhea in males

A

Urethritis, epididymitis, orchitis, prostatitis

152
Q

What are symptoms of gonorrhea in women

A

Lower pelvic pain, vaginal discharge, salpingitis

153
Q

Who has less obvious features of gonorrhea

154
Q

What does disseminated infex of gonorrhea do

A

Arthritis, tenosynovitis, skin lesions, rarely endocarditis/meningitis

155
Q

Transcervical infection from gonorrhea can lead to what

A

Neonatal conjunctivitis

156
Q

What can gonorrhea cause that is a risk of blindness in newborns

A

Neonatal conjunctivitis

157
Q

What is caused by flagellated protozoa trichomonas vaginalis

A

Trichomoniasis

158
Q

What are symptoms of trichomoniasis

A

Urethritis, prostatitis, balanitis with yellow/green discharge, laodorous

159
Q

Who are more likely to be symptomatic from trichomoniasis

160
Q

What is the mc bacterial std in the U.S. and what causes it

A

Chlamydia and chlamydia trachomatis

161
Q

What can chlamydia stimulate

A

Reactive arthritis (+HLA-B27)

162
Q

What type of std can produce regional lymphadenopathy within 1st month

A

Lymphogranuloma venereum

163
Q

What causes lymphogranuloma venereum

A

Chlamydia trachomatis

164
Q

What does haemophilus ducreyi cause

165
Q

What is the latency of chancroid

166
Q

What std is associated with prostitues and hiv within africa, SE asia

167
Q

What std is caused by klebsiella granulomatis

A

Granuloma inguinale (aka donovanosis)

168
Q

What are symptoms of granuloma inguinale

A

Painless ulcerations for 10-40 days post infx

169
Q

Who gets granuloma inguinale

A

Mc in tropics, multiple sex partners

170
Q

What can happen if a granuloma inguiinale is left untreated

A

Lymphatic fibrosis/obstruction

171
Q

What type of HPV affects the penis, vulva, cervical, or anus

172
Q

What type of std is commonly presented with squamos cell proliferatins, pre neoplastic lesions of condylomata acuminata

173
Q

How is HPV transmitted

A

Oral or transcervical infx

GM System Path 2 (5 decks)

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