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Gen Path > Exam 3 - Genitourinary Diseases > Flashcards

Exam 3 - Genitourinary Diseases Flashcards

1
Q

What is the most common penile malformation?

A

abnormal location of the distal urethral orifice

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2
Q

Describe hypospadias.

A

urethral orifice opening along the ventral aspect of the penis

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3
Q

What can result from hypospadias?

A

UTI due to constricting

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4
Q

Describe epispadias

A

urethral orifice along the dorsal aspect of the penis

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5
Q

What can result from an epispadia?

A 
UT obstruction
urinary incontinence (leaking urine)
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6
Q

Which is a less common malformation of the penis, hypospadias or epispadias?

A

epispadias

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7
Q

What are the different types of hypospadias?

A 
glanular
subcoronal
distal penile
midshaft
proximal penile
penoscrotal
scrotal
perineal
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8
Q

How can you treat hypospadias or epispadias?

A

reconstruction surgery at 6 mo. old to 1 yr old

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9
Q

What is the most common penile neoplasm?

A

squamous cell carcinoma

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10
Q

What precedes penile squamous cell carcinoma in some cases?

A

premalignant lesions of white plaque-like thickenings, irregular margins or areas of redness. OR
Bowen disease

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11
Q

Who is at risk for squamous cell carcinoma?

A

uncircumcised men over age 40

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12
Q

What type of infection is squamous cell carcinoma associated with?

A

HPV 16/18 infection

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13
Q

Where does metastases of penile squamous cell carcinoma occur?

A

inguinal lymph nodes; distant metastases is not usually common

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14
Q

What is the 5 year survival rate for penile squamous cell carcinoma?

A

66%

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15
Q

What was the first human cancer associated with occupational/environmental factors?

A

Scrotum cancer (chimney sweeps)

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16
Q

What is the most common neoplasm in scrotum cancer?

A

squamous cell carcinoma

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17
Q

Describe cryptorchidism.

A

incomplete descent of the testis from the abdomen to the scrotum

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18
Q

What is the prevalence of cryptorchidism?

A

1% of 1-yr old males

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19
Q

What are the risks of untreated cryptorchidism?

A

sterility

3-5 fold increase for testicular cancer

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20
Q

What surgical procedure can reduce the risk of sterility and cancer in patients with cryptorchidism?

A

orchiopexy - placing the testes in the scrotum.

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21
Q

What area is it more common to find inflammation in the testes?

A

the epididymis as compared to the testis proper

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22
Q

What are some symptoms involved with inflammation of the testes?

A 
swelling
tenderness
complications from UTI
associated with STD
complication of mumps in adults
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23
Q

What vascular disturbance can occur in the testes?

A

torsion - twisting of the spermatic cord

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24
Q

How/Why is the spermatic cord able to twist?

A

It is not anchored to the posterior wall.

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25
Q

What are the risks of torsion in the testes?

A

obstruction of venous drainage –> infarction

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26
Q

What is the prognosis of someone with testicular torsion?

A

If surgical intervention is done within 6 hours, there is a good chance the testis will remain viable.

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27
Q

What is the peak incidence of testicular neoplasms?

A

15-34 yrs of age

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28
Q

What is the most common cause of painless testicular enlargement?

A

testicular neoplasms

29
Q

What cell type do most heterogeneous testicular tumors arise from?

A

95% arise from germ cells and are usually malignant

5% arise from Sertoli or Leydig cells

30
Q

Is there a genetic component to testicular neoplasms?

A

No hereditary pattern, but familial clustering is noted

31
Q

What are the two groups of germ cell tumors?

A

seminomas and non-seminomatous tumors

32
Q

What tissue do seminomas arise from?

A

epithelium of the seminiferous tubules

33
Q

Can seminomas metastasize?

A

They are not aggressive, but can spread via lymphatics

34
Q

What is treatment for seminomas?

A

chemo or radiation

35
Q

Prognosis of seminomas?

A

one of most curable cancers - good!

36
Q

Do non-seminomatous tumors tend to spread?

A

yes, they spread early via lymphatica AND blood vessels

37
Q

What markers are important in diagnosis of germ cell tumors, specifically non-seminomatous tumors?

A

alpha-fetoprotein (AFP)

human chorionic gonadotropin (HCG)

38
Q

What is one type of non-seminomatous tumor?

A

embryonal carcinoma

39
Q

What is the survival/prognosis of germ cell tumors?

A

seminomas - 95% are cured
non-seminomatous - 90% in remission or cured
(like most, better prognosis when caught early)

40
Q

What is the one germ cell tumor that is the exception in terms of prognosis?

A

pure choriocarcinoma –> less chemosensitive

41
Q

Where do non-seminomatous tumors commonly metastasize?

A

liver and lungs

42
Q

What is typical treatment for non-seminomatous tumors?

A

chemo, they are less sensitive to radiation

43
Q

What are the different categories of prostate disorders?

A

inflammatory lesions
nodular hyperplasia
carcinoma

44
Q

What can be some symptoms of prostatitis?

A 
enlarged and tender prostate
UTI infection (E. coli)
dysuria
frequent urination
lower back and pelvic pain
45
Q

What is the etiology of chronic nonbacterial prostatis (chronic pelvic pain syndrome)?

A

etiology is unknown

46
Q

What area of the prostate does nodular hyperplasia affect?

A

inner periurethral zone

47
Q

What is another name for nodular hyperplasia?

A

benign prostatic hyperplasia

48
Q

In whom does nodular hyperplasia occur?

A

can occur in every male to some extent, but prevalence increases with age. (males in 8th decade)

49
Q

What tissues proliferate to cause enlargement in nodular hyperplasia?

A

stromal and glandular tissue - urinary obstruction may occur

50
Q

What are clinical symptoms of nodular hyperplasia?

A

hesitancy, urgency, nocturia, poor urinary stream

51
Q

What is the considered etiology of nodular hyperplasia?

A

hormonal stimulus –> local increase in androgens

52
Q

What is the recommended treatment for nodular hyperplasia?

A

drug treatment

surgical treatment if there is obstruction –> Transurethral Resection of the Prostate (TURP) –> may result in fibrosis

53
Q

What is the most common cancer in men over 50?

A

prostate cancer –>adenocarcinoma

54
Q

Where does adenocarcinoma of the prostate metastasize?

A

lymph nodes and skeleton

55
Q

True or False:

Prostate Adenocarcinoma can be clinically latent or silent.

A

True

56
Q

What is the etiology of carcinomas in the prostate?

A

unknown, but thought to be androgens, genes, and environment

57
Q

What is the most common anatomical area in which prostate carcinomas arise?

A

outer/peripheral glands of the prostate

58
Q

Why are prostate exams needed?

A

you can palpate most carcinomas of the prostate because they are within the peripheral glands of the prostate

59
Q

What is the treatment for prostate cancers?

A

combinations of surgery, radiation, and hormonal therapy

60
Q

Name the antigen observed in serum when diagnosing prostate cancers?

A

prostate specific antigen —> elevated levels can be due to non-neoplastic conditions!!!!!

61
Q

What determines prognosis of prostate cancer?

A

anatomic extent of disease with 98% 10 yr survival rate (10 % if spread)

62
Q

What is the most common type of bladder cancer?

A

urothelial carcinoma

63
Q

List some risk factors for urothelial carcinoma.

A

smoking, chronic cystitis, infection w/ schistosomiasis (parasitic flatworms), carcinogens

64
Q

Symptom of urothelial carcinoma

A

painless hematuria

tumor cells found in urine

65
Q

What are treatment options for urothelial carcinoma?

A

transurethral resection, immunotherapy, radical cystectomy

66
Q

What is bladder cancer usually preceded by?

A

premalignant papillary growth or flat growth.

67
Q

In whom does urothelial carcinoma occur?

A

men between ages 50-80

68
Q

What is prognosis of urothelial carcinoma dependent on?

A

tumor grade and stage (degree of atypia and extent of invasion)

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