Genito Flashcards
Hypospadias
Opening along the ventral aspect of the penis
Can be constrictive restuling in increased UT infection
Epispadias
Less common opening along the dorsal aspect of the penis
UT obstruction
Urinary incontinence
Penile Squamous cell carcinoma
.4% of male cancers
Uncircumcised men over age 40
Associated with HPV 16/18 infection
Often preced by premalignant lesion, red/white plaque
Bowen Disease
Carcinoma in situ
Squamous cell carcinoma is rare n male when
Circumcised early in life
Squamous cell carcinoma (penile) can metastise to
Inguinal lymph nodes
Cryptorchidism
Incomplete descent of the testis from the abdomen of the scrotum
Crytporchidism may lead to
Sterility
Cryptorchidism can lead to a ________ increased risk of testicular cancer
3-5 fold
Cytprochidism ______ develops within the _____tubules
Intratubular germ cell neoplasia
Atrophic tubules
Orchiepexy
Reduces risk of sterility and cancer
2 common inflammatory lesions of the testis
Epididymitits
Orchitis (testis proper)
Inflammatory lesions of the testes often associated with ______ or a complication from ______
STD
UTI
Torsion
Twisting of the spermatic cord
Torsion can lead to obstruction of
Venous drainage resulting in rapid intense vascular engorgement
Bell clapper deformity
Tunica vaginalis forms bell shape over testis
Testicular neoplasms peak incidence
15-34
Most common cause of painless testicular enlargement
Testicular neoplasms
95% of testicular neoplasm arise from
Germ cells; malignant
5% of testicular neoplasm arise from
Arise from sertoli or Leydic cells; generally benign
Germ cell tumors are divided into 2 groups
Seminomas
Nonseminomatous
Seminomas arise from
Epithelium of the seminiferous tubules
Non-seminomatous tumors
Several types tend to spread early via lymphatic and BV
Non-seminomatous tumor markers
AFP (a-fetoprotein)
HCG (human chorionic gonadotropin)
Prostatitis
Prostate enlarged and tender
Minority cases associated with UTI
Nodular Hyperplasia of the prostate generally affects the
Inner perimeter all zone of the prostate and compresses the prosaic urethra
Nodular hyperplasia of the prostate ______ and ______ proliferation results in. Enlargement +/- urinary obstruction
Stromal
Glandular
Nodular hyperplasia is extremely common and presents as
Hesitancy
Urgency
Nocturnal
Poor urinary stream
Nodular hyperplasia Treatment
Medical management -drugs
Surgical management -TURP
TURP
Transurethral resection of the prostate
Adenocarcinoma of the prostate
Most common cancer of men over 50
Metastasis possible
Low death rate
Carcinoma of the prostate most commonly arise in
The outer glands of the prostate; palatable by digital rectal exam
Elevated serum _______ useful in diagnosis/management of carcinoma of prostate
Prostate specific antigen PSA
However, elevated serum levels can be due to non-neoplasticism conditions
Bladder cancer majority are
Urothelial carcinoma
Most common in men
Painless hematuria
Bladder cancer tumor cells ____ to be detected
She’d into urine to be detect via cytology
Risk factors for bladder cancer
Cigarette smoking
Chronic cystitis
Infection with schistomasisois
Exposure to various caringogens
Urothelial carcinoma
Transurethral resection
Immunotherapy radical cystectomy
Urothelial prognosis
Dependent on tumor grade and stage
Most common STI
Genital herpes
Genital HPV infection
Syphilis caused by
Chronic infection of treponema pallidum
Syphilis transmission
By direct contact with cutaneous or mucosal lesion during early stages; highly infectious
Primary syphilis ——> Secondary—>tertiary
Chancre
Palmar rash
Lymphadenopathy
Condyloma latum
Neuro
Aortitis
Gummas
Primary Syphilis
Painless ulcer - chancre develops at site of inoculation 9-90 days after initial infection
Primarily syphilis resolves
Spontaneous in 4-6 weeks
25% develop secondary disease
Secondary Syphilis
Occurs within 2 months following resolution of primary chancre
Secondary syphilis characterized by
Maculopapular rash affecting skin (palms, soles)
Condylomata Lata and mucous patches
Secondary syphilis resolves
Spontaneous over several weeks and enters the latent phase
1/3 of patients develop tertiary syphilis in 5-20 years
Tertiary syphilis
Aoritis-Cardiovasulcar syphilis
Neurosyphilis-involvement of the brain meninges and spinal cord
Gummas-focal granulomas Osu lesions develop in bone, skin, and mucous membranes of the upper airway and mouth
Congenital syphilis has 3 patterns : transmission across the placent
Stillbirth
Infantile syphilis
Late congenital syphilis
Hutchison’s triad
1) Hutchinson’s teeth (notched incisors mulberry molars)
2) Interstitial keratitis (corneal inflammation possibly blind)
3) Eight cranial nerve deafness
Infantile syphilis
Live born infants with clinical manifestations similar to SECONDARY syphilis at birth or first few months of life
Screening for Syphilis
RPR-rapid plasma reagin
VDRL-Ventral disease research laboratory
Often negative in early stages
15% false positives
Specific syphilis test
FTA
Fluorescent treponema antibody
Remains positive indefinitely even after treatment
Gonorrhea caused by
Neisseria gonorrhoeae
Gonorrhea proves an
Intense suppurations inflammatory reaction
Gonorrhea asymptomatic
Males 40%
Females 80%
Gonorrhea diagnosis
Can be made by culture
Traditionally treated by penicillin
Untreated Gonorrhea can lead to
Sterility
Gonorrhea ascending infection result in male
Acute prostatits
Epididymitis
Orchitis
Gonorrhea ascending infection result in female
Inflammation of the uterus Fallopian tubes and ovaries
-with secondary scarring: Pelvi inflammatory disease
gonococci ophthalmia neonatorum
Infant blindness from gonococci cantimation at birth
No gonococci urethritis and certificates
Most common of STDS respectable to CDC
Chlamydia trachomatis
Chlamydia trachomatis is clinically
Similar to Gonorrhea
Chlamydia is often recognized by
President disease following antibiotic treatment for suspected gonorrhea
Gonorrhea and chlamydia treatment
Ceftriaxone and doxycycline
Complication of chlamydia
Reactive arthritis
Reactive arthritis
Immune mediated condition that develops in response to genitoruinary or GI infections may be complication of C. Trachomatis infection
Reactive arthritis may be seen in combination with
Urthetirs cervicitis conjunctivitis and mucoscutanous lesions
Genital Herpes Simplex most caused by
HSV-2
Less commonly HSV-1
Herpes: Initial infection
Asymptomatic vs painful mucocutaneous eruptions with lymphadenopathy and malaise
Herpes: Recurrent Lesions
Are small painful vesicles that quickly ulcerate
Heal in 7-10 days
HSV actively shed during periods of clinically visible lesions
Neonatal herpes
Occurs in children born to mothers with genital herpes
High mortality
Tzanck Cells
Genital herpes simplex
Viral Cytopathic effect
Ballooning degeneration of epithelial cells with large multinucleated
Human Papillomavirus Infection
Extremely common STD
Responsible for a number of proiliferative lesions on the genital mucosa
Most common: Condyloma acuminatum
Condyloma Acuminatum
Venereal warts
HPV 6 11
Benign papillary nodules frequently in clusters
Can become malignant
Can transfer to fetus
Condyloma acuminatum: Koilocytic change
Papilla proliferation of squamous epithelium
Condyloma acuminatum
Surgical excision laser treatment cryotherapy
Imiquimod
