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BHP Exam 4 > Genitourinary 2 > Flashcards

Genitourinary 2 Flashcards

1
Q

What leads to nonfunctional testes?

A

lack of descent of testes into scrotum

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2
Q

When does the descent begin? When does the testes really start to move?

A

7 mos. of gestation

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3
Q

Where does the testes migrate down through and what is it guided by during its descent?

A

migrates through inguinal ring into scrotum, guided by gubernaculum

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4
Q

cryptorchidism

A

no descent into scrotum; maldescent of testes

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5
Q

percent of testes migration fails; arrested somewhere along the route

A

4%

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6
Q

where is the most common location where the testes arrests during maldescent?

A

inguinal ring/canal

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7
Q

What percent is the maldescent of testes unilateral (just one testes fails to descend)?

A

75%

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8
Q

What causes maldescent of testes?

A

genetic + environmental factors

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9
Q

Atrophy and sterility are common if testes don’t descend, unless it is corrected by what age?

A

age 2

even after surgical correction, greatly increased incidence of germ cell tumors (seminoma + embryonal carcinoma)

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10
Q

orchitis

A

infection of the testes

  • if bilateral, may result in sterility
  • often associated with infection from epididymis (epididymitis)
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11
Q

3 testes infections + a rare one

A
  1. acute bacterial epididymoorchitis
  2. viral orchitis
  3. TB epididymorchitis
  4. tertiary syphilis- rare, gumma formation
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12
Q

viral orchitis

A

forms mumps, occurs after puberty

-if bilateral after puberty, infertility and sterility possible

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13
Q

testicular tumors

A

high proportion seen in early adult life (20-45 years)

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14
Q

2 groups of testicular tumors

A

1 germ cell

2 sex cord stromal tumors

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15
Q

germ cell testicular tumors

A

malignant, 97 % more common, derived from multipotential germ cells of testes

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16
Q

sex cord stromal testicular tumors

A

3% of tumors, benign, from specialized support cells of testis

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17
Q

seminoma

A

common in mid 30s

- painless, progressive enlargement of ONE testes (rarely bilateral)

18
Q

**what is the most common malignant testicular tumor (50% of malignant germ cell tumors?

A

seminoma

19
Q

prostate anatomy

A
  1. peripheral zone- location of carcinomas
  2. transitional zone- location of hyperplasia
  3. central zone
  4. periurethral zone
20
Q

prostate gland pathology

A
  1. benign prostate hypertrophy (BPH)

2. prostate cancer- adenocarcinoma

21
Q

older men and Benign prostate hypertrophy

A
  • almost always enlargement of prostate most commonly due to BPH
  • obstruction of urinary flow in the prostatic part of the urethra
  • rarely, the obstruction is caused by carcinoma
22
Q

Benign prostatic hypertrophy (BPH)

A
  • most common disorder of the prostate
  • affects almost all men over 70 yrs
  • more often, more severe in 45yr olds
  • difficulty w/ micturation (frequency, hesitancy, dysuria) due to compression of prostatic urethra by the enlarged prostate gland
23
Q

*What is the most frequent cause of urinary tract obstruction?

A

Benign Prostatic hypertrophy

24
Q

What is the part of the prostate most sensitive to hormones

A

periurethral group of glands

25
Q

not a risk factor for carcinoma, but can coexist w/ it

A

Benign Prostatic hypertrophy

26
Q

Gross BPH

A
  • rubbery, nodular enlargement especially the periurethral and transitional zones
  • some cystic dilations that have calcifications causing corpora amylacea
27
Q

urinary tract obstruction and does not relate to cancer

A

Benign prostate hypertrophy

28
Q

prostate cancer (adenocarcinoma)

A

increasing frequency after age 55

  • 70% of men > 70 yrs
  • occurs in periphery zone- delays symptoms (difficulty w/ micturition) until tumor is well established
29
Q

what is the 2nd most common type of cancer death in males?

A

prostate cancer (adenocarcinoma)

30
Q

What approach to prostate cancer gives the most accurate finding?

A

transrectal approach b/c of local spread through the capsule before it infiltrates medially towards the urethra

31
Q

preventative strategy for prostate cancer?

A

NO primary preventative strategy so screening is paramount

- latenet behavior= 90%= incidental findings are confined to the prostate

32
Q

histology of prostate cancer

A

gleason system= usually well differentiated glandular pattern w/ epithelial cells w/ clear cytoplasm forming gland like spaces
-well differentiated glands are back to back

33
Q

prostate cancer metastasis

A

1st manifestation is vertebral spread w/ spinal cord compression

34
Q

most common location of prostate cancer metastasis?

A

BONE (radiodense + radioluscent)

35
Q

tumor marker for prostate cancer

A

serum prostate specific antigens (PSA)

36
Q

serum prostate specific antigens (PSA)

A

serum/tissue prostate specific phosphatase

  • PSA is not specific= does not distinguish b/w aggressive and indolent types or other cancers
  • PSA is low in some men w/ prostate cancer
37
Q

Bowen disease

A

-single erythematous plaque
-shaft or scrotum
-usually uncircumsized
- median 5th decade
10% evolve into invasive carcinoma

38
Q

Bowenoid papulosis

A
  • carcinoma in situ
  • multiple verrucoid lesoins resembling condyloma acuminatum (HPV 16)
  • histologically resembles Bowen disease and erythroplasia of Queyrat, but younger age group affected
  • *premalignant, but not reported to result in invasive carcinoma
39
Q

squamous cell carcinoma

A
  • most typical carcinoma of the entire genital region

- cauliflower appearance w/ bleeding

40
Q

erythoplasia of queyrat

A

single erythematous plaque

  • glans or prepuce
  • usually uncircumcised
  • median 5th decade
  • 10% evolve into invasive carcinoma

BHP Exam 4 (4 decks)

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