Genitourinary Flashcards
What is a hypospadias?
Opening along the ventral side of the penis
Can result in more UT infection
What is epispadias?
Opening along the dorsal side of penis
Can cause UT infection and incontinence
T/F: Hypospadias is more common than epispadias.
True
What is the most common penile neoplasm?
Squamous cell carcinoma
What are some risk factors for penile neoplasms?
- Uncircumcised and over 40
- HPV infection
- Red/white plaque
Carcinoma in-situ in the penis is called _________.
Bowen Disease
Although rare, the most common neoplasm in the scrotum would be _______.
squamous cell carcinoma
chimney sweeps
Incomplete descent of the testis from the abdomen to the scrotum is termed ________.
cryptorchidism
may lead to sterility
As well as possibly leading to sterility, cryptorchidism has what effect on cancer risk?
3-5 fold increased risk for testicular cancer
What procedure can be done to reduce the risk of sterility and cancer in patients with cryptorchidism?
Orchiopexy
________ infections of the epididymis are much more common than ________ infections of the testis proper.
Epididymitis; orchitis
Inflammatory lesions of the testis are often associated with _____ and _____.
STDs and mumps
Torsion causes an obstruction of ________ in the testis.
venous drainage
Emergency!
Someone with a ________ deformity is more likely to experience torsion.
bell clapper
When is a male most likely to get testicular cancer?
15-34 years old
T/F: Testicular neoplasms will cause pain.
False
95% of testicular tumors arise from the _______ and are malignant.
germ cells
5% of testicular tumors are ________ and are generally benign.
sex cord-stromal tumors
sertoli or leydig cells
_______ respond well to chemotherapy and rarely spread.
Seminomas
__________ spread quickly.
Non-seminomatous tumors
Non-seminomatous tumors present with which two markers?
AFP and HCG
T/F: Although the prognosis for non-seminomatous tumors is worse than seminomas, both have fairly good prognosis.
True
95% cured of early seminoma
90% nonseminomatous achieve remission
T/F: Most prostatitis cases are related to E. coli from UTI.
False
90-95% are nonbacterial
Which area of the prostate is effected by nodular hyperplasia of the prostate?
inner periurethral zone
T/F: Nodular hyperplasia is fairly rare.
False
20% at age 40; 90% at age 70
What are the clinical symptoms of nodular hyperplasia?
Hesitancy, urgency, poor stream, multiple urinary tract infections
There is a local increase in _________ related to nodular hyperplasia.
androgens
Other than that etiology is not understood
How is nodular hyperplasia treated?
Drugs or surgery (TURP)
What is the most common cancer of men over the age of 50 in the USA?
Prostate adenocarcinoma
Where does prostate cancer most commonly arise?
Outer glands; palpable by rectal exam
In prostate cancer, there is an elevated level of _______.
prostate specific antigen (PSA)
But this could be seen in non-cancer patients
T/F: Overall, prognosis for prostate cancer is normally good.
True
The majority of bladder cancers are ___________.
Urothelial carcinoma
How is urothelial carcinoma often first seen?
Blood in urine but no pain
Syphilis is caused by infection from _____________.
T. Pallidum
T/F: Syphilis is 30x more prevalent in African Americans than whites.
True
Syphilis is highly infectious by which mode of transmission?
Direct contact with cutaneous/mucosal lesions
What are the various areas that can be affected by the different stages of syphilis?
Primary - chancre at infection site
Secondary - lymphadenopathy and mucocutaneous lesions
Tertiary - aortitis, neurosyphilis, gummas
T/F: If left untreated, 25% of primary syphilis patients will develop secondary syphilis.
True
Maculopapular rash, condyloma lata, and mucous patches are all associated with _________.
Secondary syphilis
After secondary syphilis the patient will enter the _________.
Latent phase
How long will it typically take to develop tertiary syphilis?
1/3 of untreated patients will develop tertiary syphilis in 5-20 years
What is the most common form of tertiary syphilis?
Aortitis (cardiovascular syphilis)
What are the three patterns of congenital syphilis?
- Stillbirth
- Infantile syphilis - secondary syphilis at birth
- Late congenital syphilis - symptoms seen after 2 years old
What is Hutchinson’s triad?
Uncommon trio of symptoms with congenital syphilis
- Hutchinson’s teeth (notched incisors/mulberry molars)
- Interstitial keratitis
- 8th cranial nerve deafness
What are two screening tests for syphilis?
RPR and VDRL
Often negative in early stages and can be false-positives
What is a very specific test for syphilis?
FTA
Will remain positive even after treatment
How is syphilis treated?
Penicillin
What bacterial agent causes gonorrhea?
N. Gonorrhoeae
Gonorrhea often provokes a ____________, however many people (esp. females) can be asymptomatic.
Purulant exudate
Untreated gonorrhea can lead to __________.
Sterility
Acute salpingitis is ovary inflammation often caused by ___________.
Gonorrhea
Secondary scarring due to gonorrhea is termed _________.
Pelvic inflammatory disease
What is gonococcal ophthalmia neonatorum?
Blindness at birth due to gonorrhea
The majority of nongonococcal urethritis and cervicitis is caused by ___________.
Chlamydia trachomatis
If the disease continues to persist during antibiotic treatment for suspected gonohhrea what is to be expected?
Chlamydia
How is chlamydia treated?
Antibiotics stronger than penicillin (ceftriaxone, doxycycline)
What is a complication of chlamydia?
Reactive arthritis (Reiter syndrome)
Most herpes infections are caused by ______.
HSV-2
T/F: Initial herpes infection can be asymptomatic or can have painful mucocutaneous eruptions.
True
___________ are small painful vesicles that quickly ulcerate.
Herpes recurrent lesions
T/F: Neonatal herpes occurs in children born to mothers with genital herpes and has a low mortality.
False
High mortality
Diagnosis of ________ involves viral cytopathic effect, which will show large, multinucleate _________.
Herpes; “Tzanck cells”
What is the most common HPV infection?
Condyloma acuminatum
T/F: Condyloma acuminatum is caused by HPV 6 and 11.
True
T/F: Condyloma acuminatum can lead to malignant transformation of genital lesions.
True
But rare
Condyloma acuminatum will cause papillary proliferation of squamous epithelium exhibiting __________ change.
Koilocytic
