Genitourinary (AKA "dat dick stuff") Flashcards
1
Q
what is a Hypospadias? how prevalent is it?
A
- an abnormal opening of the urethra along the ventral aspect of the penis
- occurs in 1/300 live male births
2
Q
what is the possible complication of a Hypospadias?
A
can be constricted and cause UTI
3
Q
what is a Epispadias?
A
urethral opening on the dorsal aspect of the penis
4
Q
which type of urethra malformation can lead to incontinence?
A
Epispadias
5
Q
_________ disease is a synonym for carcinoma in situ of the penis
A
Bowen
6
Q
what are the risk factors for developing Penile neoplasms?
A
- uncircumcised
- over 40
- associated with HPV infection types 16 & 18
7
Q
what do Premalignant Lesions on the penis appear as clinically?
A
Presents as a solitary white and/or red plaque
8
Q
about __% of premalignant penile lesions will progress to invasive squamous cell carcinoma
A
10%
9
Q
what is the 5 year survival rate for penis carcinomas?
A
66%
10
Q
in carcinomas of the penis, local metastasis to what location reduces the 5-yr survival to 27%?
A
inguinal lymph nodes
11
Q
what is Cryptorchidism?
A
Incomplete descent of the testis from the abdomen to the scrotum
12
Q
T/F: Scrotum Neoplasms are rare, but most are squamous cell carcinomas
A
true
13
Q
scrotum carcinomas were first associated with what group?
A
chimney sweeps
14
Q
what condition leads to a 3 to 5 fold increased risk of testicular cancer?
A
Cryptorchidism
failure of testes to descend
15
Q
what location/cell type do most testicular cancers arise from?
A
arising in intratubular germ cell neoplasia
within the atrophic tubules
16
Q
what surgery will reduce risk of sterility and cancer due to cryptochidism?
A
Orchiopexy
surgery to move an undescended testicle down
17
Q
inflammation in the testes is more common in the ____________ than testis proper (orchitis)
A
epididymis (epididymitis)
18
Q
___________ refers to inflammation of the testes proper
A
Orchitis
19
Q
In most cases, inflammation of the testes begins as what?
A
a primary urinary tract infection
with secondary ascending infection of the testes
20
Q
what conditions can cause orchitis (testicular inflammation)?
A
- main cause = STD’s
- mumps = effects adults (can cause sterility)
21
Q
Orchitis is a complication of mumps in ___% of infected adult males
A
20%
22
Q
______ occurs when the spermatic cord (from which the testicle is suspended) twists
A
Torsion
23
Q
what is the result of the testicular torsion?
A
obstruction of venous drainage while leaving the thick-walled more resilient arteries patent (open)
24
Q
_________ torsion occurs either in utero or shortly after birth, without know cause
A
Neonatal
25
T/F: Intense vascular engorgement and venous infarction follow unless the torsion is relieved
true
26
Adult testicular torsion generally occurs in adolescence secondary to _______________, whereby the testis has increased mobility
an anatomic defect
27
T/F: Testicular torsion is usually not a medical emergency
FALSE
Testicular torsion is one of the few urologic emergencies
28
________ of the testis are the most common causes of firm, painless enlargements of the testis
Tumors
29
where do 95% of testicular tumors arise from?
are these malignant or benign
arise from the germ cells
- germ cell tumors = MALIGNANT
(95% of testicular tumors are malignant)
30
what age group is at the highest risk for testicular tumors?
15-34 years of age
31
only ___% of patients with testicular germ cell cancer have a history of cryptorchidism
only 10%
32
Germ cell tumors (malignancies) are divided into what 2 categories?
1) seminomas
| 2) nonseminomatous germ cell tumors
33
what 2 markers can help diagnose testicular cancer?
1) α-fetoprotein
| 2) human chorionic gonadotropin (HCG).
34
what cell type do seminoma tumors arise from?
- arise from Sertoli or Leydig cells
| - make up 5% of all testicular cancers
35
why are non-seminotomatous tumors likely to metastasize?
- likely to spread early
- spread thru lymphatics & blood vessels
- even SMALL malignancies can metastasize
(opposite of seminomas)
36
T/F: Seminomas typically respond poorly to treatment, and have a low 5-yr survival rate
FALSE
they are one of the most curable cancers
(its the germ cell ones that will get you)
37
which type of testicular germ cell tumor tends to spread early via lymphatics and blood vessels
Non-seminomatous tumors
38
which tumor markers are associated with Non-seminomatous GERM CELL tumors?
1) α-fetoprotein
| 2) human chorionic gonadotropin (HCG).
39
what are the 3 main categories of prostate disease?
inflammatory lesions (prostatitis)
nodular hyperplasia
carcinoma
40
_________ is clinically apparent inflammation of the prostate which may be acute or chronic
Prostatitis
41
Prostatitis is an important cause of what other condition?
RECURRENT E. coli urinary tract infection
- swelling of prostate fucks up normal flow of urine, allows E.coli to invade
42
Both acute and chronic prostatitis present with what symptoms?
dysuria
urinary frequency
lower back pain
poorly localized suprapubic or pelvic pain
43
_____________________ refers to hyperplastic enlargement of the prostate, often associated with urinary symptoms
Nodular hyperplasia of the prostate
- AKA "benign prostatic hypertrophy"= BHP
44
Nodular hyperplasia (benign prostatic hypertrophy) Generally affects what region of the prostate?
affects the INNER PERIURETHRAL zone of the prostate
- compresses the prostatic urethra
45
During BHP, Proliferation of stromal & glandular elements in the prostate causes what?
enlargement of gland ± urinary obstruction
46
T/F: benign prostatic hypertrophy effects 20% of men at age 40; and 90% of men age 70
True
47
In patients with BPH, there is a local increase in what hormone?
androgens
48
What is the acronym for the surgery that treats benign prostatic hypertrophy?
TURP
Trans urethral resection of the prostate
49
what is the most common cancer of men over age 50 in the U.S ?
Adenocarcinoma of the prostate
50
adenocarcinomas of the prostate can metastisize to what locations?
lymph nodes and bone
51
Adenocarcinoma of the prostate accounts for ____% of all cancer
25% of all cancers
only 9% of these will be fatal
52
the Majority of urinary bladder neoplasms are what type?
urothelial carcinoma
53
urothelial carcinomas are most common in what age group? what is the most common clinical sign of it?
- most common in men btw ages 50-80 yrs
| - Present with painless hematuria
54
Worldwide, how many new cases of STDs occur annually?
15 million
55
what are the 2 most common STD's?
1) genital herpes
| 2) genital HPV infection
56
Syphilis is a chronic infection caused by what organism?
Treponema pallidum
| its a spirochete
57
what are the characteristics of primary syphilis?
1) Painless CHANCRE forms
- 9-90 days after infection
2) Resolves spontaneously in 4-6 weeks
3) If untreated, ~25% of patients develop secondary syphilis
58
Secondary Syphilis Occurs within 2 months following resolution of what?
the primary chancre
59
what types of lesions are found during secondary syphilis?
1) maculopapular rash affecting skin (palms and soles)
2) condyloma lata (wart-like lesions on the genitals)
3) mucous patches (may affect oral mucosa)
60
After secondary syphilis spontaneously resolves, it enters a ________ phase
latency
61
If secondary syphilis is left untreated, close to ____ of patients develop tertiary syphilis over a period of 5 to 20 years
one-third
62
Tertiary syphilis develops after latent period of _____ years
5+
63
what are the 3 types of TERTIARY Syphilis?
1) Aortitis (80% of patients)
2) Neurosyphilis (10%)
3) Gummas
64
________ is also known as “cardiovascular syphilis”
Aortitis
65
what is effected during Neurosyphilis?
involvement of the brain, meninges and spinal cord
66
what are "gummas"? (result of tertiary syphilis)
focal granulomatous lesions develop in bone, skin, and mucous membranes of the UPPER AIRWAY and MOUTH
67
what are the 3 forms of Congenital Syphilis?
1) Stillbirth
2) Infantile syphilis
3) Late congenital syphilis
68
what is "Hutchinson's Triad"? what form of syphilis is it associated with?
- from Late congenital syphilis
Triad:
1) Hutchinson’s Teeth
2) Interstitial keratitis
3) Eighth cranial nerve deafness
69
"saddle nose deformities" formations are secondary to _______
gummas
| focal granulomatous lesions
70
up to _____% of infants with congenital syphilis will die
40%
71
what 2 SCREENING tests can be used to detect syphilis?
RPR (rapid plasma reagin)
VDRL (Venereal Disease Research Laboratory)
72
what SPECIFIC test is used for the detection of syphilis?
FTA (Fluorescent Treponemal Antibody)
73
T/F: FTA tests have about 15% false-positive results
FALSE
the Screening tests (RPR & VDRL) have a 15% false positive rate
74
what agent causes Gonorrhea? what % of males and females are Asymptomatic?
- caused by Neisseria gonorrhoeae infection
Males: 40% asymptomatic
Females: 80% asymptomatic
75
what type of host reaction is elicited by Gonorrhea?
Provokes an intense, suppurative, inflammatory reaction (purulent exudate)
76
Untreated gonorrhea can lead to _____
sterility
77
Gonorrhea Ascending infection results in:
| what happens in males? females?
A) acute prostatitis, epididymitis, or orchitis in MALES
B) inflammation of the uterus, fallopian tubes, and ovaries (acute salpingitis) in FEMALES
C) secondary scarring gives rise to pelvic inflammatory disease
78
what is gonococcal ophthalmia neonatorum?
Blindness in infants from gonococcal contamination at birth
79
what are the most common STDs reportable to CDC
Nongonococcal Urethritis and Cervicitis
80
a majority of Nongonococcal Urethritis and Cervicitis cases are caused by what?
Chlamydia trachomatis
81
Chlamydia trachomatis infections are similar to what other STD?
gonorrhea
82
________ tests can be used for the diagnosis of Chlamydia
Molecular
83
what is Reactive arthritis (Reiter Syndrome)?
- possible manifestation of Chlamydia
- immune response to infection
- combination of urethritis/cervicitis, conjunctivitis, arthritis, and mucocutaneous lesions
84
Genital Herpes Affects how many people in the US? what virus is responsible for most of the cases?
- 50 million people a year
| - Most caused by HSV-2 (less commonly HSV-1)
85
name the characteristics of an Initial herpes simplex infection:
- asymptomatic vs painful mucocutaneous eruptions
- lymphadenopathy and malaise
- heal 3-6 weeks
86
name the characteristics of a RECURRENT herpes simplex infection:
- small painful vesicles that quickly ulcerate
| - heal in 7-10 days
87
HSV are actively shed during what times?
periods of clinical lesions (ulcers during recurrent infection)
88
what is the mortality rate for Neonatal herpes?
60%
very high
89
what is the "viral cytopathic effect " on cells infected with HSV?
- ballooning degeneration of epithelial cells
| - with large, often multinucleate, purple staining nuclei
90
"_______ cells " are the cells suffering from viral cytopathic effects associated with a HSV (herpes simplex) infection
"Tzanck cells"
91
what is the most common lesion from the Human Papilloma Virus (HPV)?
condyloma acuminatum
- AKA venereal warts
92
condyloma acuminatum is caused by HPV ___ and ___
6 and 11
93
name the characteristics of condyloma acuminatum:
- Benign papillary nodules that frequently appear in clusters
- Occur in anogenital region and oral mucosa
94
T/F: Malignant transformation of genital condyloma acuminatum lesions often occurs
FALSE
- uncommon for genital warts to become malignant
95
what is the Histology AND Treatment for condyloma acuminatum?
- Histology: KOILOCYTIC changes, papillary proliferation of epithelium
- Treatment: surgical excision, laser treatment, cryotherapy, imiquimod
