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Gen Path > Genitourinary Disease > Flashcards

Genitourinary Disease Flashcards

1
Q

hypospadias

A

penile malformation

  • opening along ventral
  • UTI
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2
Q

epispadias

A

penile malformation

  • opening along dorsal aspect
  • UT obstruction
  • urinary incontinence
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3
Q

squamous cell carcinoma- premalignant lesions

A

penile lesion
-solitary white/red plaque
-epi dysplasia
~10% gets invasive

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4
Q

Bowen Disease?

A

penile squamous cell carcinoma in-situ

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5
Q

squamous cell carcinoma

A

penile lesion

  • rare among circumcised men early on
  • crusted papule w/ ulceration/irregular margins
  • metastases: rare

survival: 66% for localized; 27% with metastases in inguinal lymph nodes

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6
Q

first human malignancy associated with environmental influences?

A

squamous cell carcinoma of the scrotum

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7
Q

scrotum neoplasms are rare but more disorders involve what?

A

the testes

-scrotum can have inflammatory processes/fungal infections/systemic dermatoses

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8
Q

cryptorchidism

A

testes disorder

  • incomplete decent from abdomen to scrotum
  • 1% of 1 yr olds
  • uni or bilateral= STERILITY
  • 3-5x risk of testicular cancer

-orchiopexy reduces risk of sterility and cancer (surgery to bring down)

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9
Q

epididymitis and orchitis

A

testis inflammation

  • epi most common
  • swelling/tender
  • UTI
  • associated with STDs
  • mumps complications (~20%)
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10
Q

torsion of testes

A

vascular disturbances

  • twisting of spermatic cord
  • venous obstruction–> vascular engorgement
  • adolescences, sudden onset of pain
  • UROLOGIC EMERGENCY: infarction will occur
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11
Q

testicular tumors- general info

A
  • 6 in 100,000
  • incidences 15-34 yrs
  • most common cause of painLESS testicular enlargment
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12
Q

testicular tumors- heterogenous group of tumors (where)

A

-germ cells: 95%= malignant

s

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13
Q

testicular tumors- heterogenous group of tumors (where)

A
  • germ cells: 95%= malignant

- stertoli/leydig cells (sex cord stromal tumors): 5%= benign

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14
Q

germ cell tumors

A

testicular tumor

  • seminomas vs non seminomatous
  • greater freq in undescended testis (3-5 fold)
  • only 10% have hx crytochidism
  • often mixed/multiple cell type, but can be pure/single
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15
Q

seminomas germ cell tumor

A

testicular tumor

  • epithelium of seminiferous tubules (less aggressive)
  • stays in testis long time–> can spread to lymphatics
  • responds well to chemo, radio
  • ONE OF THE MOST CURABLE CANCERS
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16
Q

non-seminomatous germ cell tumor

A

testicular tumor
-spreads early via lymphatics/blood vessels (even small tumors)
-markers: alpha fetoprotein and human chorionic gonadotropin
-prognosis better with newer chemo regimes
types:
-embryonal
-choriocarcinoma- very very aggressive

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17
Q

germ cell prognosis

A

-8,000 new cases,

18
Q

prostatitis

A

prostate inflammatory lesions

  • enlarged/tender
  • caused by BAC with UTIs-e. coli
  • acute or chronic
  • clinically silent, may have dysuria (pain peeing), frequency, low back pain, pelvic pain

–important cause of recurrent UTIs in men

19
Q

nodular hyperplasia of prostate =

A

benign prostatic hyperlasia (BPH)

20
Q

nodular hyperplasia of prostate affects where

A
  • inner periurethral zone compressing prostatic urethra

- proliferation of stromal and glandular elements

21
Q

nodular hyperplasia

A
  • common= 20% men affected at age 40, 90% at age 70
  • clinical symptoms= hesitancy, urgency, nocturia, poor urinary stream
  • chronic obstruction comes before recurrent UTI
  • etiology= no idea- maybe hormonal= local increase of ANDROGENS
22
Q

nodular hyperplasia tx

A
  • medical managment= drugs

- surgical (TURP)

23
Q

adenocarcinoma

A

carcinoma of prostate

  • most common cancer of men over 50= 25% cancer, only 9% die
  • can be clinically “latent”= 50% men over age 80
  • metastasis: lymph nodes/bone
24
Q

adenocarcinoma cause and location

A

carcinoma of prostate

  • unknown cause: may be androgens, genes, environment
  • outer (peripheral) glands, palpable by digital rectal exam
  • -more malignant
25
Q

adenocarcinoma marker

A

carcinoma of prostate

  • elevated prostate specific antigen (PSA)
  • good for diagnosis and management but elevation can be due to other cancer or non neoplastic conditions
26
Q

adenocarcinoma tx and prognosis

A

carcinoma of prostate
-surgery, radiation, hormonal manipulation

  • depends on anatomic extent
  • -10 yrs of 10-40% for disseminated disease (traveled)
27
Q

adenocarcinoma

A

carcinoma of prostate

  • most common cancer of men over 50= 25% cancer, only 9% die
  • can be clinically “latent”= 50% men over age 80
  • metastasis: lymph nodes/bone (patchy bone in mandible)
28
Q

adenocarcinoma cause and location

A

carcinoma of prostate

  • unknown cause: may be androgens, genes, environment
  • outer (peripheral) glands, palpable by digital rectal exam
  • -more malignant
  • seen radiographically as neoplastic glands
29
Q

urothelial carcinoma

A

urinary bladder neoplasm

  • majority (90%)
  • men 50-80 yrs
  • painless hematuria
  • tumors shed in urine= detect by cytology

–can be papillary or flat

30
Q

urothelial carcinoma risk factors

A

urinary bladder neoplasm

  • cirgarette smoking
  • chronic cystitis
  • infection w/ schistosomia
  • exposure to carcinogens
31
Q

urothelial carcinoma tx and prognosis

A

urinary bladder neoplasm
-transurethral resection, immunotherapy, radical cystectomy

-depends on tumor grade and stage= atypia and invasion

32
Q

STDs- most common

A
  • genital herpes, genital HPV

- 10 leading infectious disease in US requiring CDC reporting: 5 are STDs

33
Q

syphilis (lues)

A
  • chronic infection by spirochete Treponemia pallidum
  • > 14,000
  • 30x more in AA than whites
  • transmitted: direct contact with cutaneous/mucosal lesions during early (primary or secondary) stage, highly infectious
  • rapidly disseminate to distant sites by blood/lymphatics
34
Q

syphilis primary stage

A

chancre

35
Q

syphilis secondary stage

A
  • palmar rash
  • lymphadenopathy
  • condyloma latum
36
Q

syphilis tertiary stage

A
  • neurosyphilis: meningovascular, tabes dorsalis, general paresis
  • aortitis: aneurysms, aortic regurgitation
  • gummas: hepar lobatium, skin, bone, others
37
Q

syphilis primary stage

A

-chancre (painless ulcer) at site of inoculation 9-90 days after initial infection (genitals, oral)

  • antibody production
  • resolves spontaneously in 4-6 WEEKS
  • untreated: ~25% pts develop secondary
38
Q

syphilis secondary stage

A
  • palmar rash (maculopapular-palms/soles of feet)
  • lymphadenopathy (and mucocutaneous lesions)
  • condyloma latum (and mucous patches-on mucosa)
  • occurs within 2 MONTHS following resolution of primary
  • resolves spontaneously over SEVERAL WEEKS, enters latent phase
  • untreated: close to 1/3 develop tertiary over 5-20 YEARS
39
Q

syphilis tertiary stage

A
  • neurosyphilis: meningovascular, tabes dorsalis, general paresis (10%, brain, meninges, spinal cord)
  • aortitis: aneurysms, aortic regurgitation (80%, cardiovascular)
  • gummas: hepar lobatium, skin, bone, upper airway, mouth (focal granulomatoys lesions)
  • develops after later period of 5+ YEARS
  • pts less likely to be infectious
40
Q

congenital syphilis

A
  • maternal transmission across placenta
    1. stillbirth
    2. infantile syphilis= clinical manifestations similar to secondary
    3. late congenital syphilis= (untreated, >2yrs duration)
  • –hutchinson triad: teeth, intestitial keratitis, 8th cranial n deafness
  • convex shines
41
Q

syphilis diagnosis

A
  • bacteria within primary or secondary lesion
  • screening tests: RPR (rapid plasma reagin) and VDRL (venereal disease research laboratory): often neg early, ~15% false positive
  • specific tests: FTA (fluorescent treponemal antibiody): pos later in disease, remain pos indefinitely, even after tx

–treated with antibiotics (penicillin)

Gen Path (2 decks)

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