genitourinary diseases Flashcards
most common malformation of the penis includes abnormal location of the _____
distal urethral orifice
opening along the ventral aspect of the penis; can be constricted, resulting in increased risk for urinary tract infections
hypospadias
less common, opening on dorsal aspect of penis; UT obstruction/UT infections and urinary incontinence
epispadias
premalignant lesions of the penis appear as _____, _____, or ____
white plaque-like thickenings; areas of redness; a mixture
histologically, premalignant lesions may reveal any level of _____, including _____
epithelial dysplasia; carcinoma in situ
____ is a synonym for carcinoma in situ of the penis
bowen disease
most common penile neoplasms
squamous cell carcinoma and its precursor lesions
_____ may be involved with development of penile cancer
human papillomavirus (HPV 16/18)
first human cancer associated with occupational (environmental) factors (chimney sweeps)
SCC of the scrotum
failure of testicular descent from the abdomen to the scrotum; present in 1% of the male population; may be unilateral or bilateral
cryptorchidism
failure of descent associated with 3-5x increased risk of testicular malignancy manifesting as _____ developing within the atrophic tubules; unilateral or bilateral may also lead to _____
intratubular germ cell neoplasia; sterility
surgical placement of the testes into the scrotum
orchiopexy
inflammation of the testes
orchitis
occurs when the spermatic cord (from which the testicle is suspended) twists, resulting in obstruction of venous drainage while leaving the thick-walled, more resilient arteries patent
torsion
testicular torsion is one of the few _____
urologic emergencies
failure of normal posterior anchoring of the gubernaculum, epididymis, and testis
bell clapper deformity
most common causes of firm, painless enlargement of the testis
tumors of the testis (testicular neoplasms)
95% of testicular neoplasms arise from the ____ and are almost all malignant; 5% arise from _____ and are generally benign
germ cells; sertoli or leydig cells (sex cord-stromal tumors)
two markers in diagnosis, staging and follow-up for testicular cancers
alpha-fetoprotein and human chorionic gonadotropin (HCG)
seminomas arise from the _____ and remain localized for long periods; one of the most curable cancers)
epithelium of the seminiferous tubules
minority of cases associated with UTI infection (often E.coli); can be acute or chronic
bacterial prostatitis
90-95% of cases of prostatitis; also known as chronic pelvic pain syndrome; unknown etiology; no response to antibiotics
chronic nonbacterial prostatitis
hyperplastic enlargement of the prostate, often associated with urinary symptoms
nodular hyperplasia of the prostate (benign prostatic hyperplasia)
the central portions of the gland adjacent to the urethra (called the ______) are involved most frequently
inner periurethral zone
nodular hyperplasia etiology is unknown, but is thought that a _____ appears to have a central role in its development
local increase in androgens
most common cancer of men over 50 years of age, with peak prevalence between 65-75
carcinoma of the prostate
_____ is the most common form of hematogenous spread of carcinoma of the prostate and the metastases may be ____ but are more commonly _____
osseous metastasis; radiolucent; radiopaque
both incipient and clinically evident carcinomas of the prostate begin in the _____
outer (peripheral) zones of the posterior lobe of the prostate
useful in diagnosis/management of prostate cancer but serum elevation may be due to non-neoplastic conditions
prostate specific antigen (PSA)
most common neoplasm of the bladder (90%)
urothelial cell carcinoma
dominant presenting manifestation of bladder cancer
painless hematuria
reasonable method of detection for bladder cancer
cytology (because tumor cells are shed into the urine)
syphilis caused by:
treponema pallidum (spirochete)
two types of syphilis antibodies
nonspecific antibody- syphilitic reagin
specific antibody- treponemal antibody
histopathologic hallmark of syphilis:
lymphoplasmacytic infiltrate associated with obliterative endarteritis, a specific type of vasculitis
characteristics of primary syphilis
development of painless ulcer (chancre) at site of entry 9-90 days (mean 21 days) after initial infection
if untreated, about ____ of patients with primary syphilis develop secondary disease
25%
characteristics of secondary syphilis
generalized lymphadenopathy, maculopapular rash, condyloma lata (elevated large broad plaques), mucous patches
characteristics of tertiary syphilis - complications divided into 3 categories
aortitis- cardiovascular syphilis (80%)
neurosyphilis (10%)- involvement of the brain, meninges, and spinal cord
gummas- focal granulomatous lesions in mucocutaneous tissue and bone
3 patterns of congenital syphilis
stillbirth
infantile syphilis
late congenital syphilis
hutchinson’s triad (historically famous pattern of congenital syphilis)
- Hutchinson’s teeth (notched incisors/mulberry molars)
- interstitial keratitis (corneal)
- eighth CN deafness
gonorrhea is caused by:
Neisseria gonorrhoeae, a gram negative diplococcus
untreated gonorrhea can lead to ____ in both sexes
sterility
ascending infection of gonorrhea in males results in:
acute prostatitis, epididymitis, or orchitis
ascending infection of gonorrhea in females results in:
acute salpingitis and then pelvic inflammatory disease
infant blindness from gonococcal contamination at birth
gonococcal ophthalmia neonatorum
most common forms of STDs reportable to CDC; majority caused by chlamydia trachomatis
nongonococcal urethritis and cervicitis
significant manifestation of chlamydial infection; immune mediated process that develops in response to GU or GI infections and predominates in patients who are HLA-B27 positive
reactive arthritis (Reiter syndrome)
approx ___ of infants affected with HSV die of the infection
60%
in genital HSV, exfoliative cytology or biopsy show _____ (ballooning degeneration of epithelial cells with large, multinucleate _____)
viral cytopathic effect; Tzanck cells
usually associated with HPV types 6 or 11 and typically arises on moist mucocutaneous surfaces; present as benign papillary nodules, frequently appear in clusters
condyloma acuminatum (venereal warts)
