genitourinary diseases

Question 1

most common malformation of the penis includes abnormal location of the _____

Answer 1

distal urethral orifice

Question 2

opening along the ventral aspect of the penis; can be constricted, resulting in increased risk for urinary tract infections

Answer 2

hypospadias

Question 3

less common, opening on dorsal aspect of penis; UT obstruction/UT infections and urinary incontinence

Answer 3

epispadias

Question 4

premalignant lesions of the penis appear as _____, _____, or ____

Answer 4

white plaque-like thickenings; areas of redness; a mixture

Question 5

histologically, premalignant lesions may reveal any level of _____, including _____

Answer 5

epithelial dysplasia; carcinoma in situ

Question 6

____ is a synonym for carcinoma in situ of the penis

Answer 6

bowen disease

Question 7

most common penile neoplasms

Answer 7

squamous cell carcinoma and its precursor lesions

Question 8

_____ may be involved with development of penile cancer

Answer 8

human papillomavirus (HPV 16/18)

Question 9

first human cancer associated with occupational (environmental) factors (chimney sweeps)

Answer 9

SCC of the scrotum

Question 10

failure of testicular descent from the abdomen to the scrotum; present in 1% of the male population; may be unilateral or bilateral

Answer 10

cryptorchidism

Question 11

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 _____

Answer 11

intratubular germ cell neoplasia; sterility

Question 12

surgical placement of the testes into the scrotum

Answer 12

orchiopexy

Question 13

inflammation of the testes

Answer 13

orchitis

Question 14

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

Answer 14

torsion

Question 15

testicular torsion is one of the few _____

Answer 15

urologic emergencies

Question 16

failure of normal posterior anchoring of the gubernaculum, epididymis, and testis

Answer 16

bell clapper deformity

Question 17

most common causes of firm, painless enlargement of the testis

Answer 17

tumors of the testis (testicular neoplasms)

Question 18

95% of testicular neoplasms arise from the ____ and are almost all malignant; 5% arise from _____ and are generally benign

Answer 18

germ cells; sertoli or leydig cells (sex cord-stromal tumors)

Question 19

two markers in diagnosis, staging and follow-up for testicular cancers

Answer 19

alpha-fetoprotein and human chorionic gonadotropin (HCG)

Question 20

seminomas arise from the _____ and remain localized for long periods; one of the most curable cancers)

Answer 20

epithelium of the seminiferous tubules

Question 21

minority of cases associated with UTI infection (often E.coli); can be acute or chronic

Answer 21

bacterial prostatitis

Question 22

90-95% of cases of prostatitis; also known as chronic pelvic pain syndrome; unknown etiology; no response to antibiotics

Answer 22

chronic nonbacterial prostatitis

Question 23

hyperplastic enlargement of the prostate, often associated with urinary symptoms

Answer 23

nodular hyperplasia of the prostate (benign prostatic hyperplasia)

Question 24

the central portions of the gland adjacent to the urethra (called the ______) are involved most frequently

Answer 24

inner periurethral zone

Question 25

nodular hyperplasia etiology is unknown, but is thought that a _____ appears to have a central role in its development

Answer 25

local increase in androgens

Question 26

most common cancer of men over 50 years of age, with peak prevalence between 65-75

Answer 26

carcinoma of the prostate

Question 27

_____ is the most common form of hematogenous spread of carcinoma of the prostate and the metastases may be ____ but are more commonly _____

Answer 27

osseous metastasis; radiolucent; radiopaque

Question 28

both incipient and clinically evident carcinomas of the prostate begin in the _____

Answer 28

outer (peripheral) zones of the posterior lobe of the prostate

Question 29

useful in diagnosis/management of prostate cancer but serum elevation may be due to non-neoplastic conditions

Answer 29

prostate specific antigen (PSA)

Question 30

most common neoplasm of the bladder (90%)

Answer 30

urothelial cell carcinoma

Question 31

dominant presenting manifestation of bladder cancer

Answer 31

painless hematuria

Question 32

reasonable method of detection for bladder cancer

Answer 32

cytology (because tumor cells are shed into the urine)

Question 33

syphilis caused by:

Answer 33

treponema pallidum (spirochete)

Question 34

two types of syphilis antibodies

Answer 34

nonspecific antibody- syphilitic reagin | specific antibody- treponemal antibody

Question 35

histopathologic hallmark of syphilis:

Answer 35

lymphoplasmacytic infiltrate associated with obliterative endarteritis, a specific type of vasculitis

Question 36

characteristics of primary syphilis

Answer 36

development of painless ulcer (chancre) at site of entry 9-90 days (mean 21 days) after initial infection

Question 37

if untreated, about ____ of patients with primary syphilis develop secondary disease

Answer 37

25%

Question 38

characteristics of secondary syphilis

Answer 38

generalized lymphadenopathy, maculopapular rash, condyloma lata (elevated large broad plaques), mucous patches

Question 39

characteristics of tertiary syphilis - complications divided into 3 categories

Answer 39

aortitis- cardiovascular syphilis (80%) neurosyphilis (10%)- involvement of the brain, meninges, and spinal cord gummas- focal granulomatous lesions in mucocutaneous tissue and bone

Question 40

3 patterns of congenital syphilis

Answer 40

stillbirth infantile syphilis late congenital syphilis

Question 41

hutchinson's triad (historically famous pattern of congenital syphilis)

Answer 41

1. Hutchinson's teeth (notched incisors/mulberry molars) 2. interstitial keratitis (corneal) 3. eighth CN deafness

Question 42

gonorrhea is caused by:

Answer 42

Neisseria gonorrhoeae, a gram negative diplococcus

Question 43

untreated gonorrhea can lead to ____ in both sexes

Answer 43

sterility

Question 44

ascending infection of gonorrhea in males results in:

Answer 44

acute prostatitis, epididymitis, or orchitis

Question 45

ascending infection of gonorrhea in females results in:

Answer 45

acute salpingitis and then pelvic inflammatory disease

Question 46

infant blindness from gonococcal contamination at birth

Answer 46

gonococcal ophthalmia neonatorum

Question 47

most common forms of STDs reportable to CDC; majority caused by chlamydia trachomatis

Answer 47

nongonococcal urethritis and cervicitis

Question 48

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

Answer 48

reactive arthritis (Reiter syndrome)

Question 49

approx ___ of infants affected with HSV die of the infection

Answer 49

60%

Question 50

in genital HSV, exfoliative cytology or biopsy show _____ (ballooning degeneration of epithelial cells with large, multinucleate _____)

Answer 50

viral cytopathic effect; Tzanck cells

Question 51

usually associated with HPV types 6 or 11 and typically arises on moist mucocutaneous surfaces; present as benign papillary nodules, frequently appear in clusters

Answer 51

condyloma acuminatum (venereal warts)