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REGUB > L14 + L29: Male GU Tract Pathology > Flashcards

L14 + L29: Male GU Tract Pathology Flashcards

1
Q

What is prostatitis?

A

inflammation of the prostate

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2
Q

What are the 3 different types of prostatitis?

A
  1. Acute Bacterial
  2. Chronic Bacterial
  3. Granulomatous
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3
Q

What is the main pathology that occurs in the transitional zone of the prostate?

A

benign prostatic hyperplasia

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4
Q

What is the main pathology that occurs in the peripheral zone of the prostate?

A

cancer

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5
Q

What is benign prostatic hyperplasia?

A
  • non-neoplastic proliferation of the transitional zone of the prostate (transitional zone enlarges)
  • very common
  • incidence increases with age
  • androgens increase the size of prostate
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6
Q

What are some of the symptoms of benign prostatic hyperplasia?

A
  • poor urine flow
  • hesitancy when urinating
  • feeling of incomplete bladder emptying
  • dribbling
  • increased urgency
  • increased frequency ± nocturia
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7
Q

What is the main form of malignant prostate tumour?

A

primary tumour - adenocarcinoma

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8
Q

List some of the risk factors for prostatic cancer

A
  • age*
  • hereditary (family history, BRCA, Lynch Syndrome)
  • ethnicity
  • diet
  • hormones
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9
Q

What is another name for Lynch Syndrome?

A

Hereditary Non-Polyposis Colorectal Cancer (HNPCC)

- increases risk of colorectal + other cancers

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10
Q

What is the function of the prostate?

A

makes prostatic fluid - contributes to 70% of the ejaculate

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11
Q

What is the function of Prostate Specific Antigen (PSA)?

A
  • liquefies semen and cervical mucus

- usually raised in prostate cancer

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12
Q

List the 3 common histological features of a prostatic adenocarcinoma

A
  1. small, crowded glands
  2. large nucleoli
  3. lack of basal myoepithelial cells
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13
Q

What are the main limitations of the transrectal prostate biopsy in detecting prostate cancer?

A
  • probe may miss malignant areas of prostate

- extent + grade in biopsy may not reflect actual extent + grade in prostate

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14
Q

Where do prostate cancers spread to first?

A
  • bone*

- iliac lymph nodes

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15
Q

What is the name of the scoring system that is used for the prognosis of prostate cancer?

A

Gleason Scoring System

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16
Q

What stage, gleason score and PSA value is associated with a high-risk prostate cancer?

A

Stage T3 or above
Gleason Score > 8
PSA > 10

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17
Q

Before doing a transrectal ultrasound/biopsy what is required to reduce the risk of infection?

A

an antibiotic cover

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18
Q

Explain the role of MRI before doing a prostate biopsy.

A

Prostate MRI done and PIRADS score given

  • 1 = low risk of disease
  • 5 = high risk of disease
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19
Q

When is a bone scan done to see if the patient has a prostate cancer?

A
  • PSA > 20
  • clinical suspicion
  • looking for mets (in the bone!)
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20
Q

List 2 fairly new diagnostic imaging techniques used to check for prostate cancer before doing a biopsy

A
  1. MRI

2. Bone Scan

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21
Q

What are the indications for a radical prostatectomy?

A
  • disease confined to prostate (T1/T2)
  • < 70 years
  • life expectancy > 10 years
  • fit for surgery
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22
Q

What are the treatment options for early prostate cancer?

A
  • surgery (radical prostatectomy)
  • radiotherapy
  • surveillance
  • chemotherapy
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23
Q

What is the treatment for metastatic prostatic cancer?

A

androgen deprivation

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24
Q

List some side effects of androgen deprivation/anti-androgen drugs

A
  • erectile dysfunction
  • loss of sex drive
  • hot flashes
  • growth of breast tissue
  • weight gain
  • nausea
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25
What is the function of Leydig cells in the testis?
produce testosterone
26
What is the function of Sertoli cells in the testis?
aid in maturation of sperm
27
What is cryptorchidism?
- failure of one or both of the testis to descend into the scrotum - can be palpable in abdominal or inguinal region
28
What are some of the possible consequences of a cryptorchidism?
- atrophy of testis - infertility - increased risk of germ cell tumour
29
What is the treatment of cryptorchidism?
orchidopexi (surgery to move testicle down)
30
What is a variocele? What is a possible consequence?
- dilated tortuous veins in spermatic cord | - can lead to fertility problems
31
What is a hydrocele?
- fluid collection in tunica vaginalis
32
What is a spermatocele?
- abnormal sac (cyst) that develops in the epididymis
33
What is orchitis/epididymo-orchitis?
- caused by mumps, STDs or idiopathic | - presents like an inflamed testis
34
What is torsion of the testis?
- twisting of spermatic cord and testis - veins collapsed (blood pools in testis) - common at birth + around puberty - surgical emergency!
35
What are the main types of testicular cancer?
1. Germ Cell Tumour - Seminoma - Non-Seminoma 2. Stromal Tumour - leygid cell most common
36
What are the risk factors for testicular cancer?
- age - race - cryptoorchidism - infertility (poor semen analysis) - genetics - history of contralateral testis cancer - Klinefelter Syndrome
37
What is Klinefelter Syndrome?
male inherits one or more additional X chromosome
38
What is the most common type of testicular tumour?
Germ Cell Tumour - Seminoma
39
Where do testicular tumours usually metastasize to?
- chest lymph nodes (para-aortic and iliac) | - lungs
40
What are the 2 types of testicular germ cell tumours?
1. Seminoma | 2. Non-Seminoma
41
List some of the investigations that can be done to diagnose a testitcular tumour
- trans-scrotal ultrasound* - serum tumour markers - CXR - CT chest, abdomen and pelvis
42
List the characteristics of a seminoma
- slow growing - sensitive to radiation - no specific tumour marker - LDH may be increased though
43
List the characteristics of a non-seminoma
- fast growing - sensitive to chemotherapy - serum tumour markers present
44
What can a germ cell neoplasia in situ change into?
non-seminoma
45
How does a seminoma tumour look like in cross-section?
homogenous tumour
46
How does a non-seminoma tumour look like in cross-section?
- heterogenous | - haemorrhagic
47
List the different types of non-seminoma germ cell tumours. If there is any, list the associated tumour marker
1. Embryonal 2. Teratoma 3. Yolk Sac - AFP marker 4. Choriocarcinoma - HCG marker
48
List the possible treatment options for testicular cancer
1. Radical Orchidectomy 2. Chemotherapy - BEP [for mets] 3. Retroperitoneal Lymph Node Dissection (RPLND) - - if testis removed and pt does not respond to chemo
49
What is a radical orchidectomy?
- removing the testicle + surrounding lymph nodes | - done via inguinal incision
50
What is the treatment for metastatic testicular cancer? Be specific!
chemotherapy - BEP (Bleomycin, Etoposide, Cisplatin)
51
In the treatment for testicular cancer, when will a retroperitoneal lymph node dissection be indicated?
if testis removed and pt not responding to chemo
52
What is hypospadia?
abnormal opening of urethra ventrally
53
What is epispadia?
abnormal opening of urethra dorsally
54
What is phimosis?
inability to retract foreskin from gland penis
55
What are the possible causes of phimosis?
- congenital | - chronic inflammation (due to poor hygiene or Lichen sclerosis)
56
What is lichen sclerosis?
- patchy, white skin that appears thinner than normal | - usually affects the genital and anal areas.
57
What is the most common type of penile cancer?
squamous cell carcinoma
58
What are the possible causes of penile cancer?
- infection - hygiene - lichen sclerosis
59
Where does penile cancer usually go to/metastasize to?
inguinal lymph nodes
60
What is scrotal calcinosis?
cysts of the scrotum that calcify
61
What is another name for testicular stromal tumours?
Sex cord tumours

REGUB (22 decks)

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