Lecture 4- Genitourinary pathology

Question 1

the most common malformations of the penis includ abnormalities in location of the …

Answer 1

distal urethral orifice

Question 2

… refers to an abnormal opening of the urethra along ventral aspect of penis. occurs in 1 out of …. live male births. The opening may be restricted and lead to an increased risk of UTIs

Answer 2

hypospadias

300

Question 3

… refers to an urethral opening on the dorsal aspect of the penis. This abnormality is less common but also exhibits an increased prevalence of UTIs in addition to predisposition to urinary incontinence

Answer 3

epispadias

Question 4

Bowen disease is a synonym for … of the penis

Answer 4

carcinoma in-situ

Question 5

the clinical significance of carcinoma in situ is the potential progression to invasive…

Answer 5

squamous cell carcinoma

Question 6

… is the incomplete descent of the testis from the abdomen to the scrotum. It occurs in …% of male babies, it may be uni- or bilateral and if left untreated can lead to…

Answer 6

cryptorchidism

1

sterility

Question 7

cryptorchidism is associated with a …. increased risk for testicular cancer manifesting as intratubular germ cell neoplasia developing within the atrophic tubules

Answer 7

3-5x

Question 8

… is the surgical placement of the testes into the scrotum before puberty and it reduces the risk of sterility and cancer but doesnt eliminate it

Answer 8

orchiopexy

Question 9

peak incidence age of testicular neoplasms

Answer 9

15-34

Question 10

testicular neoplasms is the most common cause of …

Answer 10

painless testicular enlargement

Question 11

approximately 95% of testicular neoplasms arise from …. with almost all being malignant and 5% arise from …. and are generally benign

Answer 11

germ cells

sertoli or leydig cells (sex cord-stromal tumors)

Question 12

germ cell tumors are divided into 2 groups:

Answer 12

seminomas

non-seminomatous

Question 13

…. germ cell tumors arise from the epithelium of the semineferous tubules and remain localized for long periods of time. they may spread through lymphatics. they respond well to chemotheraphy and are extremely radiosensitive. therefore, they are on of the most curable cancers

Answer 13

seminomas

Question 14

…. germ cell tumors spread earlier, are less radiosensitive and utilize the hematogenous and lymphatic routes, with the lungs and liver often involved at the time of diagnosis

Answer 14

non-seminomatous

Question 15

…% of early stage seminomas are cured

Answer 15

95

Question 16

…% of pts with nonseminomatous tumors achieve remission with chemo, most are cured

Answer 16

90

Question 17

… of the prostate refers to hyperplastic enlargement of the prostate often associated with urinary symptoms. It is EXTREMELY common, affecting …% of men at age 40 and …% of men at age 80

Answer 17

nodular hyperplasia

20%

95%

Question 18

most common cancer of men over age 50 in the US?

Answer 18

carcinoma of the prostate

Question 19

which is more readily detectable by exam: benign prostatic hyperplasia or carcinoma of the prostate?

Answer 19

carcinoma of the prostate because it is on the posterior aspect

Question 20

… represents a useful marker in the management of prostate cancer but is elevated in both normal prostates and those affected by cancer, prostatitis, or nodular hyperplasia

Answer 20

PSA (prostate speicifc antigen)

Question 21

…. is a chronic infection caused by the spirochete Treponema pallidum

Answer 21

syphilis

Question 22

syphilis is 30x more common in

Answer 22

african americans

Question 23

transmission for syphilis?

Answer 23

direct contact with cutaneous or mucosal lesions during early (primary or secondary) stages; highly infectious

Question 24

the histopathologic hallmark for syphillis is a ….. associated with obliterative endarteritis, a specific type of vasculitis

Answer 24

lymphoplasmacytic infiltrate

Question 25

primary syphilis is characterized by the painless…. which arises at the site of entry …. days after exposure

Answer 25

chancre

9-90 (mean is 21)

Question 26

sites of chancre from syphilis?

Answer 26

females-vulva, cervix
males-glans penis

lips, fingers, oropharynx and anus are other possible sites

Question 27

in …% of patients that are untreated for syphilis, healing of the chancre is followed within 2 months by secondary syphilis

Answer 27

25

Question 28

secondary syphilis presents with generalized…. combines with widespread…. that are maculopapular, scaly or pustular and even involve palms and soles

Answer 28

lymph node enlargement

mucutaneous lesions

Question 29

condyloma lata occurs in

Answer 29

secondary syphilis

Question 30

secondary syphilis can resolve over several weeks and enter the … phase and if left untreated …. of patients develop tertiary syphilis in … to… years

Answer 30

latent

1/3

5-20

Question 31

3 characterisitics of tertiary syphilis affects

Answer 31

aortitis
neurosyphilis
gumma

Question 32

a historically famous pattern of congenital syphilis is called hutchinsons triad and consists of …

Answer 32

1. interstitial keratitis
2. hutchinsons teeth (notched incisors/mulberry molars)
3. 8th cranial nerve deafness

Question 33

3 patterns of congenital syphilis

Answer 33

stillbirth
infantile syphilis
late congenital syphilis

Question 34

Gonorrhea: … % of males are asymptomatic and …% of females are asymptomatic

Answer 34

40

80

Question 35

condyloma acuminatum is associated with …

Answer 35

HPV 6 and 11

Question 36

beneficial tumor markers in non-seminomatous germ cell tumors

Answer 36

alpha-fetoprotein (AFP)

human chorionic gonadotropin (HCG)

Question 37

diagnosis of herpes: exfoliative cytology or biopsy showing …

Answer 37

viral cytopathic effect

ballooning degeneration of epithelial cells with large, multinucleate “Tzanck cells”

Question 38

… is a significant manifestation of chlamydial infection. It is an immune-mediate process that develops in response to GU or GI infections and predominates in patients who are HLA-B27 positive.

Answer 38

Reactive arthritis (reiter syndrome)

Question 39

Reactive arthritis (reiter syndrome) typical presents as a combination of….

Answer 39

urethritis/cervicitis
arthritis
conjunctivits
mucutaneous lesions