Lecture 8.2 highlights Flashcards
*also MJ slide
*Hypospadias often constricts the meatus; what is the effect of this?
Predisposes to UTI
Inflammatory Lesions of the Penis
1) Define balanitis
2) Define balanoposthitis. What may it cause?
3) Name a common cause
1) Inflammation of the glans
2) Inflammation of the prepuce; phimosis
3) Candida albicans
1) 95% of penis neoplasms arise from what cell type?
2) Penis neoplasms are also often associated with ______.
1) Squamous epithelium
2) HPV
*1) Define cryptorchidism
2) Unilateral or bilateral?
3) What are the 2 complications?
4) What is the Tx? Why?
1) Failure of testicular descent
2) Either unilateral or bilateral (undescended gonad may be atrophic)
3) Atrophy → sterility; ↑ risk of testicular cancer (3-5x)
4) Early orchiopexy; reduces risk of sterility and cancer
Inflammatory Lesions of the Testicles: List 2 causes
1) Epididymitisandorchitis (nonspecific)
2) Mumps
Nonspecific epididymitisandorchitis: How does it begin and spread?
Begins as a UTI → spreads via vas deferens or the lymphatics of the spermatic cord.
(neutrophilic infiltrate)
Mumps:
1) What can it affect?
2) What can cause possible sterility?
1) Testes (edematous and congested)
2) Severe mumps orchitis
TB: What does it cause?
Epididymitis → spreads to testis
*Germ cells are the source of 95% of testicular tumors, and the remainder arise from Sertoli or Leydig cells:
1) What histologic pattern makes up 60% of cases?
2) What makes up the rest?
1) Single “pure” pattern
2) Mixed patterns (40%).
*What are the 2 Clinical patterns of germ cell tumors:
Seminomas and Nonseminomatous
What is a key testicular tumor marker for seminomas?
HCG (produced by syncytiotrophoblasts) is secreted
*In acute bacterial prostatitis(2%–5% of cases), what is the usual pathogen? What about chronic?
E. colior another gram-negative rod; also caused by common uropathogens
1) How does acute prostatitis manifest?
2) What is contraindicated? Why?
1) Sudden onset of fever, chills, dysuria, perineal pain, and bladder outlet obstruction
2) DRE to risk of septicemia
How does chronic prostatitis manifest? What are the Sx?
1) Recurrent UTIs bracketed by asymptomatic periods.
2) Low back pain, dysuria, and perineal and suprapubic discomfort
DRE is contraindicated to risk of septicemia for what condition?
Acute prostatitis
Benign Prostatic Hyperplasia:
1) What stimulates proliferation?
2) Where does it originate?
1) DHT, an androgen derived from testosterone, is the major hormonal stimulus for proliferation.
2) Periurethral zone
*Most common cause of cancer in men is what?
Prostate carcinoma
Prostate cancer:
1) What is the hereditary risk?
2) Is there an environmental risk?
1) ↑ risk among patients w/ first degree relative w/ prostate CA
2) diet? Japanese immigrants ↑ risk
True or false: prostate cancer is more common in african americans
True
What is PSA? Is it cancer specific? Explain.
Biomarker; not cancer specific, which may lead to overtreatment of indolent cancers
T. pallidum causes what?
Syphilis
What stage of syphilis is characterized by a chancre?
Primary
What are 3 Sx of secondary syphilis?
1) Palmar rash
2) Lymphadenopathy
3) Condyloma latum
What are the Sx of the 3 manifestations of tertiary syphilis?
1) Neurosyphilis: meningiovascular, tabes dosalis, general paresis
2) Aortitis: aneurysms, aoritc regurg
3) Gummas: hepar lobatum; skin, bone, others
List the childhood Sx of congenital syphilis
1) Interstitial keratitis
2) Hutchinson teeth
3) CN8 deafness
*True or false: chancres don’t hurt, chancroids do
True
*What causes chancroids?
H. ducreyi.
1) A milky, purulent urethral discharge, is a common presentation of what?
2) What is a key Sx of chlamydia?
1) Gonorrhea
2) Painful urination
True or false: Pregnant women can transmit Gonorrhea and Chlamydia to newborns during passage through the birth canal.
True
Other urethritis: Reactive arthritis/ Reiter syndrome
1) What is positive?
2) C. trachomatisinfection can cause what 3 things?
1) HLA-B27 positive
2) Reactive arthritis, conjunctivitis, and generalized mucocutaneous lesions.
*HSV: Describe the initial/ primary infection
May be asymptomatic or cause painful, erythematous, intraepithelial vesicles on the mucosa and skin of external genitalia, along with painful regional lymph node enlargement.
*1) When does neonatal herpes occur? Describe it
2) What may affect infants have?
Neonatal herpes can be life-threatening and occurs in children born to mothers with genital herpes.
2) Generalized herpes, often associated with encephalitis and consequent high mortality.
*List 3 lesions that HPV can cause
1) Condyloma acuminatum
2) Precancerous lesions
3) Invasive cancers.
