Lecture 8.2 highlights

Question 1

*Hypospadias often constricts the meatus; what is the effect of this?

Answer 1

Predisposes to UTI

Question 2

Inflammatory Lesions of the Penis
1) Define balanitis
2) Define balanoposthitis. What may it cause?
3) Name a common cause

Answer 2

1) Inflammation of the glans
2) Inflammation of the prepuce; phimosis
3) Candida albicans

Question 3

1) 95% of penis neoplasms arise from what cell type?
2) Penis neoplasms are also often associated with ______.

Answer 3

1) Squamous epithelium
2) HPV

Question 4

*1) Define cryptorchidism
2) Unilateral or bilateral?
3) What are the 2 complications?
4) What is the Tx? Why?

Answer 4

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

Question 5

Inflammatory Lesions of the Testicles: List 2 causes

Answer 5

1) Epididymitisandorchitis (nonspecific)
2) Mumps

Question 6

Nonspecific epididymitisandorchitis: How does it begin and spread?

Answer 6

Begins as a UTI → spreads via vas deferens or the lymphatics of the spermatic cord.
(neutrophilic infiltrate)

Question 7

Mumps:
1) What can it affect?
2) What can cause possible sterility?

Answer 7

1) Testes (edematous and congested)
2) Severe mumps orchitis

Question 8

TB: What does it cause?

Answer 8

Epididymitis → spreads to testis

Question 9

*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?

Answer 9

1) Single “pure” pattern
2) Mixed patterns (40%).

Question 10

*What are the 2 Clinical patterns of germ cell tumors:

Answer 10

Seminomas and Nonseminomatous

Question 11

What is a key testicular tumor marker for seminomas?

Answer 11

HCG (produced by syncytiotrophoblasts) is secreted

Question 12

*In acute bacterial prostatitis(2%–5% of cases), what is the usual pathogen? What about chronic?

Answer 12

E. colior another gram-negative rod; also caused by common uropathogens

Question 13

1) How does acute prostatitis manifest?
2) What is contraindicated? Why?

Answer 13

1) Sudden onset of fever, chills, dysuria, perineal pain, and bladder outlet obstruction
2) DRE to risk of septicemia

Question 14

How does chronic prostatitis manifest? What are the Sx?

Answer 14

1) Recurrent UTIs bracketed by asymptomatic periods.
2) Low back pain, dysuria, and perineal and suprapubic discomfort

Question 15

DRE is contraindicated to risk of septicemia for what condition?

Answer 15

Acute prostatitis

Question 16

Benign Prostatic Hyperplasia:
1) What stimulates proliferation?
2) Where does it originate?

Answer 16

1) DHT, an androgen derived from testosterone, is the major hormonal stimulus for proliferation.
2) Periurethral zone

Question 17

*Most common cause of cancer in men is what?

Answer 17

Prostate carcinoma

Question 18

Prostate cancer:
1) What is the hereditary risk?
2) Is there an environmental risk?

Answer 18

1) ↑ risk among patients w/ first degree relative w/ prostate CA
2) diet? Japanese immigrants ↑ risk

Question 19

True or false: prostate cancer is more common in african americans

Answer 19

True

Question 20

What is PSA? Is it cancer specific? Explain.

Answer 20

Biomarker; not cancer specific, which may lead to overtreatment of indolent cancers

Question 21

T. pallidum causes what?

Answer 21

Syphilis

Question 22

What stage of syphilis is characterized by a chancre?

Answer 22

Primary

Question 23

What are 3 Sx of secondary syphilis?

Answer 23

1) Palmar rash
2) Lymphadenopathy
3) Condyloma latum

Question 24

What are the Sx of the 3 manifestations of tertiary syphilis?

Answer 24

1) Neurosyphilis: meningiovascular, tabes dosalis, general paresis
2) Aortitis: aneurysms, aoritc regurg
3) Gummas: hepar lobatum; skin, bone, others

Question 25

List the childhood Sx of congenital syphilis

Answer 25

1) Interstitial keratitis 2) Hutchinson teeth 3) CN8 deafness

Question 26

*True or false: chancres don't hurt, chancroids do

Answer 26

True

Question 27

*What causes chancroids?

Answer 27

H. ducreyi.

Question 28

1) A milky, purulent urethral discharge, is a common presentation of what? 2) What is a key Sx of chlamydia?

Answer 28

1) Gonorrhea 2) Painful urination

Question 29

True or false: Pregnant women can transmit Gonorrhea and Chlamydia to newborns during passage through the birth canal.

Answer 29

True

Question 30

Other urethritis: Reactive arthritis/ Reiter syndrome 1) What is positive? 2) C. trachomatis infection can cause what 3 things?

Answer 30

1) HLA-B27 positive 2) Reactive arthritis, conjunctivitis, and generalized mucocutaneous lesions.

Question 31

*HSV: Describe the initial/ primary infection

Answer 31

May be asymptomatic or cause painful, erythematous, intraepithelial vesicles on the mucosa and skin of external genitalia, along with painful regional lymph node enlargement.

Question 32

*1) When does neonatal herpes occur? Describe it 2) What may affect infants have?

Answer 32

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.

Question 33

*List 3 lesions that HPV can cause

Answer 33

1) Condyloma acuminatum 2) Precancerous lesions 3) Invasive cancers.