Lecture 8.2 MJ slides Flashcards
Hypospadias:
1) What is it?
2) What can it cause?
1) Urethral opening on ventral penis; anywhere along the shaft
2) Meatus often constricted; predisposes to UTI
Epispadias:
1) What is it?
2) How common is it?
1) Urethral opening is on dorsal aspect of penis
2) Much less common [than hypospadias]
Inflammatory Lesions of the Penis
1) Define balanitis
2) Define balanoposthitis. What may it cause?
3) What are some common pathogens?
4) What do they result from?
1) Inflammation of the glans
2) Inflammation of the prepuce; phimosis
3) Candida albicans,anaerobic bacteria,Gardnerella,and pyogenic bacteria
4) Poor hygiene & build up of smegma
1) Most common cause of painless testicular enlargement is what?
2) What causes 95% of these? What cause the rest?
3) What are the two different patterns? of etiologies?
1) Testicular neoplasms
2) Germ cells are the source of 95% of testicular tumors, and the remainder arise from Sertoli or Leydig cells.
3) Single “pure” histologic pattern (60% of cases)
Mixed patterns (40%).
Testicular neoplasms
1) What are the Histologic patterns of germ cell tumors?
1) Seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma.
Non-semanomatous tumors: most commonly embryonal carcinoma, choriocarcinoma, teratoma, and yolk sac tumor.
Testicular neoplasms
What are the 2 main clinical patterns of germ cell tumors? Describe the spread of each
1) Seminomas: remain confined to the testis for a long time and spread mainly to paraaortic nodes; distant spread is rare.
2) Nonseminomatous: tumors tend to spread earlier, by both lymphatics and blood vessels.
What are the 2 tumor markers of testicular neoplasms?
1) HCG (produced by syncytiotrophoblasts) and is secreted in patients with seminomas
2) AFP is elevated when there is a yolk sac tumor component.
What is the most common cause of painless testicular enlargement?
Testicular neoplasms
What are the 4 types of prostatitis? What % does each make up?
1) Acute bacterial prostatitis(2%–5% of cases)
2) Chronic bacterial prostatitis(2%–5% of cases)
3) Chronic pelvic pain syndrome(90%–95% of cases)
4) Granulomatous prostatitis (?%)
1) What is the usual pathogen of acute bacterial prostatitis(2%–5% of cases)?
2) What abt chronic bacterial prostatitis(2%–5% of cases)?
3) What are the 2 kinds of Granulomatous prostatitis?
1)E. colior another gram-negative rod.
2) Also caused by common uropathogens
3) Infectious and noninfectious
Chronic pelvic pain syndrome(90%–95% of prostatitis cases): What are the 3 main kinds? How do you tell them apart?
1) Inflammatory: + leukocytes in prostatic secretions
2) Noninflammatory: No leukocytes
3) Unknown etiology and difficult to treat
What are the 3 clinical manifestations of prostatitis?
1) Acute
2) Chronic
3) Chronic pelvic pain syndrome
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; risk of septicemia
Chronic prostatitis:
1) How does it manifest?
2) What are some specific Sx?
1) Recurrent UTIs bracketed by asymptomatic periods.
2) Low back pain, dysuria, and perineal and suprapubic discomfort
Chronic Pelvic Pain Syndrome:
1) Where is pain localized? (3 locations)
2) When is pain a prominent finding?
1) To the perineum, suprapubic area, and penis
2) During or after ejaculation
Benign Prostatic Hyperplasia:
1) What is it characterized by? What stimulates this?
2) Where does it originate?
3) What are the Sx? Why? Describe them
4) What does chronic obstruction predispose to?
1) Proliferation of benign stromal and glandular elements.
-DHT, an androgen derived from testosterone, is the major hormonal stimulus for proliferation.
2) In the periurethral transition zone (hyperplastic glands are lined by two cell layers)
3) Starts at periurethral zone: Hesitancy, urgency, nocturia, and poor urinary stream
4) Recurrent urinary tract infections.
BPH Where does it originate? Explain this area
Originates in the periurethral transition zone → hyperplastic glands are lined by two cell layers:
1) Inner columnar layer
2) Outer layer composed of flattened basal cells
Carcinoma of the Prostate:
1) What is it the most common cause of?
2) How severe is it? Who are they more common in?
3) Describe the pathogenesis
1) Cancer in men
2) Prostate carcinomas range from indolent lesions that will never cause harm to aggressive fatal tumors - more common in African-Americans.
3) -Androgens: provides the Cellular context for the cancer to develop
-Heredity: ↑ risk among patients w/ first degree relative w/ prostate CA
-Environment: diet? Japanese immigrants ↑ risk
-Acquired genetic aberrations
What are 2 nontreponemal antibody tests?
VDRL and RPR
1) Define chancroid and what causes it
2) What leads to enlargement and ulceration?
3) How is Dx made?
1) Painful ulceratice genital infection; H. ducreyi.
2) Inguinal node involvement
3) By culture.
