Lower Urinary Tract Flashcards
Ureter
3
Constrictions
Ureteropelvic junction
Ureterovesical junction
Cross iliac vessels
Most common cause of hydronephrosis in infants and children
Ureteropelvic junction obstruction
Left ureter
Sudden severe pain at flank radiating post and inf
Cannot find comfortable position
Ureteral colic or ureterolithodynia
Majority of retroperitoneal abscess
Idiopathic
Ormond disease
Cx: r varicocele
WOF retroperitoneal fibrosis
Methysergide
Nests of urothelium or inbudding of the surface of the epithelium found in mucosa lamina
Brunn nests
Developmental failure in the anterior wall of the abdomen and bladder
Bladder exstrophy
Drainage of urine from umbilicus
MCC bladder adenoca
Patent urachus
Two variants of chronic cystitis
Follicular
Eosinophilic allergic
Schistosomoa haematobium
Predisposes to sq cell of bladder
Hemorrhagic cystitis
Inflammation And fibrosis of all bladder layers without evidence of bacterial infection
Fissures and punctate hemorrhages in bladder mucosa
Chronic mucosal ulcers
Mast cell infiltration
Glomerulations
Hunner ulcers
Interstitial cystitis
Soft yellow raised mucosal plaques
Large foamy macrophages with laminated mineralized concretions
Chronic e coli
Michaelis gutmann bodies
Malacoplakia
Bladder 95% epithelial origin
T
Urothelial carcinoma
Decrease in survival involves invasion of the
Muscularis propria
Detrusor
Most important risk factor in urothelial cell ca
Cigarette smoking
No familial preponderance
MC symptom of urothelial ca
Painless hematuria
Recurrence prevention of urothelial ca
Intravesicle instillation of BCG
UB obstruction
Males
Females
BPE
Cystocele
Urethritis organisms
N gonorrhea
C trachomatis
E coli
Fibromatosis of Buck’s fascia
Penile curvature and pain during sex
Peyronie
Inflamed granulation tissue polyp at urethral meatus in older females
Urethral caruncle
Hypospadia
Epispadia
Ventral
Dorsal
Orifice of the prepuce is too small
Phimosis
Infection of glans and prepuce
Poor local hygiene in uncircumcised males
Balanoposthitis
Solitary thickened gray white opaque plaque at the shaft of the penis
10% malignant risk
Bowen disease
Penile CIS
Multiple reddish brown papules at shaft of young sexually active males
Not premalignant
Bowenoid papulosis
Penile CIS
Condyloma acuminata
Penile sq cell ca
6 11
16 18
Failure of descent of testes
Marked hyalination and thickening of BM
Prominent Leydig cells
Cryptorchidism
Testicular atrophy
Infection
Mumps
Epididymitis
Age 35
C trachomatis N gonorrhea
E coli P aeruginosa
Twisting of spermatic cord resulting in bell clapper deformity in adults
Testicular Torsion
Most common benign paratesticular tumor
Small nodules at the UPPER POLE OF THE EPIDIDYMIS
Adenomatoid tumor
Spermatic cord
Proximal
Distal
Lipoma
Malignant paratesticular tumor
- rhabdomyosarcoma in children
- liposarcoma in adults
Testicular tumors
Germ cell tumors
Sex cord stromal tumors
Most common type of GCT
Large polyhedral distinct cell membrane with clear cytoplasm and large central nucleus
Intact tunica albuginea
Classic seminoma cell
Seminoma
Extends through tunica albuginea
Primitive glandular differentiation
Papillary convolutions
Embryonal ca
Schiller Duval bodies
AFP
A1 antitrypsin
Yolk Sac tumor
No testicular enlargement
Syncitiotrophoblasts HCG
Cytotrophoblast
Chorioca
Helter skelter collection of differentiated cells
Painless enlargement of the testes
Teratoma
Paraaortic mediastinal supraclav
Lungs liver brain bones
Golden brown homogenous surface
Rod shaped crystalloids of Renke
Androgen production
Testicular mass
Leydig cell tumor
Crystalloids of Charcot Butcher
Testicular mass
No androgen production
Sertoli cell tumor
Testicular dysgenesis
Gonadoblastoma
NHL
Male over 60
Testicular lymphoma
Intraprostatic urine reflux
Tender boggy prostate
Minute disseminated abscesses
Acute Bacterial prostatitis
Recurrent UTIs
Chronic bacterial prostatitis
No history of recurrent UTI
>10 WBCs/HPF
Bacterial culture negative
Chronic abacterial prostatitis
Periurethral transition zone
Median lobe hypertrophy
NODULAR HYPERPLASIA
BPH
Most common prostate adenoca
Acinar
Prostate adenoca
Spread
LN: obturator to para aortic nodes
Hema: lumbar prox femur pelvis thoracic spine ribs
Most hyperplasias arise in _ whereas carcinomas arise in _
Transitional
Peripheral
