Male Flashcards
1
Q
Name the congenital bladder abnormality: pouch like evaginations of the bladder wall
A
bladder diverticula
2
Q
congenital—focal failure of normal muscle development
A
bladder diverticula
3
Q
Name the congenital bladder abnormality: caused by persistent urethral obstruction, most commonly BPH
A
bladder diverticula
4
Q
How does BPH cause bladder diverticula?
A
- Usually, BPH causes an increase in pressure and thickening of the bladder wall
- Increased pressure causes outpouching of the bladder and formation of diverticula
5
Q
frequently multiple, each can measure up to 10 cm
A
bladder diverticula
6
Q
cause of urinary stasis, which can predispose to infection
A
bladder diverticula
7
Q
Name the congenital bladder abnormality: incompetence of the vesicoureteral valve
A
vesicoureteral reflex
8
Q
allows the backflow of urine into the ureter, may also allow bacteria to ascend the ureter into the kidney –> frequent UTIs
A
vesicoureteral reflex
9
Q
Who does the vesicoureteral reflex affect?
A
infants and children
10
Q
Name the congenital bladder abnormality: spectrum of severity (graded 1-5), most cases mild
A
vesicoureteral reflex
11
Q
Name the congenital bladder abnormality: bedwetting, incontinence, usually resolves by around age 5-6
A
vesicoureteral reflex
12
Q
treatment for vesicoureteral reflex
A
antibiotic prophylaxis
13
Q
Name the congenital bladder abnormality: congenital or acquired connections between the bladder and other structures (rectum, vagina, uterus)
A
fistula
14
Q
channel between bladder and umbilicus during fetal development where urine initially drains, normally should seal off after first trimester
A
urachus
15
Q
patent urachus affects this gender
A
males
16
Q
What happens if the urachus is totally patent?
A
If totally patent (half of cases), a fistula-like tract is created that connects the bladder with the umbilicus –> fluid can drain from umbilicus
17
Q
Patent urachus causes an increased risk of two things:
A
- UTIs
- urachal carcinoma (bladder)
18
Q
patent urachus treatment
A
surgical correction
19
Q
bladder inflammation due to infection
A
cystitis
20
Q
Common bacterial causes of cystitis:
A
E. coli, Proteus, Klebsiella, and Enterobacter
21
Q
more common in women due to shorter urethra
A
cystitis
22
Q
Triad of symptoms of cystitis:
A
o Increased frequency of urination
o Lower abdominal pain
o Pain with urination (dysuria)
23
Q
pain with urination
A
dysuria
24
Q
Cystitis can lead to _______.
A
pyelonephritis
25
persistent, painful form of cystitis found in women, no evidence of infection
interstitial cystitis
26
fissures, ulcers, and punctate hemorrhages on the bladder mucosa
interstitial cystitis
27
tumor that usually begins as precursor papillary or flat lesion
urothelial tumor
28
usually arise from hyperplasia with a range of epithelial changes and are graded according to biological behavior
urothelial tumor
29
papillary lesions are the most common with this tumor
urothelial tumor
30
90% of all bladder tumors
urothelial carcinoma
31
tumors are often multifocal, grossly appears as a fungating, ulcerated mass
urothelial carcinoma
32
Major decrease in survival from a urothelial carcinoma is associated with...?
muscularis propria invasion
33
etiology is unknown, formation of fibrous bands involving the corpus cavernosum of the penis
peyronie disease
34
results in penile curvature and pain during intercourse
peyronie disease
35
abnormal opening of the urethra on the ventral surface of the penis
hypospadias
36
Name the penis disorder: common congenital anomaly, seen in 1 in 300 male births
hypospadias
37
congenital, abnormal opening of the urethral canal on the dorsal surface of the penis
epispadias
38
may be associated with failure of normal descent of the testes and with other malformations of the urinary tract
epispadias
39
Name the penis disorder: infection of the glans and prepuce caused by a wide variety of organisms
balanoposthitis
40
Organisms that cause balanoposthitis:
Candida albicans, anerobic bacteria, Gardnerella, and pyogenic bacteria
41
Name the penis disorder: caused by poor hygiene in the uncircumcised, with an accumulation of smegma, common cause of phimosis
balanoposthitis
42
Name the penis disorder: affects non-circumcised penis, orifice of the prepuce is too small to permit normal retraction
phimosis
43
Name the penis disorder: frequently the result of repeated infections that cause scarring of the preputial ring
phimosis
44
Name the penis disorder: interferes with cleanliness and permits the accumulation of secretions and particulate material under the prepuce, this may lead to secondary infection or malignancy
phimosis
45
Name the penis disorder: most common bacterial STD in the world
chlamydia (Chlamydia trachomatis)
46
Name the penis disorder: symptoms similar to N. gonorrhea
chlamydia
47
urethritis may be asymptomatic in men
chlamydia
48
purulent bacterial infection
gonorrhea (Neisseria gonorrhea)
49
#2 bacterial cause of STDs
gonorrhea (Neisseria gonorrhea)
50
infection in men causes urethritis
gonorrhea
51
spirochete bacteria
syphilis (Treponema pallidum)
52
first sign of infection is chancre
syphilis
53
single, firm, nontender ulcer located at the site of inoculation
chancre (first sign of syphilis)
54
highly contagious STD, chancre heals in 3-6 weeks with or without treatment
syphilis
55
cause of genital herpes
HSV2
56
vesicles on the external genitalia and mucous membranes that rupture to form superficial ulcers
herpes
57
virus remains latent in nerve ganglia
herpes
58
recurring outbreaks—individual battles with infection the rest of their life
herpes
59
"genital warts” that occurs on any moist surface of the external genitalia
condyloma acuminatum
60
cause of condyloma acuminatum
HPV
61
two most common low risk types of HPV
6 and 11
62
vaccine that prevents HPV
Gardasil
63
Bowen disease
carcinoma in situ
64
caused by HPV, most commonly serotype 16 (high risk)
carcinoma in situ
65
o Adults over 35 years
o Usually involves skin of shaft or scrotum
o Appears as a solitary, thickened, gray-white, opaque plaque
o Transform to invasive squamous cell carcinoma in 10%
carcinoma in situ
66
relatively uncommon in the US, < 1% of cancers in males
squamous cell carcinoma of the penis
67
_______ can be detected in 50% of patients with penile cancer.
HPV
68
can be protective against squamous cell carcinoma (penis) because it allows for better hygiene and a reduction in potential carcinogens that may accumulate in smegma and decreases risk of HPV
circumcision
69
cigarette smoking is a risk factor
squamous cell carcinoma (penis)
70
locally invasive, metastasis to the inguinal lymph nodes is common early
squamous cell carcinoma (penis)
71
failure of the testicle to descend from the abdomen (where it first develops) into the scrotum, usually palpable in the inguinal canal
cryptorchidism
72
more common in premature baby boys
cryptorchidism
73
unilateral vs bilateral stats of cryptorchidism
unilateral 90%
| bilateral 10%
74
Cryptorchidism:
Most spontaneously descend into the scrotum (within first few months of life). Those that do not are surgically relocated into the scrotum. What is this called?
orchiopexy
75
testicle that is at a higher risk of developing cancer
cryptorchid testicle
*orchiopexy reduces chance of cancer but does not eliminate it
76
Cryptorchidism is usually an isolated anomaly, but may occur with other malformations like _______.
hypospadias
77
inflammation of the epididymis, most often due to infections of the urinary tract
epididymitis
78
How does infection reach the epididymis and testes during epidydymitis?
through the vas or lymphatics of the spermatic cord
79
can cause abscess formation or complete suppurative necrosis of the entire epididymis
epididymitis
80
term if epididymitis progresses to involve the testis
orchitis
81
Affects of epididymitis in men under vs over 35
Sexually active men under 35, C. trachomatis and N. gonorrhea are the most frequent culprits
Men over 35, the common UTI pathogens are the culprits (E. coli and Pseudomonas)
82
gonorrhea (bacterial) infection of the epididymis
from the posterior urethra --> prostate --> epididymis
83
children and young adults, affects the testicles in 20-30% of post pubertal males with disease, orchitis develops about 1 week after parotid involvement
mumps (viral)
84
twisting of the spermatic cord that typically cuts off the venous drainage of the testicle, arteries remain open leading to engorgement
torsion
85
sudden onset of testicular pain, medical emergency requiring immediate surgery
torsion
86
most common male tumor in 15-34 year olds and cause approximately 10% of all cancer deaths
germ cell tumors
87
tumors with a strong family predisposition, most are highly treatable and curable (95% 5-year survival rate in the US)
germ cell tumors
88
Germ cell tumors can be an isolated neoplasm or associated with a spectrum of disorders known as ______.
TDS (testicular dysgenesis syndrome)
89
TDS (testicular dysgenesis syndrome) includes:
Includes cryptorchidism, hypospadias, and poor sperm quality
*Cryptorchidism is the strongest risk factor
90
standard treatment of a solid tumor mass (germ cell tumor)
orchiectomy based on the presumption of malignancy
91
surgical removal of both testicles
orchiectomy
92
Germ cell tumors common spread through...
What are involved first?
Hematogenous spread is primarily to...?
lymphatics / retroperitoneal para-aortic nodes / lungs, but liver, brain and bones may be involved
93
Name the germ cell tumor: most common testicular tumor (makes up 50% of all germ cell tumors)
seminoma
94
Name the germ cell tumor: produce bulky masses that may make the testicle up to 10x normal
seminoma
95
Name the germ cell tumor: most common testicular tumor in infants and children up to age 3, very good prognosis in this age group
yolk sac tumor
96
Name the germ cell tumor:
Microscopically
Schiller-Duval bodies may be seen- mesodermal core with a central capillary and a visceral and parietal layer of cells resembling glomeruli
yolk sac tumor
97
Name the germ cell tumor:
o Highly malignant
o Rare, < 1% of germ cell tumors
o Clinical: small palpable nodule
choriocarcinoma
98
Microscopically seen with choriocarcinoma:
| Two cell types (both components necessary for dx):
* Syncytiotrophoblasts
| * Cytotrophoblasts
99
Microscopically seen with choriocarcinoma:
| Two cell types (both components necessary for dx):
* Syncytiotrophoblasts
| * Cytotrophoblasts
100
Group of complex tumors with various cellular components reminiscent of normal tissues from all three germ layers
Can produce any type of tissue
May be benign or malignant
teratoma
101
Teratomas are common in ______ but rare in ______.
children /adults
102
these tumors have malignant potential, but most are benign
sex cord stromal tumors (leydig cell tumor, sertoli cell tumor)
103
Name the sex cord stromal tumor: arise at any age, most commonly between 26 and 60
Leydig cell tumor
104
Name the sex cord stromal tumor: secrete hormones (androgens and sometimes estrogens)
Leydig cell tumor
105
Name the sex cord stromal tumor: presenting feature is usually testicular swelling, but can be gynecomastia
Leydig cell tumor
106
Name the sex cord stromal tumor: precocious puberty is a feature in children
Leydig cell tumor
107
Name the sex cord stromal tumor: usually hormonally silent and present as a testicular mass
Sertoli cell tumor
108
non-neoplastic enlargement of prostate, cause unknown, possibly due to change in balance of sex hormones
benign prostatic hyperplasia
109
Incidence of benign prostatic hyperplasia:
20% of men aged 40 years
| 90% of men aged 80 years
110
Symptoms of urinary outlet obstruction, gradually worsen over time
• Frequent urination and nocturia
• Difficulty starting and stopping, can’t fully empty bladder
• Increased risk of bacterial infections of the bladder and kidney
clinical features of benign prostatic hyperplasia
111
degree of enlargement doesn’t always correlate with symptoms
benign prostatic hyperplasia
112
mild vs moderate/severe cases of benign prostatic hyperplasia
Mild cases can be treated conservatively with medication
Relaxation of muscles in the bladder, neck, and prostate
Actual shrinkage of gland size
Combination therapy
Moderate to severe cases resistant to medical therapy: surgery is the answer
TURP—gold standard (transurethral resection of the prostate)
Other new therapies are being developed that are less severe
113
most common cancer in US men (excluding skin)
prostate cancer
114
1:8 probability of being diagnosed in your lifetime
prostate cancer
115
prostate cancer stats
- Most common cancer in US men (excluding skin)
- 1:8 probability of being diagnosed in your lifetime
- 2nd leading cause of cancer death in males, although most men who get it won’t die from it
- Dramatic increase from 50 to 80 years
- Average age diagnosis is 66
- Rare under age 40
- No symptoms in early stages
116
is a blood test used to screen for prostate cancer in men without symptoms
PSA (prostate specific antigen)
If levels are > 10 ng/mL, 50% chance it means cancer
Normal is less than 4
117
Microscopically: adenocarcinoma
Diagnosed by core needle biopsy
prostate cancer
118
grading and staging of prostate cancer
Gleason scoring
Higher number = worse (higher grade)
Add two numbers together: most prominent + secondary pattern
• Score of 6 or less is low-grade
• 10 is highest (worst) possible score
119
clinical course of prostate cancer
metastasizes to bone
| spine, femur, pelvis, ribs
