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General Pathology > Male > Flashcards

Male Flashcards

1
Q

Name the congenital bladder abnormality: pouch like evaginations of the bladder wall

A

bladder diverticula

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2
Q

congenital—focal failure of normal muscle development

A

bladder diverticula

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3
Q

Name the congenital bladder abnormality: caused by persistent urethral obstruction, most commonly BPH

A

bladder diverticula

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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
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5
Q

frequently multiple, each can measure up to 10 cm

A

bladder diverticula

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6
Q

cause of urinary stasis, which can predispose to infection

A

bladder diverticula

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7
Q

Name the congenital bladder abnormality: incompetence of the vesicoureteral valve

A

vesicoureteral reflex

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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

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9
Q

Who does the vesicoureteral reflex affect?

A

infants and children

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10
Q

Name the congenital bladder abnormality: spectrum of severity (graded 1-5), most cases mild

A

vesicoureteral reflex

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11
Q

Name the congenital bladder abnormality: bedwetting, incontinence, usually resolves by around age 5-6

A

vesicoureteral reflex

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12
Q

treatment for vesicoureteral reflex

A

antibiotic prophylaxis

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13
Q

Name the congenital bladder abnormality: congenital or acquired connections between the bladder and other structures (rectum, vagina, uterus)

A

fistula

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14
Q

channel between bladder and umbilicus during fetal development where urine initially drains, normally should seal off after first trimester

A

urachus

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15
Q

patent urachus affects this gender

A

males

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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

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17
Q

Patent urachus causes an increased risk of two things:

A
  • UTIs

- urachal carcinoma (bladder)

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18
Q

patent urachus treatment

A

surgical correction

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19
Q

bladder inflammation due to infection

A

cystitis

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20
Q

Common bacterial causes of cystitis:

A

E. coli, Proteus, Klebsiella, and Enterobacter

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21
Q

more common in women due to shorter urethra

A

cystitis

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22
Q

Triad of symptoms of cystitis:

A

o Increased frequency of urination
o Lower abdominal pain
o Pain with urination (dysuria)

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23
Q

pain with urination

A

dysuria

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24
Q

Cystitis can lead to _______.

A

pyelonephritis

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25
Q

persistent, painful form of cystitis found in women, no evidence of infection

A

interstitial cystitis

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26
Q

fissures, ulcers, and punctate hemorrhages on the bladder mucosa

A

interstitial cystitis

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27
Q

tumor that usually begins as precursor papillary or flat lesion

A

urothelial tumor

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28
Q

usually arise from hyperplasia with a range of epithelial changes and are graded according to biological behavior

A

urothelial tumor

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29
Q

papillary lesions are the most common with this tumor

A

urothelial tumor

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30
Q

90% of all bladder tumors

A

urothelial carcinoma

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31
Q

tumors are often multifocal, grossly appears as a fungating, ulcerated mass

A

urothelial carcinoma

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32
Q

Major decrease in survival from a urothelial carcinoma is associated with…?

A

muscularis propria invasion

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33
Q

etiology is unknown, formation of fibrous bands involving the corpus cavernosum of the penis

A

peyronie disease

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34
Q

results in penile curvature and pain during intercourse

A

peyronie disease

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35
Q

abnormal opening of the urethra on the ventral surface of the penis

A

hypospadias

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36
Q

Name the penis disorder: common congenital anomaly, seen in 1 in 300 male births

A

hypospadias

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37
Q

congenital, abnormal opening of the urethral canal on the dorsal surface of the penis

A

epispadias

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38
Q

may be associated with failure of normal descent of the testes and with other malformations of the urinary tract

A

epispadias

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39
Q

Name the penis disorder: infection of the glans and prepuce caused by a wide variety of organisms

A

balanoposthitis

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40
Q

Organisms that cause balanoposthitis:

A

Candida albicans, anerobic bacteria, Gardnerella, and pyogenic bacteria

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41
Q

Name the penis disorder: caused by poor hygiene in the uncircumcised, with an accumulation of smegma, common cause of phimosis

A

balanoposthitis

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42
Q

Name the penis disorder: affects non-circumcised penis, orifice of the prepuce is too small to permit normal retraction

A

phimosis

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43
Q

Name the penis disorder: frequently the result of repeated infections that cause scarring of the preputial ring

A

phimosis

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44
Q

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

A

phimosis

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45
Q

Name the penis disorder: most common bacterial STD in the world

A

chlamydia (Chlamydia trachomatis)

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46
Q

Name the penis disorder: symptoms similar to N. gonorrhea

A

chlamydia

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47
Q

urethritis may be asymptomatic in men

A

chlamydia

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48
Q

purulent bacterial infection

A

gonorrhea (Neisseria gonorrhea)

49
Q

2 bacterial cause of STDs

A

gonorrhea (Neisseria gonorrhea)

50
Q

infection in men causes urethritis

A

gonorrhea

51
Q

spirochete bacteria

A

syphilis (Treponema pallidum)

52
Q

first sign of infection is chancre

A

syphilis

53
Q

single, firm, nontender ulcer located at the site of inoculation

A

chancre (first sign of syphilis)

54
Q

highly contagious STD, chancre heals in 3-6 weeks with or without treatment

A

syphilis

55
Q

cause of genital herpes

A

HSV2

56
Q

vesicles on the external genitalia and mucous membranes that rupture to form superficial ulcers

A

herpes

57
Q

virus remains latent in nerve ganglia

A

herpes

58
Q

recurring outbreaks—individual battles with infection the rest of their life

A

herpes

59
Q

“genital warts” that occurs on any moist surface of the external genitalia

A

condyloma acuminatum

60
Q

cause of condyloma acuminatum

A

HPV

61
Q

two most common low risk types of HPV

A

6 and 11

62
Q

vaccine that prevents HPV

A

Gardasil

63
Q

Bowen disease

A

carcinoma in situ

64
Q

caused by HPV, most commonly serotype 16 (high risk)

A

carcinoma in situ

65
Q

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%

A

carcinoma in situ

66
Q

relatively uncommon in the US, < 1% of cancers in males

A

squamous cell carcinoma of the penis

67
Q

_______ can be detected in 50% of patients with penile cancer.

A

HPV

68
Q

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

A

circumcision

69
Q

cigarette smoking is a risk factor

A

squamous cell carcinoma (penis)

70
Q

locally invasive, metastasis to the inguinal lymph nodes is common early

A

squamous cell carcinoma (penis)

71
Q

failure of the testicle to descend from the abdomen (where it first develops) into the scrotum, usually palpable in the inguinal canal

A

cryptorchidism

72
Q

more common in premature baby boys

A

cryptorchidism

73
Q

unilateral vs bilateral stats of cryptorchidism

A

unilateral 90%

bilateral 10%

74
Q

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?

A

orchiopexy

75
Q

testicle that is at a higher risk of developing cancer

A

cryptorchid testicle

*orchiopexy reduces chance of cancer but does not eliminate it

76
Q

Cryptorchidism is usually an isolated anomaly, but may occur with other malformations like _______.

A

hypospadias

77
Q

inflammation of the epididymis, most often due to infections of the urinary tract

A

epididymitis

78
Q

How does infection reach the epididymis and testes during epidydymitis?

A

through the vas or lymphatics of the spermatic cord

79
Q

can cause abscess formation or complete suppurative necrosis of the entire epididymis

A

epididymitis

80
Q

term if epididymitis progresses to involve the testis

A

orchitis

81
Q

Affects of epididymitis in men under vs over 35

A

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
Q

gonorrhea (bacterial) infection of the epididymis

A

from the posterior urethra –> prostate –> epididymis

83
Q

children and young adults, affects the testicles in 20-30% of post pubertal males with disease, orchitis develops about 1 week after parotid involvement

A

mumps (viral)

84
Q

twisting of the spermatic cord that typically cuts off the venous drainage of the testicle, arteries remain open leading to engorgement

A

torsion

85
Q

sudden onset of testicular pain, medical emergency requiring immediate surgery

A

torsion

86
Q

most common male tumor in 15-34 year olds and cause approximately 10% of all cancer deaths

A

germ cell tumors

87
Q

tumors with a strong family predisposition, most are highly treatable and curable (95% 5-year survival rate in the US)

A

germ cell tumors

88
Q

Germ cell tumors can be an isolated neoplasm or associated with a spectrum of disorders known as ______.

A

TDS (testicular dysgenesis syndrome)

89
Q

TDS (testicular dysgenesis syndrome) includes:

A

Includes cryptorchidism, hypospadias, and poor sperm quality

*Cryptorchidism is the strongest risk factor

90
Q

standard treatment of a solid tumor mass (germ cell tumor)

A

orchiectomy based on the presumption of malignancy

91
Q

surgical removal of both testicles

A

orchiectomy

92
Q

Germ cell tumors common spread through…

What are involved first?

Hematogenous spread is primarily to…?

A

lymphatics / retroperitoneal para-aortic nodes / lungs, but liver, brain and bones may be involved

93
Q

Name the germ cell tumor: most common testicular tumor (makes up 50% of all germ cell tumors)

A

seminoma

94
Q

Name the germ cell tumor: produce bulky masses that may make the testicle up to 10x normal

A

seminoma

95
Q

Name the germ cell tumor: most common testicular tumor in infants and children up to age 3, very good prognosis in this age group

A

yolk sac tumor

96
Q

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

A

yolk sac tumor

97
Q

Name the germ cell tumor:
o Highly malignant
o Rare, < 1% of germ cell tumors
o Clinical: small palpable nodule

A

choriocarcinoma

98
Q

Microscopically seen with choriocarcinoma:

 Two cell types (both components necessary for dx):

A
  • Syncytiotrophoblasts

* Cytotrophoblasts

99
Q

Microscopically seen with choriocarcinoma:

 Two cell types (both components necessary for dx):

A
  • Syncytiotrophoblasts

* Cytotrophoblasts

100
Q

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

A

teratoma

101
Q

Teratomas are common in ______ but rare in ______.

A

children /adults

102
Q

these tumors have malignant potential, but most are benign

A

sex cord stromal tumors (leydig cell tumor, sertoli cell tumor)

103
Q

Name the sex cord stromal tumor: arise at any age, most commonly between 26 and 60

A

Leydig cell tumor

104
Q

Name the sex cord stromal tumor: secrete hormones (androgens and sometimes estrogens)

A

Leydig cell tumor

105
Q

Name the sex cord stromal tumor: presenting feature is usually testicular swelling, but can be gynecomastia

A

Leydig cell tumor

106
Q

Name the sex cord stromal tumor: precocious puberty is a feature in children

A

Leydig cell tumor

107
Q

Name the sex cord stromal tumor: usually hormonally silent and present as a testicular mass

A

Sertoli cell tumor

108
Q

non-neoplastic enlargement of prostate, cause unknown, possibly due to change in balance of sex hormones

A

benign prostatic hyperplasia

109
Q

Incidence of benign prostatic hyperplasia:

A

 20% of men aged 40 years

 90% of men aged 80 years

110
Q

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

A

clinical features of benign prostatic hyperplasia

111
Q

degree of enlargement doesn’t always correlate with symptoms

A

benign prostatic hyperplasia

112
Q

mild vs moderate/severe cases of benign prostatic hyperplasia

A

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
Q

most common cancer in US men (excluding skin)

A

prostate cancer

114
Q

1:8 probability of being diagnosed in your lifetime

A

prostate cancer

115
Q

prostate cancer stats

A
  • 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
Q

is a blood test used to screen for prostate cancer in men without symptoms

A

PSA (prostate specific antigen)
 If levels are > 10 ng/mL, 50% chance it means cancer
 Normal is less than 4

117
Q

Microscopically: adenocarcinoma

Diagnosed by core needle biopsy

A

prostate cancer

118
Q

grading and staging of prostate cancer

A

 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
Q

clinical course of prostate cancer

A

metastasizes to bone

spine, femur, pelvis, ribs

General Pathology (11 decks)

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