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DMD 5249 > Male and Female Tract Pathology (6) > Flashcards

Male and Female Tract Pathology (6) Flashcards

1
Q

What is Cryptorchidism

A

incomplete testicular descent at 1 that can be unilateral or bilateral

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2
Q

what are the types of cryptorchidism

A

true (it follows the inguinal canal but doesn’t descend completely)
ectopic (it doesn’t follow the inguinal canal and can end up somewhere else)

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3
Q

What are the problems with cryptorchidism

A

its associated with sterility and malignancy

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4
Q

how is cryptorchidism treated

A

orchiopexy - moving the testicle into the right location via surgery

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5
Q

What is the most common type of cancer in men 15-35

A

testicular cancer

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6
Q

What is looked for when doing a self evaluation for testicular cancer

A

enlarged testicle with a distinct lump
feeling of heaviness in the testicle or groin
changes in the way the testicle feels

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7
Q

What are the two main groups of testicular cancer

A

seminomas and nonseminomas

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8
Q

What are seminomas

A

tumors that arise from germinal epithelium of seminiferous tubules.
they often remain localized and don’t metastisize early. they are very sensitive to radiation and chemotherapy

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9
Q

What are the four types of nonseminomas

A

embryonal carcinoma
yolk sac tumor
choriocarcinoma
teratoma

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10
Q

What is an embryonal carcinoma

A

a tumor of undifferentiated stem cells, poorly differentiated and pleiomorphic.
there are usually no tumor markers

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11
Q

What is a yolk sac tumor

A

a tumor of yolk sac cells that occurs around 3 years
there are glomerulus like structures (Schiller-duval bodies)
90% of patients have an elevated alpha fetoprotein

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12
Q

What is a choriocarcinoma

A

a tumor of trophoblastic cells.

all patients have elevated hCG

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13
Q

What is a teratoma

A

a tumor of somatic tissue cells
the tissues are random (neural, muscle, brain, etc.)
no tumor markers

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14
Q

How is treatment of testicular cancer

A

with early detection there is a 90% cure rate
seminomas metastisize less, and are more sensitive to chemo and radiation
non seminomas metastisize earlier and farther and have a worse prognosis

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15
Q

What is torsion of the testis

A

rotation of the testi which causes blood vessels and the spermatic cord to twist. Its painful and causes the testis to swell. it can happen all on its own or due to strenuous activity

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16
Q

What are the three disorders of the scrotum

A

varicocele - inflammation/dilation of veins (valve problem)
hydrocele - scrotal swelling, fluid in the tunica vaginalis
spematocele - dilation of the epididymis

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17
Q

What is orchitis

A

acute inflammation of the testis

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18
Q

What is epididymitus

A

painful inflammation of the epididymis that is common among sexually active young men. an infection from the bladder or urethra travels to the epididymis.

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19
Q

What are the two types of prostate cancer

A

nodular hyperplasia and carcinoma

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20
Q

What is nodular hyperplasia of the prostate

A

benign proliferation of the glands and stroma
due to excessive androgen stimulation.
symptom is urinary obstruction due to compression of urethra

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21
Q

What are the stages and symptoms of prostate carcinoma

A

early = no symptoms (PSA exam detection)
late = hard nodule felt in rectal exam
very late = local pain and obstuctive syndromes

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22
Q

What is a PSA exam

A

PSA is an enzyme made in the prostate
PSA 10 suggests cancer
But it isn’t terribly reliable

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23
Q

What things influence likelyhood of prostate carcinoma

A

hormones, genetics, environment

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24
Q

how do we know hormones influence prostate carcinoma

A

castrated males before puberty don’t get it

orchiectomy and estrogen treatment works

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25
Q

how do we know genes influence prostate carcinoma

A

there is an increased risk in first-degree relatives

there is an earlier onset in African American

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26
Q

How do we know that the environment influences prostate carcinoma

A

there is an increase in scandinavian countries, and a decrease in asian countries

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27
Q

how does it appear that diet affects prostate carinoma

A

hyperinsulinemia is associated with accelerated growth of prostate cancer

28
Q

How is prostate carcinoma treated

A

surgery, radiation, and hormone therapy

29
Q

what is phimosis

A

foreskin is too tight to retract

30
Q

what is paraphimosis

A

foreskin is too tight to go over the glans

31
Q

What causes phimosis and paraphimosis

A

poor hygiene or chronic infections

32
Q

What is peyronie Syndrome

A

“bent nail syndrome” which is excessive curvature of the penis during erection. it is painful and caused by the development of fibrous plaques in the corpus cavernosa

33
Q

What is the precursor to cervical carcinoma

A

cervical intraepithelial neoplasia (CIN)

almost all cases of cervical carcinoma arise from CIN, but not all CIN leads to cervical carcinoma

34
Q

What are the different grades of Cervical intraepithelial neoplasia (CIN)

A

I , II, and III (I and II are low grade, III is high grade)

the higher the grade, the more likely it is to progress to carcinoma

35
Q

What are the risk factors for developing cervical carcinoma

A 
early age at first intercourse
multiple sexual parteners
persistent HPV infection
Smoking
Immunodeficiency
36
Q

How is HPV and cervical cancer correlated

A

HPV is detectable in almost all CIN and cancer
High risk HPV is found in carcinomas
Low rist HPV is found in condylomas

37
Q

From what do most cervical carcinomas arise

A

most cases are squamous arising from CIN,some are adenocarcinomas

38
Q

What is endometriosis

A

endometrial tissue located outside the uterus, often in peritoneum (rarely in lymph nodes)
The endometrial tissue stil undergoes cyclic bleeding and causes scarring, pain and sometimes sterility

39
Q

What causes a chocolate cyst in the ovaries

A

endometriosis

40
Q

What is endometrial hyperplasia

A

the proliferation of endometrium due to excess estrogen that can cause anovulatory cycles, obesity, estrogen producing ovarian tumors, exogenous hormone use

41
Q

What are the three types of endometrial hyperplasia, and which is most likely to develop into carcinoma

A

simple, complex, and atypical

this is the order of least to most likely to develop into carcinoma

42
Q

What is leiomyoma

A

a fibroid benign tumor of smooth muscle that is pretty common and is stimulated by estrogen.

43
Q

what are the symptoms of leiomyoma

A

menorrhagia
metrorrhagia
asymptomatic

44
Q

What is leiomyosarcoma

A

a malignant tumor of smooth muscle with necrosis, atypical cells and lots of mitoses. many of these metastisize

45
Q

What is endometrial cancer

A

cancer of the endometrium that usually arises from endometrial hyperplasia.

46
Q

What are the risk factors for endometrial cancer

A

obesity, nulliparity, estrogen replacement

47
Q

What are the symptoms of endometrial cancer

A

leukorrhea, irregular bleeding

48
Q

What are the different classifications of ovarian tumors

A

surface epithelial tumors
germ cell tumors
sex cord-stromal tumors

49
Q

what are the three different surface epithelial tumor types

A

serous (60% benign, p53 mutation)
mucinous (80% benign, proliferation of mucus secreting cells)
cystadenofibroma (benign tumor of surface epithelium, Large, cysts then neoplasm)

50
Q

What are the symptoms of ovarian tumors

A

feeling full or bloated
pelvic pain
back pain
abnormal menses

51
Q

What are the risk factors for ovarian tumors

A

nulliparity
family history
not using oral contraceptives

52
Q

what is the prognosis for ovarian tumors

A

when confined to the ovary, 5y = 70%

when through the ovarian capsule, 5y = 13%

53
Q

What is Polycystic ovarian syndrome (PCOS)

A

multiple cystic follicles that secrete excess androgens

54
Q

What are the symptoms of PCOS

A

Hirsutism
oligoovulation (infrequent) or anovulation
Hyperadrogenism
Infertility

55
Q

What effects does insulin have on the ovaries (premenopause)

A

it causes Testosterone production in the ovaries

and it inhibits aromatase, which converts Testosterone to Estradiol. so a low CHO diet helps with PCOS

56
Q

What effect does insulin have (postmenopause) on adipose

A

it increases Testosterone production in adipose

57
Q

What effect does insulin have on the testis

A

decreases testosterone production in testis

58
Q

What is a breast mouse

A

fibroadenoma, the most common benign breast tumor. it is stimulated by estrogens and is discrete and movable

59
Q

What are the risk factors for breast carcinoma

A 
age (75% of patients are older than 50)
familiy history
increased estrogen exposure
alcohol
obesity
high-sugar diet
60
Q

how do CHO influence breast cancer risk

A

CHOs increase risk of breast cancer (tumors can have more insulin receptors)

61
Q

What are the non-invasive carcinomas

A

Ductal carcinoma in situ (DCIS)

Lobular carcinoma in situ (LCIS)

62
Q

What are the invasive carcinomas

A

ductal (most common)
lobular
inflammatory ( peau d’orange, inflamed breast)

63
Q

How is a prognosis for breast carcinoma determined

A 
size of tumor
lymph node involvement
distant metastises
grade of tumor
histological type
64
Q

What is gynecomastia

A

overdevelopped breast tissue in males

65
Q

what can cause gynecomastia

A

hormone alterations
hypogonadism
obesity

DMD 5249 (10 decks)

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