Male Genital System Flashcards
which bacteria can cause cystitis?
E. coli, Proteus, Klebsiella, Enterobacter
which fungus can cause cystitis?
Candida
which parasite can cause cystitis?
S. hematobium
what are iatrogenic causes of cystitis?
chemotherapy, radiation (hemorrhagic cystitis)
list predisposing factors for cystitis
- more common in female (short urethra)
- diabetes mellitus
- instrumentation
- catheter, cystoscopy
- bladder calculi
- bladder outlet obstruction
- male = BPH
name clinical features of cystitis
- urinary frequency
- dysuria = pain or burning micturition
- pain over bladder/suprapubic
- fever and chills
- microhematuria
describe what is seen on pathological exam in chronic interstitial cystitis
- chronic inflammation
- mast cells
the condition seen in the image is associated with mutations in ___, ___ and ___ genes
urothelial carcinoma is associated with mutations in p53, Rb and p16 genes
the greatest risk factor for the condition seen in the image is ___
the greatest risk factor for the condition seen in the image is SMOKING
which drugs are associated risk factors for the condition in the image?
analgesic abuse (phenacetin)
cyclophosphamide
which chemicals are associated risk factors for the condition in the image?
naphthylamine
rubber products
infection with ___ is a risk factor for the ____ type of the condition seen in the image
infection with Schistosomiasis is a risk factor for squamous cell carcinoma of the bladder (NOT urothelial)
describe the presentation of the condition seen in the image
- painless hematuria
- dysuria
- urgency & frequency
- flank pain
in the papillary form of the condition in the image, it projects into ____ and causes ___ and therefore the patient presents earlier
in the papillary form of the condition in the image, it projects into the lumen of the bladder and causes obstructive symptoms and therefore the patient presents earlier
the flat type of the condition seen in the image is a ___ grade tumor that presents ___ and has a ____ prognosis because it ____
the flat type of the condition seen in the image is a high-grade tumor that presents late and has a poor prognosis because it invades the bladder wall
the squamous cell type of the condition seen in the image is associated with ___ and ___
the squamous cell type of the condition seen in the image is associated mainly with S. hematobium and bladder stones
a vignette with an “Egyptian immigrant” who has the condition seen in the image. Diagnosis and etiology?
squamous cell carcinoma of the bladder caused by S. hematobium (parasite)
describe clinical features of prostatitis
- dysuria, frequency, urgency
- low back/pelvic or genital pain
- fever, chills and leukocytosis
- loss of sex drive
- painful erections/ejaculation
describe the findings of a DRE in prostatitis
enlarged, tender prostate
describe what is seen in the image
describe the etiology of the condition seen in the image
testosterone → DHT by 5-alpha reductase (found in stromal cells) causes hyperplasia of stroma & glands
affects central/periurethral & transitional zones
the condition seen in the image affects ___ and ___ zones
it does NOT affect the ___ zone which is affected by ____ only
the condition seen in the image affects central/periurethral and transitional zones
it does NOT affect the peripheral zone which is affected by prostate cancer only
____ is the most important predisposing factor for the condition seen in the image
testosterone is the most important predisposing factor for the condition seen in the image
list the signs and symptoms of the condition seen in the image
- urethral compression:
- difficulty starting & stopping urination
- frequency/dribbling
- nocturia. dysuria
the histology of the condition seen in the image is hyperplasia of ___ and ___ (torturous, dilated/distended)
with 2 layers: inner ___ and outer ____
the histology of the condition seen in the image is hyperplasia of stroma and glands (torturous, dilated/distended)
with 2 layers: inner columnar and outer flattened basal cells
on DRE of the condition seen in the image, what is seen?
uniformly enlarged, NOT nodular
the initial complication of the condition seen in the image is ___; what else can this cause?
the initial complication of the condition seen in the image is obstruction;
back up of urine → bilateral hydroureters/hydronephrosis→chronic renal failure→ increased serum calcium → recurrent kidney & bladder stones →infections and acute urinary retention
list 2 potential treatments for the condition seen in the image
- TURP = transurethral resection
- 5-alpha reductase inhibitors
____ is the most common cancer in men and 2nd most common cancer related cause of death in men >50 yrs
prostate cancer is the most common cancer in men and 2nd most common cancer-related cause of death in men >50 yrs
list the risk factors for the condition seen in the image
- AGE (>65)
- African Americans
- high fat diet
- HPC1 gene
- RNASEL gene
- family history
the condition seen in the image affects the ___ zone and therefore presents late because it is further away from ____
the condition seen in the image affects the peripheral zone and therefore presents late because it is further away from the urethra
the condition associated with the image metastasizes to ___ via the ____ and can cause ___ pain
the condition seen in the image metastasizes to CNS via the venous plexus of Batson and can cause back pain
describe the presentation of the condition seen in the image
50% asymptomatic
- microscopic hematuria
- lower back pain (due to osteoblastic lesions seen in late stage/metas.)
- weight loss
- urinary symptoms
- dysuria
- weak, interrupted urine flow
describe DRE findings in the condition seen in the image
this is compared to BPH, where the prostate is ___
prostate is hard, nordular & irregularly enlarged
this is compared to BPH, where the prostate is uniformly enlarged and NOT nodular
describe what is seen on biopsy of the condition associated with the image
____ cells → ____ cells with atypia and NO ____ cells
biopsy: malignant glands back to back with little stroma
lined by SINGLE layer of cuboidal epithelial cells w/ atypia
columnar cells → cuboidal cells with atypia and NO flattened basal cells
PSA is normally produced by _____
what is a normal PSA value?
PSA is normally produced by prostatic glandular epithelium
normal = <4 ng/mL
high = >10 ng/mL
a complication of the condition seen in the image is ____
a complication of the condition seen in the image is urethral stricture
list conditions where PSA is high
- cancer
- BPH
- prostatitis, infarction
- ejaculation
- extensive exercise
describe the image
the condition seen in the image is described as failure of ____
the condition seen in the image is described as failure of a testis to descend completely into its normal position within the scrotum
the most common location of the condition seen in the image is ____, ____, ____
the most common location of the condition seen in the image is upper scrotal, inguinal canal, abdominal
an ____ is done to correct the condition in the image:
before 2 years old to reduce ___
before 5 years old to reduce ____
an orchiopexy is done to correct the condition in the image:
before 2 years old to reduce infertility
before 5 years old to reduce testicular cancer/germ cell tumors
in the histology of the condition seen in the image, there is atrophied ____ due to increased ____ which ultimately affects the ____ causing NO ____
in the histology of the condition seen in the image, there is atrophied seminiferous tubules due to increased temperature outside of scrotum which ultimately affects the Sertoli cells causing NO spermatogenesis
in the condition seen in the image;
____ is normal (but still infertile b/c no ___ cells)
___ is low and ____ is high
LH and testosterone are normal (but still infertile b/c no Sertoli cells)
inhibin is low and FSH is high
complications of the condition seen in the image are ___ and ___
complications of the condition seen in the image are infertility and increased risk of germ cell tumors
the etiology of epididymo-orchitis in children is ____
the etiology of epididymo -orchitis in children is G-ve bacilli
the etiology of epididymo-orchitis in males <35 years is ____
the etiology of epididymo -orchitis in males <35 years is:
STD, caused by Gonorrhea or C. trachomatis
the etiology of epididymo-orchitis in males >35 years is ____
the etiology of epididymo -orchitis in males >35 years is:
UTI, caused by E. coli or Pseudomonas
list causes of pre-testicular male infertility
hypopituitarism, estrogen excess
list causes of testicular male infertility
agonadism, atrophy, germ cell aplasia, maturation arrest
list causes of post-testicular male infertility
blood/lymph obstruction, infections, immotile cilia syndrome (Kartgener’s)
list risk factors for testicular tumors
- cryptorchidism = biggest risk factor
- isochromosome 12p
- duplicate of the P arm
- testicular dysgenesis (Klinfelter’s syndrome)
- radiation
list the testicular tumors associated with ages:
infant/children
15-30
30-50
>60 yrs
infant/children = teratomas & yolk sac
15-30 = mixed germ cell tumor
30-50 = seminoma
>60 yrs = lymphomas
the condition seen in the image is well circumscribed with no ___ & ___ and is therefore painless
the condition seen in the image is well circumscribed with no hemorrhage & necrosis and is therefore painless
the condition seen in the image spreads via ___, especially to which 2 nodes?
the condition seen in the image spreads via lymphatics, especially to the para-aortic and iliac lymph nodes
the histology of the condition in the image would have a ____ appearance with sheets of ___ with __ and ____ infiltrate
the histology of the condition in the image would have a fried egg appearance with sheets of uniform cells with delicate septa and lymphocytic infiltrate
___ is a tumor marker for the condition seen in the image with no increase in serum ___ or ____
LDH is a tumor marker for the condition seen in the image with no increase in serum HCG or AFP
describe treatments for the condition seen in the image
- treatment:
- excisional biopsy = allows for diagnosis and treatment
- radiosensitive, so do radiotherapy
- does NOT cause infertility
describe the composition of the condition seen in the image
seminiferous (seminoma) + non-seminiferous tubules (choriocarcinoma, embryonal, teratoma, yolk sac)
therefore, all 5 germ cells are seen
the condition seen in the image is a solid, (unilateral or bilateral?) tumor with ____ and ____
the condition seen in the image is a solid, unilateral tumor with hemorrhage and necrosis
since the condition in the image is partly seminoma, there would be an increase in ____
since the condition in the image is partly seminoma, there would be an increase in LDH
since the condition in the image is partly choriocarcinoma, there would be an increase in ____ which is secreted by _____
since the condition in the image is partly choriocarcinoma, there would be an increase in B-hCG = “male pregnancy” (secreted by syncytiotrophoblasts)
since the condition in the image is partly yolk sac, there would be an increase in ____ bodies, as well as in increase in serum ___
since the condition in the image is partly yolk sac, there would be an increase in Schiller-Duval bodies (primitive glomeruli) as well as an increase in serum AFP, A1AT
since the condition in the image is partly embryonal, ____ would be seen on histology
since the condition in the image is partly embryonal, small, round blue cells in a bizarre arrangement would be seen on histology
urethral opening on the ventral surface of penis = ___
urethral opening on the dorsal surface of penis = ___
urethral opening on the ventral surface of penis = hypospadias
urethral opening on the dorsal surface of penis = epispadias
phimosis is due to ____ or ____
phimosis is due to development anomalies or infection and scarring of the preputial ring
describe paraphimosis
when a phimotic prepuce is forcibly retracted over the glans penis, causing marked constriction and swelling
painful, urethral constrictions, UTIs
list the penile carcinoma in-situ
all are due to ____
all are due to HPV infection
the etiology of the condition seen in the image is ____
the etiology of the condition seen in the image is HPV 16 & 18
integrates into host chromosome → E6 and E7 inactivate p53 and Rb (respectively)
list risk factors for the condition seen in the image
- multiple sexual partners
- smoking
- smegma (dirty lubricating fluid in uncircumscribed males)
the condition seen in the image spreads via ____
the condition seen in the image spreads via lymph
describe the histology of the condition seen in the image
malignant squamous cells with keratin pearls
describe a complication of the condition seen in the image
skin is breached → secondary bacterial infxn (S. aureus) → epididymo-orchitis
hematocele is blood in the ___ caused by ____
hematocele is blood in the tunica vaginalis caused by trauma
a hydrocele is accumulation of fluid in ____
a hydrocele is accumulation of fluid in the tunica
varicocele is ____
varicocele is dilatation of congested blood vessels in spermatic cord
spermatocele is ____
spermatocele is dilatation of epididymis with semen
scrotal cancer is commonly seen in ____ and is associated with ____
scrotal cancer is commonly seen in chimney sweepers and is associated with coal tar
