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Bud Notes > Male Genital System > Flashcards

Male Genital System Flashcards

1
Q

Condition in which the urethral orifice is on the dorsal aspect of the penis. This is most commonly associated with ____.

A

Epispadia.
Associated with bladder extrophy.
Epispadia is less common than hypospasia

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2
Q

Condition in which the prepuce cannot be retracted easily over the glans. Most commonly due to? Complication?

A

Phimosis.
May be congenital, but mostly acquired from scarring secondary to previous episodes of balanoposthitis. If one retracts phimosis forcefully, circulation to the glans may be compromised with resultant congestion and pain of the distal penis (paraphimosis).

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3
Q

Solitary, plaquelike lesion on the shaft of the penis of an uncircumcised male. Histology reveals malignant cells throughout the epidermis with no invasion of the underlying stroma. Diagnosis?

A

Bowen disease.

May progress to SCCA in 33%

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4
Q

Erythematous patch on the glans penis. Histology reveals malignant cells in the epidermis.

A

Erythroplasia of Queyrat

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5
Q

Multiple, reddish brown papules on the glans. Histology reveals malignant cells in the epidermis with no invasion of the underlying stroma.

A

Bowenoid papulosis

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6
Q

Most common cause of scrotal enlargement

A

Hydrocele

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7
Q

Name one congenital syndrome with characteristic cryptorchidism

A

Prader-Willi Syndrome

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8
Q

Complications of cryptorchidism

A
  1. Sterility (esp in bilateral)

2. Malignancy (3x to 5x increase in incidence)

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9
Q

T/F. Orchipexy for cryptorchidism eliminates risk of CA and infertility.

A

NO! It only decreases likelihood of testicular atrophy.

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10
Q

Which ball is more commonly involved in cryptorchidism?

A

Right > Left.

Bilateral in 10%

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11
Q

Histologic features of cryptorchidism

A

Tubular atrophy
Hyalinization
HYPERPLASIA of Leydig cells
Foci of intratubular germ cell neoplasia

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12
Q

GCT QUIZ!

Large, uniform cells with distinct cell borders, clear, glycogen rich cytoplasm and round nuclei with conspicuous nucleoli

A

Seminomas

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13
Q

GCT QUIZ!

Mixture of medium-sized cells, large uninucleate or multinucleate tumor cells, and small cells with round nuclei reminiscent of secondary spermatocytes

No association with intratubular germ cell neoplasia

A

Spermatocytic seminoma

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14
Q

GCT QUIZ!

Large and primitive looking, with basosphilic cytoplasm, indistinct cell borders, and large nuclei with prominent nucleoli

A

Embryonal carcinoma

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15
Q

GCT QUIZ!

Most common primary testicular neoplasm in children younger than 3 yrs of age

A

Yolk sac tumor (aka endodermal sinus tumor)

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16
Q

GCT QUIZ!

Ill-defined, invasive mass containing foci of hemorrhage and necrosis

A

Embryonal carcinoma

Presence of hemorrhage should prompt scrutiny for histologic types other than pure seminoma.

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17
Q

GCT QUIZ!

Mass reveals cuboidal to columnar epithelial cells forming microcysts, sheets, glands and papillae, often associated with eosinophilic hyaline globules; “endothelium-like”

A

Yolk sac tumor

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18
Q

GCT QUIZ!

May be small and nonpalpable even with systemic mets!

A

Choriocarcinomas

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19
Q

GCT QUIZ!

Sheets of small cuboidal cells irregularly intermingled with large, eosinophilic syncytial cells containing multiple dark, pleomorphic nuclei

A

Choriocarcinoma

2 populations of cell represent cyto- and syncytiotrophoblast

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20
Q

GCT QUIZ!

Firm masses that on cut surface contain cysts and recognizable areas of cartilage

A

Teratomas

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21
Q

Choriocharcinoma forms chorionic villi. True or False.

A

False!

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22
Q

Metastasis of seminomas most commonly arises in which lymph nodes:

A

Iliac and para-aortic!

This reflects intraperitoneal origin of testes.

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23
Q

Germ cell tumors that are HCG(+)

A

Choriocarcinoma (100%)
Embryonal carcinoma (remember that they may have yolk sac and choriocarcinoma elements)
Teratoma, mixed tumor
Seminoma

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24
Q

SOME pure seminomas are AFP(+).

A

NO! AFP is one of the tumor markers that reliably raise likelihood of a mixed tumor.

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25
Q

Causes of chronic abacterial prostatitis

A

Chlamydia trachomatis

Ureaplasma urealyticum

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26
Q

Major hormonal stimuli for stromal and glandular proliferation in men with BPH

A

Dihydrotestosterone

27
Q

Proteinaceous secretory material in the glandular lumina in BPH

A

Corpora amylacea

28
Q

Irritative urinary symptoms

A

FUN!
Frequency
Urgency
Nocturia

29
Q

55/M presents with obstructive signs. Histology of prostate specimen obtained from TURP reveals hyperplastic glandular elements exhibiting dual population with an inner columnar cell and an outer flattened basal cell layer

A

BPH

30
Q

“The most common visceral cancer in males”

A

Prostate CA

31
Q

Among environmental influences, ___ has been suggested as a risk factor.

A

Diet high in animal fat

32
Q

This connective tissue layer prevents the growth of prostate CA posteriorly into the rectum

A

Denonvilliers fascia

Invasion of the rectum is thus less common

33
Q

Prostate specimen reveals glands lined by a single layer of cuboidal cells with conspicuous nucleoli and lie ‘back to back’ with each other.

A

Prostate CA

vs 2 layered glands in BPH

34
Q

Probable precursor lesion of prostate CA

A

Prostatic intraepithelial neoplasia (PIN)

35
Q

The presence of OSTEOBLASTIC METASTASIS in an older male is suggestive of.

A

Advanced prostatic CA

36
Q

Most important STDs in the homosexual population

A

Shigella (enterocolitis)
Campylobacter (enterocolitis)
Entamoeba histolytica (amebiasis)
Giardia lamblia (Giardiasis)

37
Q

Mean duration of the appearance of a chancre (primary lesion) after initial infection

A

21 days

38
Q

T/F. In tertiary syphilis, patients are less likely to be infectious and spirochetes are much more difficult to demonstrate.

A

True!

39
Q

The fundamental microscopic lesion of syphilis is:

A

Proliferative endarteritis

with inflammatory infiltrate rich in PLASMA CELLS (lymphoplasmacytic infiltrate)

40
Q

Microscopically, this lesion contains a central zone of coagulation necrosis surrounded by a mixed inflammatory infiltrate of lymphocytes, plasma cells and activated macrophages, and a peripheral zone of dense fibrous tissue.

A

Gumma

41
Q

Hard chancre is caused by __ while soft chancre is caused by ___.

A 
Treponema pallidum (syphilis)
Haemophilus ducreyi (chancroid)
42
Q

When is serologic test strongly positive for syphilis?

A

Second stage. Both nontreponemal and antitreponemal antibodies are strongly positive.

In the early stage of primary syphilis, serologic tests are often negative and should be complemented by dark-field microscopy of direct fluorescent antibody testing.

43
Q

T/F. Antibiotic therapy is required for resolution of the chancre in syphilis.

A

False. It resolves over a period of several weeks to form a scar.

44
Q

Patient comes in with symptoms suggestive of tertiary syphilis. You order non-treponemal and anti-treponemal antibody tests. What would be expected results?

A

Anti-treponemal tests remain positive.

Non-treponemal tests may revert to negative.

45
Q

Three forms of tertiary syphilis.

A

Cardiovascular (syphilitic aortitis)
Neurosyphilis (chronic meningovascular disease, tabes dorsalis, general paresis)
Benign tertiary syphilis (gummas)

46
Q

Gummas occur most commonly in:

A

Bone
Skin
Mucus membranes of upper airway and mouth

47
Q

Hutchinson triad of late (tardive) congenital syphilis

A

Late syphilis defined as congenital syphilis untreated for > 2 years.

Notched central incisors
Intersittial keratitis with blindness
Deafness from CNVIII injury

Other manifestations include saber shin deformity, mulberry molars, chorioretinitis, gummas of nasal bone resulting in ‘saddle nose deformity’

48
Q

Characteristic lesions in:

  1. Primary
  2. Secondary
  3. Tertiary
A
  1. Chancre
  2. Generalized lymphadenopathy with mucocutaneous lesions
  3. Aortitis, neurosyphilis, gummas
49
Q

Gonorrhea attaches to mucosal epithelium using structures called ___.

A

Pili

50
Q

MOST COMMON forms of STDs today

A

Nongonococcal urethritis and cervicitis

51
Q

MOST COMMON bacterial cause of STD in the US

A

Chlamydia trachomatis

52
Q

Second most common cause of nongonococcal urethritis (after Chlamydia)

A

Ureaplasma urealyticum

53
Q

Patient with lymphogranuloma venereum presents with:

A

Nonspecific urethritis
Papular or ulcerative lesions in the lower genitalia
Regional adenopathy
Anorectal syndrome

54
Q

Lymph node biopsy reveals granulomatous inflammatory reaction associated with irregularly shaped foci of necrosis and neutrophilic infiltration

A

Stellate abscesses characteristic of LGV

55
Q

Chancre or chancroid?

  1. Painful
  2. Indurated
  3. Multiple
  4. Shaggy, yellow gray exudate on the ulcer base
A
  1. Chancroid
  2. Chancre
  3. Chancroid
  4. Chancroid (clean base in chancre)
56
Q

Regional lymph nodes become enlarged and tender in 50% of cases. The buboes may then erode the overlying skin to produce chronic, draining ulcers.

A

Chancroid!

57
Q

Ulcer biopsy reveals a superficial zone of neutrophilic debris and fibrin, underlying zone of granulation tissue, and lymphoplasmacytic infiltrate beneath.

A 
Chancroid
Coccobacillary gram (-) bacilli sometimes seen on Gram / silver stain.
58
Q

Raised papular lesion undergoes ulceration accompanied by extensive granulation, manifesting grossly as protuberant, soft, painless mass. Border of the lesion becomes raised and indurated.

A

Granuloma inguinale

59
Q

Histology of a genital lesion reveals marked epithelial hyperplasia at the borders of the ulcer.

A

Granuloma inguinale!

Pseudoepitheliomatous hyperplasia

60
Q

T/F. Lymphogranuloma venereum, chancroid, and granuloma inguinale are all characterized by lymph node involvement.

A

False. Granuloma inguinale usually does not involve the lymph node

61
Q

Trichomonas vaginalis is often associated with loss of acid-producing ____ bacilli.

A

Doderlein bacilli (WTF?)

62
Q

Manifestations of neonatal herpes

A

Rash
Encephalitis
Pneumonitis
Hepatic necrosis

63
Q

Condyloma Quiz!

  1. Venereal warts caused by HPV 6 and 11
  2. Seen in secondary syphilis
A
  1. Condyloma acuminata

2. Condyloma lata

64
Q

In HPV infection, superficial epithelial cells contain irregular, hyperchromatic nuclei surrounded by a characteristic perinuclear halo

A

Koilocytosis

Bud Notes (25 decks)

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