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SP16- Gen Path Exam 3 > Male- Genitourinary Disease > Flashcards

Male- Genitourinary Disease Flashcards

1
Q

The genitourinary system consists of: (Five parts)

A
  1. Bladder
  2. Prostate
  3. Penis
  4. Urethra
  5. Testis
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2
Q

Hypospadias and Epispadias are what kind of penile malformation? Which of these is more common?

A

Abnormal location of the distal urethral orifice
Hypospadias = ventral (more common)
Epispadias = dorsal

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3
Q

Both hypospadias and epispadias increase the prevalence of ________ infections.

A

urinary tract

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4
Q

What is the most common type of penile neoplasm?

A

Squamous cell carcinoma and its precursor

make up 0.4% of all male cancers; so it’s still rare, but is the most common penile neoplasm

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5
Q

Squamous Cell Carcinoma is most common in ________ men and is associated with _____ infection.

A

uncircumcised (greater than 40)

HPV

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6
Q

Penile neoplasms are often preceded by ________.

A

premalignant lesions (red/white plaque)

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7
Q

What is the other name for carcinoma in-situ?

A

Bowen Disease

only about 20% will progress to cancer

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8
Q

True or False: Distant metastases are relatively common in squamous cell carcinoma of the penis.

A

False, uncommon

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9
Q

The 5 year survival rate for localized penile squamous cell carcinoma is ______%.

A

66

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10
Q

To which nodes will penile neoplasms typically metastasize?

A

inguinal

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11
Q

What was the first human cancer that was found to be associated with occupational factors?

A

scrotal squamous cell carcinoma (chimney sweeps)

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12
Q

_______ is the incomplete descent of the testis from the abdomen to the scrotum.

A

Cryptorchidism

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13
Q

When do the testis normally descend from the abdomen?

A

into the pelvis = by the third month of gestation

into the scrotum = during last two months intrauterine

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14
Q

Can cryptorchidism result in sterility?

A

Yes, both in the case of uni- and bilateral

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15
Q

How common is cryptorchidism in 1 year old males?

A

1%

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16
Q

Crytorchidism results in a ____fold increased risk for testicular cancer.

A

3 to 5

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17
Q

______ is the procedure used to treat cryptorchidism and therefore reduce the risk of sterility or cancer.

A

Orchiopexy (pull ‘em back down)

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18
Q

Inflammatory lesions of the testis are more common in _______ than ________.

A 
epididymis (epididymitis)
testis proper (orchitis)
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19
Q

Inflammatory lesions of the testis can be the result of complications from _______, ______, or _____.

A

urinary tract infections
mumps in adults (>20years old= 25% chance of lesion)
STDs

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20
Q

What is torsion? What are the two types?

A

twisting of the spermatic cord that causes obstruction of venous drainage and results in RAPID, INTENSE, vascular engorgement

  1. Tunica Vaginalis
  2. Bell Clapper
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21
Q

“partial enclosure with tie off at the gubernaculum” describes which type of torsion?

A

Tunica Vaginalis

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22
Q

“testis is inadequately affixed to the scrotum allowing it to move freely on its axis and is susceptible to induced twisting of the cord and its vessels” describes which type of torsion?

A

Bell Clapper

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23
Q

Testicular neoplasms occur in ______ out of 100,000 males with a peak incidence of _____ years old.

A

6

15-34 years old

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24
Q

What is the most common cause of painless testicular enlargement?

A

Testicular neoplasms

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25
Q

Which type of cell typically causes testicular neoplasms to be malignant? Which cell type is related to benign tumors?

A

Germ Cells = malignant

Sex-cord-Stromal cells = benign

26
Q

Of the testicular neoplasms, what percentage are sex-cord-stromal tumors and germ-cell tumors?

A 
Germ = 95%
Sex-Cord-Stromal = 5%
27
Q

Germ cell tumors (which account for 95% of testicular neoplasms), are divided into what two groups?

A
  1. Seminomas

2. Non-seminomatous tumors

28
Q

Histologic appearance of germ cell tumors can be pure (single cell type) or will often be ______.

A

mixed (multiple cell types)

29
Q

_____ are germ cell tumors that arise from epithelium of the seminiferous tubules.

A

seminomas

30
Q

True or False: Seminomas respond well to chemotherapy due to radiosensitivity and therefore are one of the most curable cancers.

A

True

31
Q

Non-seminomatous tumors (germ cell tumor type) will tend to spread early via _____ and _______.

A

lymphatics
blood vessels
(even small tumors may present with extensive metastases to liver and lung)

32
Q

What are the tumor markers used to detect Non-seminomatous tumors?

A
  1. alpha-fetoprotein (AFP)

2. Human Chorionic gonadoropin (hCG)

33
Q

Which type of germ cell tumor is characterized as “well-circumscribed with a high nucleus:cytoplasm ratio?”

A

Seminoma

34
Q

There are _____ new cases of germ cell tumors annually in the U.S.

A

8,000

less than 400 deaths

35
Q

____% of early-stage seminomas are cured. _____% of patients with nonseminomatous tumors achieve remisison with chemotherapy, most are cured.

A

95
90
(choriocarcinoma is the exception)

36
Q

Pure choriocarcinoma have a _____ prognosis than other germ cell tumors.

A

worse (distal disseminated infection)

37
Q

What are the three categories of prostate disorders?

A
  1. inflammatory lesions
  2. nodular hyperplasia
  3. carcinoma
38
Q

Prostate hyperplasia begins in the ______ zone.

A

transitional (tz)

39
Q

In which zone of the prostate can carcinomas be felt via digital palpation?

A

peripheral zone (pz)

40
Q

True or False: The majority of men will have some form of prostate hyperplasia by the age of 50-60.

A

True

41
Q

What is prostatitis?

A

prostate enlargement and tenderness that leads to dysuria, increased frequency, and low back or pelvic pain

42
Q

Prostatitis can be associated with _____ (minority of cases) or can be _______ (most cases).

A 
UTI infection (often e.coli)
nonbacterial prostatitis (most cases)
43
Q

True or False: Nonbacterial prostatitis has an unknown etiology and shows no response to antibiotics.

A

True

aka: Chronic Pelvic Pain Syndrome

44
Q

Nodular Hyperplasia of the Prostate, aka ________, generally affects the _____ periurethral zone of the prostate and compresses the prostatic urethra.

A

Benign Prostatic Hyperplasia (BPH)

inner

45
Q

Benign Prostatic Hyperplasia (nodular hyperplasia) is the proliferation of ____ and _____ cells that results in enlargement and possible urinary obstruction.

A

stromal

glandular

46
Q

True or False: Nodular Hyperplasia is extremely common.

A

True,
20% of men by age 40
90% of men by age 70

47
Q

What are the clinical symptoms of nodular hyperplasia?

A

hesitancy
urgency
nocturia
poor urinary stream

48
Q

One theory for the development of nodular hyperplasia is the local increase in _____.

A

androgens (hormonal stimulus)

49
Q

What is the treatment for nodular hyperplasia?

A
  1. Medical Management (drug treatment)

2. Surgical Management (TURP)

50
Q

What is TURP?

A

transurethral resection of the prostate (small pieces of tissue are cut from inside the prostate)

51
Q

What is the most common cancer of men over age 50 in the U.S.?

A

adenocarcinoma (accounts for 25% of cancer but only 9% of cancer deaths)

52
Q

Free movement of cells through the _____ plexus allows metastasis of adenocarcinoma from the genitourinary system to other parts of the skeleton (ex. the mandible mimicking PA lesion)

A

paravertebral

53
Q

Carcinoma of the prostate most commonly arises from the the ______ glands.

A

outer (peripheral)

= allows them to be palpable during digital exam

54
Q

Carcinoma of the prostate causes an elevated serum __________ level, but elevated levels could be due to other conditions as well.

A

prostate specific antigen (PSA)

55
Q

What is the treatment for carcinoma of the prostate?

A

combination therapy:

  • surgery
  • radiation
  • hormonal
56
Q

The prognosis for Prostate Carcinoma is ______% overall 10 year survival or ______% 10 year survival if disseminated.

A

98%

30%

57
Q

The majority (90%) of bladder cancers are _________

A

urothelial carcinoma

58
Q

How can bladder cancer be measured/detected?

A

tumor cells shed into the urine and can be detected via cytology

59
Q

In which portion of the population is bladder cancer most common?

A

men age 60-80 years

60
Q

What are the risk factors that contribute to bladder cancer occurrence?

A

cigarette smoking
chronic cystitis
infections with schistosomiasis
exposure to carcinogens

61
Q

Bladder (urothelial) cancer can begin as ______ carcinoma or _____carcinoma. Both have potential to become invasive

A

papilloma-papillary (looks like “coral”)

flat

62
Q

Urothelial cancer is treated via _______ or _____ or (less effectively) by ______. What is the prognosis?

A

transurethral resection
radical cystectomy

immunotherapy

prognosis depends on tumor grade and stage

SP16- Gen Path Exam 3 (12 decks)

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