Male GU

Question 1

Congenital Hypospadias

Answer 1

urethra opens on dorsum of the penis** notice before circumcision (need foreskin to repair)due to abnormal closure of the median raphe- epispadias = towards eye- hypospadias = down

Question 2

Balantis

Answer 2

infection of the glansuncircumcised

Question 3

Hydrocele

Answer 3

fluid in testestransilluminatein babies the fluid is peritoneal bc inguinal ring often hasn’t closed

Question 4

Elephantitis

Answer 4

due to filiariasis (transmitted by mosquitos) which blocks lymphatic drainage

Question 5

Varicocele

Answer 5

more common on LEFT (drainage of L testicular vein into the L renal vein)bag of worms

Question 6

Causes of prostatitis1) acute bacteria2) chronic bacteria3) chronic abacterial4) granulomatous

Answer 6

1) gram (-) bacteria, assoc w/ UTI or surgery2) gm (-), hx of prior UTI3) sexually transmitted4) TB, fungal, BCG

Question 7

Prostate Ca

Answer 7

Firm tan-yellow nodules; peripheral lobesProminent nucleoli, lack enveloping basal cellsLove invading the nervesAdenocarcinomas!!There is a small cell carcinoma; poor prognosis, lung met until proven otherwiseUsually only palpable on DRE w/ stage 3 or 4

Question 8

Malakoplakia

Answer 8

Mimics testicular neoplasm; area of dense fibrosis; inflammatory infiltrate w/ plasma cells/lymphocytes and macrophagesSome macrophages contain bluish spherules; these macrophages are called Von Hansemann cells and the bodies are called Michaelis-Gutman bodiesRelated to infection, but host reaction abnormal causing a granulomatous-like, mass-forming inflammation

Question 9

Causes of Atrophic Testicle

Answer 9

chronic alcoholismhypopituitarismatherosclerosischemoradiationmumps**cryptorchidism

Question 10

Testicular Tumors

Answer 10

White males 15-35Germ cell tumors = malignant (90% of tumors are germ cell)Sex-cord tumors = benign (opposite of female)

Question 11

Testicular Tumors Causes

Answer 11

cryptorchid testicleKlinefelter’stesticular feminization

Question 12

Testicular Seminoma

Answer 12

most common15-34; peak in 30s40-50% of all germ cell tumors Good prognosis, radiosensitive Well-circumscribed, no necrosis or hemorrhage (slick and shiny); may have trophoblastic cells; clear cell borders, T lymphocytes common, low mitosesElevated hCG>65yo (spermatocytic seminomas)

Question 13

Testicular Embryonal Carcinoma

Answer 13

2nd most common20-25Elevated AFP and hCG Less radiosensitive than seminomas, bulky, hemorrhage and necrosisMets = hematogenous, then lymphaticEpididymis involvementMore mitoses, more pleomorphic, no distinct borders