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MHD > Male Path 2 > Flashcards

Male Path 2 Flashcards

1
Q

Hypospadias

A

urethra opening on the ventral surface (1 in 300)

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2
Q

Epispadias

A

urethral opening on the dorsal surface

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3
Q

Phimosis

A

prepuce can not be retracted

poor hygiene–infection–phimosis–infection–?carcinoma

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4
Q

Paraphimosis

A

phimotic prepuce is forcibly retracted

-constriction and swelling–pain–acute urinary retention

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5
Q

What are complications of gonorrhea?

A

urethritis-urethral strictures-sterility- and ectopic pregnancies

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6
Q

Who is more likely to get chlamydia non gonorrheal urethritis male or female?

A

male

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7
Q

chlamydia lymphogranuloma venereum

A

small epidermal vesicle–ulcer—inguinal and rectal lymphadenopathy

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8
Q

chlamydia trachomatis

A

chronic keratoconjuntivitis

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9
Q

reiter syndrome

A

can pee cant see cant climb a tree

-conjunctivitis, polyarthritis and genital infection

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10
Q

What is 1,2,3 syphilis?

A

1 (3 weeks)- chancre
2 (2-10 weeks)-palmar, solar rash, lymphadenopathy, arthritis, headache, fever, condyloma latum
3 (years)- neurosyphilis, aortitis, gummas

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11
Q

Condyloma Acuminatum

A

HPV 6,11
Gross: single or multiple sessile or pedunculated, red papillary excrescencies, one-several mm

Micro: papillary proliferation of squamous cells. koilocytosis- clear vacuolization of cytoplasm

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12
Q 
Squamous cell carcinoma of the penis
Risk factors 
HPV type
Gross 
Micro
A

poor hygiene and phimosis-accumulation of smegma, and history of genital warts
-circumcision confers protection
HPV types 16 and 18

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13
Q

Cryptorchisidism

A

Undescended testis

  • majority idiopathic, trisomy 13
  • unilateral, 25%-bilateral
  • complications-infertility and germ cell neoplasia

Gross: small, firm testicles
Micro: tubular atrophy

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14
Q

Testicular Torsion

A

twisting of the cord–thick walled arteries patent–vascular engorgement–infarction

  • sudden severe pain
  • congestion, edema, hemorrhage—hemorrhagic infarct–fibrosis
  • surgery within 8 hrs–80% slalvage
  • after 10 hours–20 % salvage

UROLOGIC EMERGENCY

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15
Q

What is the epidemiology of testicular tumors?

A 
15-34 most common tumor in men 
bimodal 
young and old
young-germ cell
old-lymphoma
white: african american 5:1
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16
Q

Germ cell tumors can be split up into seminomas and nonseminomatous germ cell tumors, what is the difference?

A

Seminoma

  • localized to testis for long time
  • 70% stage 1 (at presentation)
  • metastasis to lymph nodes
  • RADIOSENSITIVE
  • 95% cured

NSGCT

  • more aggressive
  • 60% stage 2 and 3
  • hematogenous spread (lungs and liver)
  • radioresistant
  • 90% complete remission and cure with aggressive chemotherapy
17
Q

What are risk factors for testicular tumors?

A
  • Cryptorchidism-higher the testis location, higher the risk of cancer (R>L)
  • gonadal dysgenesis with Y chromosome
  • testicular feminization
  • presence of ITGCN
  • HIV infection
  • **Trauma is not a risk factor
18
Q

What is a molecular risk factor for invasive testicular tumors regardless of the histological type?

A

isochromosome of the short arm of chromosome 12

90% of invasive tumors

19
Q

What are the clinical features of germ cell tumors?

A
  1. Painless enlargement of testis
  2. Lymphatic spread-retroperitoneal, para aortic, mediastinal, supraclavicular LN
  3. Hematogenous spread-lungs, liver, brain

AFP-yolk sac tumor
HCG-chroiocarcinoma

20
Q

ITGCN

Intratubular germ cell neoplasia

A

seen often associated with malignant germ cell tumors

Intratubular proliferation of malignant gem cells

Large atypical cells, abundant clear cytoplasm, central nucleus, prominent nucleoli “fried egg appearance”

21
Q

Seminoma

A

most common germ cell tumor
peak 30-40 years old
gross: homogenous gray-white cut surface
micro:
-sheets of uniform large cells with distinct cell membrane clear cytoplasm, large central nucleolus
-fibrous septae infiltrated with lymphocytes
-serum bHCG could be high in 10% of cases, AFP is normal

22
Q

Embryonal carcinoma

A

peak 20-30 old

gross-variegated poorly demarcated, foci of necrosis and hemorrhage

micro-large anaplastic cells with prominent nucleoli with indistinct borders arranged in solid, glandular, tubular, papillary patterns

23
Q

yolk sac tumor

A

two peaks: 1 infants(good prognosis) and young adults (mixed tumors)

most common testicular tomor in infants up to 3 Y**

micro: reticular network of cuboidal cells, papillary and solid patterns (Schiller-Duval or glomeruloid bodies) and hyaline-like globules (AFP and alpha 1 antitrypsin)

24
Q

choriocarcinoma

A

Metastasis at presentation, highly aggressive

-Pure form

25
Q

teratoma

A

Random admixture of tissue derived from ectoderm, endoderm and mesoderm

  • From infancy (pure) to adulthood (mixed germ cell tumors)
  • Mature, immature, with malignant transformations
  • NO BENIGN TERATOMAS IN POST PUBERTAL MALES **
26
Q

Leydig cell tumor

A

common sex cord-stromal tumor

  • any age 20-60s
  • usually unilateral
  • testicular enlargement, endocrine manifestations

Gross: well circumscribed ~3-4 cm nodule with homogenous, golden-brown cut surface

Micro: solid growth of large, polygonal cells with abundant granular cytoplasm and singe, round, centrally located nuclei with prominent nucleoli

CRYSTALLOIDS of REINKE***

27
Q

lymphoma

A

Usually secondary
Most common- large b cell lymphoma

> 60 MOST COMMON testicular neoplasm (the second-metastasis to testes)

-prognosis-poor

Gross-fleshy, white gray to pink, usually replace testicular parenchyma

28
Q

Most common testicular tumor in adults

A

seminoma

29
Q

most common bilateral primary testicular tumor

A

seminoma

30
Q

most common bilateral testicular tumor

A

lymphoma

31
Q

Most common testicular cancer in infants and children?

A

yolk sac tumor

32
Q

Most common non germ cell tumor of the testes?

A

leydig cell tumor

33
Q

Which are more common in the testis-mixed or pure histological tumor types?

A

mixed

MHD (81 decks)

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