male Path III

Question 1

what testicular tumors are associated with testicular dysgenesis syndrome

Answer 1

the germ cell tumors

seminomatous and non-seminomatous

Question 2

what is the triad of testicular dysgenesis syndrome

Answer 2

cryptorchidms
hypospadius
poor sperm quality

Question 3

what are the seminomatous tumors

Answer 3

seminoma

spermatocytic seminoma

Question 4

what are the non seminomatous germ cell tumors

Answer 4

embryonal Carcinoma
yolk sac tumor
choriocarcinoma
teratoma

Question 5

why do some patients with testicular torsion develop infertility

Answer 5

because once the blood testicle barrier is broken immune bodies recognize no as self and destory both testicles

Question 6

when does the carcinoma in situ cell arise in germ cell tumors

Answer 6

with boy at birth

Question 7

majority germ cell tumors are what

Answer 7

seminomas
embryonal
mixed

Question 8

germ cell tumor chromatin morphology

Answer 8

i12p band

Question 9

risk factors germ cell tumors

Answer 9

cryptorchidism, prior GCT
FMH (KIT and BK)
whites>blacks
brothers increase risk if have it

Question 10

where do germ cells mets to

Answer 10

periaortic abdominal lymph nodes

Question 11

what serume markers can be + in germ cell tumores

Answer 11

hCG LDH and afetalprotein

Question 12

how do germ cell tumors present

Answer 12

painless mass

Question 13

what is the most common GermCellTumor

Answer 13

seminoma

Question 14

serum markers for seminomas

Answer 14

LDH

hCG

Question 15

staging of seminomas

Answer 15

low risk-no mets

intermediate risk-mets

Question 16

what serum marker is never in a pure seminoma

Answer 16

AFP

Question 17

Tx seminoma

Answer 17

radical orchiectomy +/- retroperitoneal lymph node dissection

Question 18

Tx low risk seminoma

Answer 18

radiotherapy

Question 19

Tx intermediate risk seminoma

Answer 19

platinum based chemo

Question 20

gross morphology seminomas

Answer 20

lobular homogenous fleshy tan cut surface

Question 21

how do you prevent seeding of seminoma when cutting testis out

Answer 21

through inguinal canal

Question 22

histo seminoma

Answer 22

large cells with distinct borders, prominent nuclei and watery cytoplasm
lymphoid infiltrate
look like fried eggs

Question 23

schiller duval body

Answer 23

yolk sac tumor

Question 24

what are the pathologies of the prostate

Answer 24

inflammation
nodular hyperplasia (BPH)
adenocarcinoma

Question 25

What are the zones of prostate

Answer 25

central transitional peripheral

Question 26

what zone does BPH arise? most CA?

Answer 26

BPH in transitional | CA in peripheral

Question 27

what can cause acute prostatitis

Answer 27

bacteria like acute UTI agents | reflux of urine or iatrogenic

Question 28

presentation acute prostatitis

Answer 28

fever, chills, dysuria

Question 29

Tx acute prostattisi

Answer 29

antibiotics

Question 30

presentation chronic bacterial prostatitis

Answer 30

Hx of recurrent UTIs dysuria and localized pain

Question 31

Dx chronic prostatitis

Answer 31

PMNs in urine and a + culture

Question 32

what causes granulomatous prostatitis

Answer 32

secondary to ruptured acini | commonest cause is BCG

Question 33

what causes BPH

Answer 33

stomal cells make 5 hydroxy reductase that converts T to DHT which increases growth factors

Question 34

signs of BPH

Answer 34

poor flow, incomplete emptying | secondary infection: cystitis, pyelonephritis

Question 35

Tx BPH

Answer 35

alpha blockers 5 alpha reductase inhibitors to dec DHT tissue destruction: TURP, heat, US, laser

Question 36

corpora amylacea

Answer 36

pink secretions in glandular lumen | BPH

Question 37

signs BPH

Answer 37

enlarged prostate- lose distinction of R and L lobes | can feel median sulcus

Question 38

imaging prostate

Answer 38

rectal US

Question 39

TURP

Answer 39

transurethral prostatectomy

Question 40

phenazopyridine

Answer 40

drug given before urinary procedure | turns urine red

Question 41

complications BPH

Answer 41

obstruction bladder infection internal genitalia urosepsis

Question 42

If serum Cr doubles (even in normal range) in a year

Answer 42

bad! put in foley if suspect post renal obstruction

Question 43

most common Dx no non cutaneous malignancy in men

Answer 43

adenocarcinoma of prostate

Question 44

risk factors adenocarcinoma of prostate

Answer 44

age>50 y.o african american +FMH

Question 45

pathogenesis adenocarcinoma prostate

Answer 45

androgen dependent multiplicity of genetic mutations prostatic intraepithelial neoplasm is precursor lesion

Question 46

screening for adenocarcinoma

Answer 46

DRE | prostatic specific antigen

Question 47

where does adenocarcinoma of prostate arise

Answer 47

posterior wall

Question 48

needle Bx prostate glands with dark nuclei prominent nucleoli dark cytoplasm

Answer 48

Adenocarcinoma

Question 49

basal layer - and racemose + of prostate Bx stains

Answer 49

adenocarcinoma

Question 50

Gleason grades for adenocarcinoma of prostate

Answer 50

``` 1- well differentiated 2- well differentiated 3- moderately differentiated 4- poorly differentiated 5- undifferentiated commonest and second commenest scores added together ```

Question 51

T in staging adenocarcinoma of prostate

Answer 51

extracapsular extension T2 confined T3 extracapsular T4 adjacent organs

Question 52

N score in adenocarcinoma of prostate

Answer 52

no longer curable

Question 53

M score in adenocarcinoma of prostate

Answer 53

widespread dissemination OSTEOBLASTIC Tx with androgen deprivation

Question 54

perineural invasion in prostate Bx

Answer 54

correlates with extracapsular invasion T3

Question 55

how to detect boney mets from prostate

Answer 55

increase serum alk phosphatase because of increase osteoblast activity