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Reproductive > Male path (robbins) > Flashcards

Male path (robbins) Flashcards

1
Q

What is the most common male malformation?

A

Hypospadias-> opening on ventral surface of the penis

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2
Q

What are the complications/ associations with Hypospadias?

A

Infections
Inguinal hernias
Undescended testis

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3
Q

What is balanitis and balanoposthitis?

A

Local inflammation of glans penis and overlying prepuce

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4
Q

MCC of balanitis?

A

Candida albicans
Anaerobes
Gardnerlla
pyogenic bacteria

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5
Q

Condition in which the prepuce cannot be retracted?

A

Phimosis–> Often 2nd to balanosposthitis

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6
Q

MC penile neoplasm and factors?

A

Squamous carcinoma
Poor hygiene (smegma formation)
Smoking
HPV 16+18

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7
Q

Difference btwn SCC in situ and invasive in the penis?

A 
in situ (Bowen disease)--> solitary, plaque on shaft
    No invasion of stroma

Invasive-> gray, crusted, papular, on Glans or prepuce. invasion producing ulcers

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8
Q

What is the MCC of scrotal enlargement?

A

Hydrocele–> collection of fluid within Tunica vaginalis

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9
Q

What is Cryptorchidism?

A

Failure of the testes to descend into the scrotum

1% of all 1yo infants + 10% bilateral

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10
Q

What are the complications of Cryptorchidism? Both Unilateral + bilateral?

A

infertility

3-5x increased risk of Testicular Cancer

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11
Q

Nonspecific epididymitis + orchitis usually are 2nd to what other condition?

A

UTI that spread through urethra or lymphatics

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12
Q

Difference between orchitis due to UTI and mumps?

A

UTI–> predominantly PMN infiltration

Mumps–> Lymphocyte infiltration

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13
Q

What is the MCC of granulomatous inflammation in the Testes (epididymis)?

A

TB

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14
Q

Adult male pt with sudden testicular pain associated with anatomical defect?

A

Torsion–> caused by increased testicular movement called the BELL Clapper abnormality

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15
Q

How long are the testis viable during torsion?

A

6 hrs

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16
Q

What are 95% of testicular tumors?

A

Germ cell tumors (seminomas)

Malignant

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17
Q

What are sex-stromal tumors?

A

neoplasms derived from Sertoli and Leydig cells

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18
Q

What are some of the risk factors for Germ cell tumors?

A

White
Cryptorchidism
Intersex syndromes (androgen insensitivity and gonadal dysgenesis)
FHx (increased by 8-10x)

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19
Q

50% of germ cell tumors histologically Identical to Ovarian Dysgerminomas and CNS germinomas

A

Seminomas

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20
Q

What is the genetic association to all Germ cell tumors?

A

Isochromosome on short of chromosome 12

i(12p)

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21
Q

Peak age 40-50, sheets of polygonal cells with clear cytoplasm, lymphocytes in the stroma, 10% have elevated hCG?

A

Seminoma

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22
Q

Peak age 20-30, poorly differentiated, pleomorphic cells in cords, sheets, or papillary formation; contain yolk sac and choriocarcinoma cells?

A

Embryonal carcinoma

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23
Q

Peak age 3 yo, poorly differentiated endothelium-like, cuboidal, or columnar cells, 90% associated with elevated AFP?

A

Yolk sac tumor

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24
Q

Peak age 20-30, Cytotrophoblast and syncytiotrophoblast without villus formation, 100% with elevated hCG?

A

Choriocarcinoma

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25
peak age 15-30, variable, depending on mixture, commonly teratoma and embryonal carcinoma, 90% with elevated hCG + AFP?
Mixed tumor
26
Soft well-demarcated, gray white tumors that bulge from the cut surface of the affected testis. Large uniform cells with distinct cell borders, clear, glycogen rich cytoplasm and round nuclei with conspicuous nucleoli?
Seminoma
27
15% of seminomas are associated with what?
Synctiotrophoblasts= elevated hCG
28
What is the organism causing Syphilis?
Spirochete--> Treponema pallidum
29
What is the sequelae of HPV in males?
Cancer of penis
30
What is the disease sequelae of HPV in females?
Cervical dysplasia and cancer, | vulvar cancer
31
HPV sequelae in both males and females?
condyloma acuminatum
32
Chlamydia trachomatis associated disease in males?
Urethritis epididymitis proctitis
33
Chlamydia trachomatis associated disease in females?
Urethral syndrome cervicitis bartholinitis salpingitis
34
Ureaplasma urealyticum associated disease in males and females?
males--> urethritis | females--> Cervicitis
35
what is the presentation of Primary syphilis?
Chancre
36
Presentation of secondary syphilis?
Palm/sole Rash Lymphadenopathy Condylomata latum
37
Presentation of Tertiary syphilis?
Neuro: Meningovascular, tabes dorsalis, paresis Aortitis: aneurysms, regurgitation Gummas: Hepar lobatum, skin, bone
38
Congenital syphilis presentation?
Late abortion/ stillbirth Infantile: Rash, osteochondritis, periostitis, liver+lung fibrosis Childhood: Interstitial keratitis, Hutchinson teeth, Deafness
39
Child with bifid incisors, and deafness?
Congenital syphilis
40
Proliferative ednoarteritis with inflammatory infiltrate rich in plasma cells?
Syphilis
41
Describe primary syphilis infection?
Hard, painless, well-defined chancre Spontaneous resolution Lymphocytic and plasmocytic infiltrates
42
Describe the secondary syphilis infection?
``` Generalized LAD mucocutaneous lesions Rash= symmetrical and on palms/soles Proliferative endarteritis Lymphocytic inflammation ```
43
Describe tertiary syphilis?
Aortitis Neurosyphilis Gummas
44
What is Hutchinson triad?
``` Late congenital syphilis: notched central incisors Interstitial keratitis + blindess Deafness Saddle nose Sabre shins ```
45
What ist the test of choice for syphilis Dx?
PCR RPR VDRL
46
Pt with purulent urethral discharge, edematous, congested urethral meatus?
Gonorrheae
47
What are the complication of ascending GC infections>
``` Acute prostatitis Epididmyitis Orchitis Acute sapingitis PID ```
48
Pt with dysuria, urinary frequency, mucopurulrent discharge?
N. gonorrheae
49
Chronic ulcerative disease caused by Chlamydia trachomatis?
Lymphogranuloma Venereum
50
Pt with mixed granulomatous + neutrophilic inflammatory response, Tender regional LAD?
Lymphogranuloma venereum== C trachomatis
51
Infection by small, G- coccobacillus causing genital ulcers MC in Africa and Southeast Asia?
Chancroid--> Haemophilus ducreyi
52
Painful ulcers/ erythematous papules, with regional tender LAD?
H. ducreyi--> Chancroid
53
Acute and chronic inflammatory lesions that progress to fibrosis and lymphedema, formation of Rectal strictures?
Lymphogranuloma venerum
54
Acute painful ulcerative genital chancroid?
H ducreyi
55
Vaginal pruritus, profuse + frothy yellow vaginal discharge, with dysuria and frequency?
Trichomoniasis--> T vaginalis
56
Initial HSV genital lesions are?
Painful Erythematous vesicles Histo: Intranuclear viral inclusions--> Cowdry A inclusions Syncytia
57
What are Cowdry type A inclusions?
Light purple, homogenous intranuclear structure surrounded by a halo
58
What are manifestations of neonatal herpes developed during 2nd wk?
Rash Encephalitis pneumonitis hepatic necrosis
59
Pt with painful vesicular lesions, dysuria, urethral discharge, LAD and tenderness, fever, myalgia, headache?
First episodes of HSV
60
ill Defined invasive masses containing foci of hemorrhage and necrosis, with Large Primitive basophilic cells, indistinct boarders and Prominent Nucleoli?
Embryonal Carcinoma
61
Which type of testicular tumor can appear as undifferentiated sheets or glandular structure and irregular papillae?
Embryonal carcinoma
62
What are the Most common primary testicular neoplasm in children < 3 yo?
Yolk sac tumor
63
Testicular neoplasm showing loosely textured micro-cystic tissue and papillary structures resembling Glomeruli (Shiller-Duval bodies)?
Yolk sac tumor
64
What type of testicular tumor is AFP and alpha 1 antitrypsin positive?
Yolk sac tumor
65
Testicular tumor revealing sheets of small cuboidal cells irregularly intermingled or capped with large cytotrophoblasts or syncytiotrophoblasts, Prominent Hemorrhage and Necrosis?
Choriocarcinoma
66
What is the immunostain used for Choriocarcinoma?
hCG
67
Testicular tumors that contain cysts and recognizable areas of cartilage?
Teratoma | 2nd MC in children to Yolk sac
68
MCC of non translucent painless testicular mass?
Germ cell tumor (Seminoma)
69
Seminomas most commonly metastasize where?
Iliac or paraaortic lymph nodes
70
Nonseminomas most commonly metastasize early and spread hematogenously where?
Liver + lungs
71
What marker is associated with Tumor burden?
LDH
72
Where do hyperplastic vs. neoplastic lesions occur in the prostate?
``` Hyperplastic= Inner transitional zone Neoplastic= outer peripheral zone ```
73
What hormone is mostly responsible for BPH?
DHT
74
Serine protease whose function is to cleave and liquify the seminal coagulum formed after ejaculation?
PSA

Reproductive (6 decks)

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