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
Q

peak age 15-30, variable, depending on mixture, commonly teratoma and embryonal carcinoma, 90% with elevated hCG + AFP?

A

Mixed tumor

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26
Q

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?

A

Seminoma

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27
Q

15% of seminomas are associated with what?

A

Synctiotrophoblasts= elevated hCG

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28
Q

What is the organism causing Syphilis?

A

Spirochete–> Treponema pallidum

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29
Q

What is the sequelae of HPV in males?

A

Cancer of penis

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30
Q

What is the disease sequelae of HPV in females?

A

Cervical dysplasia and cancer,

vulvar cancer

31
Q

HPV sequelae in both males and females?

A

condyloma acuminatum

32
Q

Chlamydia trachomatis associated disease in males?

A

Urethritis
epididymitis
proctitis

33
Q

Chlamydia trachomatis associated disease in females?

A

Urethral syndrome
cervicitis
bartholinitis
salpingitis

34
Q

Ureaplasma urealyticum associated disease in males and females?

A

males–> urethritis

females–> Cervicitis

35
Q

what is the presentation of Primary syphilis?

A

Chancre

36
Q

Presentation of secondary syphilis?

A

Palm/sole Rash
Lymphadenopathy
Condylomata latum

37
Q

Presentation of Tertiary syphilis?

A

Neuro: Meningovascular, tabes dorsalis, paresis
Aortitis: aneurysms, regurgitation
Gummas: Hepar lobatum, skin, bone

38
Q

Congenital syphilis presentation?

A

Late abortion/ stillbirth
Infantile: Rash, osteochondritis, periostitis, liver+lung fibrosis
Childhood: Interstitial keratitis, Hutchinson teeth, Deafness

39
Q

Child with bifid incisors, and deafness?

A

Congenital syphilis

40
Q

Proliferative ednoarteritis with inflammatory infiltrate rich in plasma cells?

A

Syphilis

41
Q

Describe primary syphilis infection?

A

Hard, painless, well-defined chancre
Spontaneous resolution
Lymphocytic and plasmocytic infiltrates

42
Q

Describe the secondary syphilis infection?

A
Generalized LAD 
mucocutaneous lesions 
Rash= symmetrical and on palms/soles
Proliferative endarteritis
Lymphocytic inflammation
43
Q

Describe tertiary syphilis?

A

Aortitis
Neurosyphilis
Gummas

44
Q

What is Hutchinson triad?

A
Late congenital syphilis: 
notched central incisors
Interstitial keratitis + blindess
Deafness 
Saddle nose
Sabre shins
45
Q

What ist the test of choice for syphilis Dx?

A

PCR
RPR
VDRL

46
Q

Pt with purulent urethral discharge, edematous, congested urethral meatus?

A

Gonorrheae

47
Q

What are the complication of ascending GC infections>

A
Acute prostatitis 
Epididmyitis 
Orchitis 
Acute sapingitis 
PID
48
Q

Pt with dysuria, urinary frequency, mucopurulrent discharge?

A

N. gonorrheae

49
Q

Chronic ulcerative disease caused by Chlamydia trachomatis?

A

Lymphogranuloma Venereum

50
Q

Pt with mixed granulomatous + neutrophilic inflammatory response, Tender regional LAD?

A

Lymphogranuloma venereum== C trachomatis

51
Q

Infection by small, G- coccobacillus causing genital ulcers MC in Africa and Southeast Asia?

A

Chancroid–> Haemophilus ducreyi

52
Q

Painful ulcers/ erythematous papules, with regional tender LAD?

A

H. ducreyi–> Chancroid

53
Q

Acute and chronic inflammatory lesions that progress to fibrosis and lymphedema, formation of Rectal strictures?

A

Lymphogranuloma venerum

54
Q

Acute painful ulcerative genital chancroid?

A

H ducreyi

55
Q

Vaginal pruritus, profuse + frothy yellow vaginal discharge, with dysuria and frequency?

A

Trichomoniasis–> T vaginalis

56
Q

Initial HSV genital lesions are?

A

Painful
Erythematous vesicles
Histo: Intranuclear viral inclusions–> Cowdry A inclusions
Syncytia

57
Q

What are Cowdry type A inclusions?

A

Light purple, homogenous intranuclear structure surrounded by a halo

58
Q

What are manifestations of neonatal herpes developed during 2nd wk?

A

Rash
Encephalitis
pneumonitis
hepatic necrosis

59
Q

Pt with painful vesicular lesions, dysuria, urethral discharge, LAD and tenderness, fever, myalgia, headache?

A

First episodes of HSV

60
Q

ill Defined invasive masses containing foci of hemorrhage and necrosis, with Large Primitive basophilic cells, indistinct boarders and Prominent Nucleoli?

A

Embryonal Carcinoma

61
Q

Which type of testicular tumor can appear as undifferentiated sheets or glandular structure and irregular papillae?

A

Embryonal carcinoma

62
Q

What are the Most common primary testicular neoplasm in children < 3 yo?

A

Yolk sac tumor

63
Q

Testicular neoplasm showing loosely textured micro-cystic tissue and papillary structures resembling Glomeruli (Shiller-Duval bodies)?

A

Yolk sac tumor

64
Q

What type of testicular tumor is AFP and alpha 1 antitrypsin positive?

A

Yolk sac tumor

65
Q

Testicular tumor revealing sheets of small cuboidal cells irregularly intermingled or capped with large cytotrophoblasts or syncytiotrophoblasts, Prominent Hemorrhage and Necrosis?

A

Choriocarcinoma

66
Q

What is the immunostain used for Choriocarcinoma?

A

hCG

67
Q

Testicular tumors that contain cysts and recognizable areas of cartilage?

A

Teratoma

2nd MC in children to Yolk sac

68
Q

MCC of non translucent painless testicular mass?

A

Germ cell tumor (Seminoma)

69
Q

Seminomas most commonly metastasize where?

A

Iliac or paraaortic lymph nodes

70
Q

Nonseminomas most commonly metastasize early and spread hematogenously where?

A

Liver + lungs

71
Q

What marker is associated with Tumor burden?

A

LDH

72
Q

Where do hyperplastic vs. neoplastic lesions occur in the prostate?

A
Hyperplastic= Inner transitional zone
Neoplastic= outer peripheral zone
73
Q

What hormone is mostly responsible for BPH?

A

DHT

74
Q

Serine protease whose function is to cleave and liquify the seminal coagulum formed after ejaculation?

A

PSA