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pathology > male pathology > Flashcards

male pathology Flashcards

1
Q

Acute bacterial prostatitis etiology

A

Same as UTI

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2
Q

Acute bacterial prostatitis pathogenesis

A

Organisms ascend from urethra and urinary bladder Rarely, hematogenous spread

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3
Q

Acute bacterial prostatitis morphology

A

Acute inflammation in the glands with micro abscess, congestion & edema

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4
Q

Micro abscess are aggregation of ____ in the glands

A

Neutrophils

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5
Q

Acute bacterial prostatitis clinical course

A

Dysuria, frequency, low back pain & pelvic pain.
The prostate is enlarged and exquisitely tender.
+/- fever, chills, or Leukocytosis.

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6
Q

Prostate size in Abp

A

Enlarged

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7
Q

Which is more common bacterial or abacterial chronic prostatitis

A

Abacterial

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8
Q

Bacterial chronic prostativies etiology

A

Same as acute

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9
Q

Abacterial chronic prostatitis etiology

A

Chlamydia, trichomonas & ureaplasma urealyticum

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10
Q

Chronic prostatitis morphology

A

Lymphocytic infiltrate, PMN & macrophages, Some evidence of tissue destruction

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11
Q

Where does nodular hyperplasia occur

A

Transitional &periurethral zones

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12
Q

Most common age for bah

A

Over 70

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13
Q

What’s the main hormone in Bph

A

Dihydrotestosterone

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14
Q

Estrogen role in nodular hyperplasia

A

Increase in older men cause an increase in DHT receptors

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15
Q

BPH clinical course

A

Only in 10%, hesitancy, urinary retention & elevated PSA

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16
Q

BPH treatment

A

5 alpha- reductase type 2 inhibitors
: Transurethral resection of prostate tissue to relieve the obstruction

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17
Q

Enzyme that convert testosterone to dihydrotestosterone

A

5 alpha reduces type 2

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18
Q

Is BPH premalignant

A

BPH is not a premalignant condition and is not precursor of carcinoma

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19
Q

___% of BPH cases contain incidental carcinoma

A

10%

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20
Q

PSA > 4ng/ml

A

Carcinoma, BPH, Prostatitis, After biopsy

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21
Q

PSA can be used for:

A

Monitoring success of Prostatectomy
Detecting early relapses & DDx of other malignancies

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22
Q

Most common visceral CA in Male

A

Carcinoma of the prostate

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23
Q

2nd most common cause of CA death in men.

A

Carcinoma of the prostate, 20%

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24
Q

Peak incidence of clinical prostate CA

A

65-75 years
10% at 50 y & 80% at 80 y

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25
Q

in which race is prostatic carcinoma more common

A

black

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26
Q

prostatic carcinoma clinical features

A

Often clinically silent, (start at the peripheral zone)
Urinary obstructive symptoms → extensive prostate CA

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27
Q

75% of prostatic cancer patients present in what stage

A

C&d

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28
Q

Diagnosis of prostatic cancer

A

Routine surveillance in men over 40 yr
Incidental finding in Transurethral Resection of the Prostate TURP
Adenocarcinoma with unknown primary
rarely , rectal or perirectal mass.

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29
Q

Metastases in prostatic carcinoma

A

osteoblastic bone lesions.

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30
Q

Prostatic cancer clinical course

A

Digital rectal exam (DRE), PSA: > 4 ng/ml in peripheral blood (Free PSA < 25%)
Transrectal ultrasound, Needle biopsy (hard mass on the peripheral zone).
Metastases

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31
Q

free PSA in prostatic cancer

A

<25%

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32
Q

Prostate carcinoma pathology

A

Yellow-white hard multifocal foci with predilection for peripheral zones
Haphazard small irregularly shaped invasive glands with abortive lumens.
Glands lack basal cell layer & Cells contain prominent nucleoli
Perineural invasion.

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33
Q

Prostatic intraepithelial neoplasia

A

precursor lesion for prostatic adenoCA & no invasive component, but the glands have malignant cells

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34
Q

At which stage needle biopsy start

A

3

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35
Q

What’s well differentiated score in Gleason scoring

A

2

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36
Q

What’s well differentiated score in Gleason scoring during needle biopsy

A

6

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37
Q

Abnormal location of the urethral orifice

A

Hypospadias & epispadias

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38
Q

Hypospadias

A

Ventral aspect, common, associated with genital abnormalities

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39
Q

Epispadias

A

Dorsal & rare

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40
Q

Abnormal location of the urethral orifice clinical consequences

A

Constriction of orifice, UT obstruction, UTI
impaired reproductive function

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41
Q

Sexually transmitted inflammatory lesions most commonly caused by

A

HPV

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42
Q

Banalities etiology

A

Poor local hygiene in uncircumcised men

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43
Q

Define banalities

A

Inflammation of the glans with prepuce

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44
Q

Smegma

A

Accumulation of desquamared epithelial cells, sweat & dermis

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45
Q

Banalities clinically

A

Distal penis is red, swollen, tender, +/- purulent discharge

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46
Q

Define phimosis

A

Prepuce can’t easily be retracted over glans

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47
Q

Paraphimosis

A

Associated with urethral constriction

48
Q

Phimosis etiology

A

Congenital, balanoposthiris & scarring

49
Q

Trapped glans

A

Paraphimosis

50
Q

Fungal infections etiology

A

Poor local hygiene especial diabetics, warm moist conditions

51
Q

Fungal infections clinical course

A

Erosive, painful, pruritic & can involve entire male external genital

52
Q

Fungal infections diagnosis

A

Scraping or biopsy

53
Q

Fungal infections microscopy

A

Budding yeast & pseudohyphae

54
Q

Condyloma acuminaram etiology

A

St, HpV 6 (common) & 11

55
Q

Condyloma acuminatam microscope

A

Abnormal squamous cells & koilocytic changes

56
Q

Condyloma acuminariam benign or malignant

A

Design

57
Q

Penile carcinoma etiology

A

HPV 16 & 18

58
Q

Bowen Disease _____ age of 35

A

Above

59
Q

Bowenoid populaces ___ age of 35

A

Below

60
Q

Solitary plaquelike lesion

A

Bowen disease

61
Q

Multiple red brown populous

A

Boweroid populaces

62
Q

Incidence of Bowen disease to become invasive carcinoma

A

%10

63
Q

Incidence of bowenoid populaces to become invasive carcinoma

A

Never

64
Q

Erythroplasia of Queyrat

A

erythematous patch on the glans

65
Q

Squamous cells carcinoma incidence

A

1% in uncircumcised men 40 -70

66
Q

Scc affects

A

Glans & prepuce

67
Q

SCc pathogeneis

A

Poor hygiene, Smegma (exposure to potential carcinogens) HPV (16,18) /Environmental irritants (coal tar, soot)
CIS first then progression to invasive SCC

68
Q

SCc clinical course

A

Usually indolent, Locally invasive, rare distant metastasis 25% of cases has spread into inguinal lymph nodes

69
Q

Scc survival

A

5 years, 70% without Ln 27 % with

70
Q

Scrotal enlargement syndromes

A

Hydrocele, hematocele & chylocele

71
Q

Which testis is more common to have crytorchidism

A

Right

72
Q

Cryptorchidism hormonal etiology

A

Deficient of lhrf, intrinsic testicular abnormalities

73
Q

Cryptorchidism mechanical etiology

A

Short spermatic cord or blocked inguinal canal

74
Q

Crypoorchidism morphology

A

Smaller than normal testes
Hypoplastic or atrophic germinal layer of tubules
Leydig cell hyperplasia, Thickened BM
Intratubular germ cell neoplasia

75
Q

Crypbochridism management

A

Orchiopexy

76
Q

causes of Testicular atrophy

A

Chronic ischemia, inflammation or trauma & Hypopituitarism
Excess female sex hormones: Therapeutic administration & Cirrhosis
Malnutrition, Irradiation & Chemotherapy

77
Q

cryptorchidism ____ fold ↑risk of testicular malignancy i

A

4

78
Q

Nonspecific epididymitis & orchitis etiology

A

Secondary to UTI

79
Q

Nonspecific epididymitis & orchitis clinically

A

swelling & tenderness, Acute inflammatory infiltrate

80
Q

Mumps clinically

A

Edema, congestion & chronic inflammatory infiltrate

81
Q

Tuberculosis

A

Granulomatous inflammation and Caseous necrosis

82
Q

Seminoma metastasity

A

5%- 10 %

83
Q

Seminoma median age

A

25 - 50

84
Q

Seminoma of testicular GCT

A

35% - 50%

85
Q

Testicular tumor peak age

A

15-34

86
Q

Testicular tumors risk factors

A

Cryptorchidism, testicular feminization syndrome, Klinefelter syndrome, siblings, cytogenic abnormalities

87
Q

most important cause of painless enlargement of testis

A

Testicular tumor

88
Q

In what race is testicular tumor more common

A

White

89
Q

One histological partner testicular cancer

A

60% seminoma (30%) emburyonal, yolk sac, choricarcinoma & teratome

90
Q

multiple histological partner testicular cancer

A

(40%): Embryonal CA, teratoma, Choricarcinoma + other, Other combinations

91
Q

Large cells with distinct cell borders

A

Seminoma

92
Q

Large cells with indistinci cell borders

A

Embryonal carcinoma

93
Q

Seminoma microscopy

A

large Cells (clear or granular Cytoplasm) with Distinct cell borders (CM)
Round nuclei and conspicuous nucleoli
Lymphocytic infiltrate (T) and granulomas are common

94
Q

Is seminoma pure or mixed

A

Pure

95
Q

Seminoma metastasis to

A

Iliac & para aortic lymph nodes

96
Q

In seminoma, the precursor of GCT is _____

A

present

97
Q

In spermatocyric seminoma, the precursor of GCT is _____

A

Absent

98
Q

Positive plap test

A

Classical seminoma

99
Q

Intratubular component in spermatocytic seminoma

A

False

100
Q

Differentiation in seminomatous

A

Gondola

101
Q

Differentiation in embryonic carcinoma

A

Totipotential

102
Q

2nd most common GCT

A

Embryonal carcinoma 20% - 30%

103
Q

Embryonal carcinoma mixed or pure

A

Mixed

104
Q

Embryonal carcinoma presentation

A

Pain or metastasis (even if small).

105
Q

Embryonal carcinoma grossly

A

Invasive hemorrhagic masses with necrosis

106
Q

Embryonal carcinoma microscopically

A

solid nests or gland like structures
Large Cells with indistinct cell borders (undifferentiated cell (Embryonal)) Basophilic cytoplasm, large nuclei and conspicuous nucleoli

107
Q

Most common testicular tumor below the age of 3 years

A

Yolk sac tumor

108
Q

Yolk sac tumor microscopically

A

Cub & columnar cells forming sheets, Glands, papillae & microcysts.
Schiller Duval bodies (2 layers of cells & in the middle there is BVs)
Hyaline globules are also common

109
Q

Differentiation in teratoma

A

Somatic

110
Q

Postpubertal

A

Malignant

111
Q

Prepubertal

A

Benign

112
Q

Differentiation in Choriocarcinoma

A

Trophoblastic

113
Q

The worst GCT prognosis

A

Choriocarcinoma

114
Q

Choriocarcinoma morphology

A

Often small non palpable tumor with wide spread metastases
Cytotrophoblasts & syncytiotrophoblasts in a hemorrhagic background.

115
Q

Non seminomas Mets to

A

Lymph nodes, liver & lung

116
Q

Most radiosensitive tumor

A

seminoma

117
Q

Where does prostate cancer arise

A

Peripheral zone

pathology (5 decks)

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