Male pathology Flashcards
Dysuria, frequency, urgency, low back pain
Prostatitis
Acute prostatitis in young
C. trachomatis, N. gonorrhea
Acute prostatitis in old
E. coli, Pseudomonas
Hyperplasia of prostate gland, smooth, elastic firm nodular enlargment of the periurethral (lateral and middle) lobes
BPH
Difficulty starting and stopoping the stream of urine, may lead to distention of bladder nad hydronephrosis
BPH
Tx of BPH
alpha-1 antagonists (terazosin, tamsulosin) which relax smooth muscle & finasteride
Posterior lobe (peripheral zone) of prostate
Prostatic Adenocarcinoma
Diagnosis of Prostatic Adenocarcinoma
Increase in total PSA with decreased fraction of free PSA; increase PAP; needle core biopsy
Prostatic cancer marker when hits vertebra
ALP, PSA and PAP
Tx of prostate cancer
Local - prostectomy
Diffuse - GnRH analogs (Leuprolide) and Androgen-R inhibitor (Flutamide)
Undescended testis
Cryptorchidism
Increased temperature of testis affects
Spermatogenesis (not Leydig so testosterone is normal)
decreased inhibin; increase FSH and LH; testosterone only decreased if BL
Varicocele
dilated veins in pampiniform plexus as a result of increased venous pressure (usually left sided)
Orchitis
inflammation of testicle - caused by C. trachomatis D-K; N. gonorrhea (in young); Pseudomonas and E. coli (in old); Mumps and Autoimmune Orchitis
testicular torsion
twisting of spermatic cord leading to hemorrhagic infarction blocking thin walled veins; blood enters but can’t leave; failure of testes to attach to inner ining of scrotum
Sudden testicular pain with absent cremaster reflex
testicular torsion
Fluid collection within tunica vaginalis
Hydrocele
Painless, homogenous testicular enlargement; most common in 3rd decade of life
Seminoma
Watery cytoplasmand fried egg appearance, increase in placental ALP; Radiosensitive; most common testicular tumor
Seminoma
most common testicular tumor in boys
Yolk sac (endodermal sinus) tumor
Schiller-Duval Bodies
looks like glomeruli; yolk sc (endodermal sinus) tumor
Disordered syncytiotrophoblastic and cytotrophoblastic elements. Hematogenous spread to lungs and brain; hyperthyroidism
Choriocarcinoma (remember hCG is an LH and TSH analog)
malignant, hemorrhagic mass with necrosis; painful; immature primitive cells
Embryonal Carcinoma
Reinke Crystals
Leydig cell tumors
Androgen producing tumor, gynecomastia in men, precocious puberty in boys; golden-brownn color
Leydig cell tumors
Androblastoma from sex cord strome
Sertoli cell tumor
Common testicular cancer in older men; not a primary cancer
Testicular Lymphoma (usually B cell)
Increases fluid is testes secondary to incomplete obliteration of processus vaginalis
Hydrocele
Dilated epididymal duct
Spermatocele
Erythroplasia of Queyrat
cancer of glans, SCC
Bowenoid papulosis
reddish papule on penis; SCC
Bowen disease
in penile shaft; presents as leukoplakia
Painful sustained erection not associated with sexual stimulation or desire.
Priapism
Possible causes of Priapism
Trauma, Sickle Cell, anticoagulants, PDE-5 inhibitors, antidepressants, alpha-blockers, cocaine
