Male pathology

Question 1

Dysuria, frequency, urgency, low back pain

Answer 1

Prostatitis

Question 2

Acute prostatitis in young

Answer 2

C. trachomatis, N. gonorrhea

Question 3

Acute prostatitis in old

Answer 3

E. coli, Pseudomonas

Question 4

Hyperplasia of prostate gland, smooth, elastic firm nodular enlargment of the periurethral (lateral and middle) lobes

Answer 4

BPH

Question 5

Difficulty starting and stopoping the stream of urine, may lead to distention of bladder nad hydronephrosis

Answer 5

BPH

Question 6

Tx of BPH

Answer 6

alpha-1 antagonists (terazosin, tamsulosin) which relax smooth muscle & finasteride

Question 7

Posterior lobe (peripheral zone) of prostate

Answer 7

Prostatic Adenocarcinoma

Question 8

Diagnosis of Prostatic Adenocarcinoma

Answer 8

Increase in total PSA with decreased fraction of free PSA; increase PAP; needle core biopsy

Question 9

Prostatic cancer marker when hits vertebra

Answer 9

ALP, PSA and PAP

Question 10

Tx of prostate cancer

Answer 10

Local - prostectomy

Diffuse - GnRH analogs (Leuprolide) and Androgen-R inhibitor (Flutamide)

Question 11

Undescended testis

Answer 11

Cryptorchidism

Question 12

Increased temperature of testis affects

Answer 12

Spermatogenesis (not Leydig so testosterone is normal)

decreased inhibin; increase FSH and LH; testosterone only decreased if BL

Question 13

Varicocele

Answer 13

dilated veins in pampiniform plexus as a result of increased venous pressure (usually left sided)

Question 14

Orchitis

Answer 14

inflammation of testicle - caused by C. trachomatis D-K; N. gonorrhea (in young); Pseudomonas and E. coli (in old); Mumps and Autoimmune Orchitis

Question 15

testicular torsion

Answer 15

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

Question 16

Sudden testicular pain with absent cremaster reflex

Answer 16

testicular torsion

Question 17

Fluid collection within tunica vaginalis

Answer 17

Hydrocele

Question 18

Painless, homogenous testicular enlargement; most common in 3rd decade of life

Answer 18

Seminoma

Question 19

Watery cytoplasmand fried egg appearance, increase in placental ALP; Radiosensitive; most common testicular tumor

Answer 19

Seminoma

Question 20

most common testicular tumor in boys

Answer 20

Yolk sac (endodermal sinus) tumor

Question 21

Schiller-Duval Bodies

Answer 21

looks like glomeruli; yolk sc (endodermal sinus) tumor

Question 22

Disordered syncytiotrophoblastic and cytotrophoblastic elements. Hematogenous spread to lungs and brain; hyperthyroidism

Answer 22

Choriocarcinoma (remember hCG is an LH and TSH analog)

Question 23

malignant, hemorrhagic mass with necrosis; painful; immature primitive cells

Answer 23

Embryonal Carcinoma

Question 24

Reinke Crystals

Answer 24

Leydig cell tumors

Question 25

Androgen producing tumor, gynecomastia in men, precocious puberty in boys; golden-brownn color

Answer 25

Leydig cell tumors

Question 26

Androblastoma from sex cord strome

Answer 26

Sertoli cell tumor

Question 27

Common testicular cancer in older men; not a primary cancer

Answer 27

Testicular Lymphoma (usually B cell)

Question 28

Increases fluid is testes secondary to incomplete obliteration of processus vaginalis

Answer 28

Hydrocele

Question 29

Dilated epididymal duct

Answer 29

Spermatocele

Question 30

Erythroplasia of Queyrat

Answer 30

cancer of glans, SCC

Question 31

Bowenoid papulosis

Answer 31

reddish papule on penis; SCC

Question 32

Bowen disease

Answer 32

in penile shaft; presents as leukoplakia

Question 33

Painful sustained erection not associated with sexual stimulation or desire.

Answer 33

Priapism

Question 34

Possible causes of Priapism

Answer 34

Trauma, Sickle Cell, anticoagulants, PDE-5 inhibitors, antidepressants, alpha-blockers, cocaine