Male Pathology

Question 1

Acute prostatitis etiologies
young adults
older adults

Answer 1

young: STDs
old: UTI bugs, like Gram - rods

Question 2

Chronic bacterial prostatitis
presentation
Tx

Answer 2

presents as low back pain, non-specific Sx

Tx: longer course of Abx

Question 3

Abacterial prostatitis

etiology

Answer 3

usually STD

Question 4

PSA may be elevated during

Answer 4

prostatitis or cancer

Question 5

How can estrogens cause BPH

Answer 5

estrogens increase expression of testosterone receptors

make prostate more sensitive to androgens

Question 6

Feared complication of BPH

Answer 6

obstruction required suprapubic cath

Question 7

Bladder complication of BPH

Answer 7

bladder hypertrophy and trabeculation
makes more muscle to try and push urine out
gets to big –> ureter openings become two-way
increased risk of pyelo and renal failure

Question 8

Appendix epidydimis

Answer 8

superior point of epididymis on testes
may have torsion –> point superior testicular tenderness
not medical emergency

Question 9

Why is a varicocele almost always on the left

Answer 9

left testicular vein drains into the left renal vein
L renal vein is smaller diameter then IVC
so more resistance to flow then on right
blood backs up

Question 10

Cryptorchid testis

Answer 10

undescended testicle

Question 11

When to do orchoplexy in cryptorchid testes

Answer 11

before 2 y/o for fertility purposes

before 10 y/o for cancer prevention

Question 12

What causes granulomatous epidiymo-orchitis

Answer 12

Tb, autoimmune condition

Question 13

How does mumps cause infertility

Answer 13

causes orchititis
pts >10 y/o
scarring –> infertility

Question 14

Seminoma
pathology
prognosis

Answer 14

histo: non-hemorrhagic, large clear cells w/ lymphocytes
prognosis: excellent

Question 15

Embynomal carcinoma
pathology
prognosis

Answer 15

path: hemorrhagic w/ necrosis –> pain
prognosis: very aggressive

Question 16

Yolk sac tumor of testis
pathology
tumor marker

Answer 16

path: Schiller-Duval bodies, resemble primitive glomerulus “glomeruloid”
tumor marker: α-FP

Question 17

Choriocarcinoma
pathology
tumor marker

Answer 17

most aggressive, resembles placental tissue
path: hematogenous spread, found most often w/ mets
βhCG is classic tumor marker

Question 18

Teratoma

pathology

Answer 18

always malignant in males

pathology: contains 2+ embryological layers (ie ecto-, meso-, and endoderm), grossly contains cysts

Question 19

Which testicular tumor spreads hematogenously

Answer 19

choriocarcinoma

Question 20

Staging of testicular tumors

Answer 20

Ia: within testicle
Ib: adenexa
Ic: scrotum
II: mets to retroperitoneal lymphatics
III: mets outside of retroperitoneal lymphatics

Question 21

AFP as tumor marker

Answer 21

yolk sac carcinoma

Question 22

βhCG as tumor marker

Answer 22

choriocarcinoma

Question 23

Seminoma Tx

Answer 23

surgery + chemo

also very radiosensitive

Question 24

Testicular mass in older patient

Answer 24

more likely lymphoma

germ cell tumors generally in younger males