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Male pathology Flashcards

1
Q

Benign prostatic hyperplasia - age

A

common in over 50

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2
Q

Benign prostatic hyperplasia - appearance/result

A

smooth elastic, firm nodular enlargement (HYPERPLASIA, not hypertrophy) of periurethral (lateral and middle lobes) –> compress urethra into a vertical slit

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3
Q

Benign prostatic hyperplasia - hyperplasia or hypertrophy

A

hyperplasia

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4
Q

Benign prostatic hyperplasia - location of hyperplasia

A

periurethral - lateral and middle lobes

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5
Q

Benign prostatic hyperplasia - cancer

A

not premalignant

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6
Q

Benign prostatic hyperplasia - presentation

A
  1. increased frequencey of urination
  2. nocturia
  3. difficulty starting and stoping urine stream
  4. dysuria
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7
Q

Benign prostatic hyperplasia - complications

A

may lead to distention and hypertrophy of bladder, hydronephrosis, UTIs

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8
Q

Benign prostatic hyperplasia - markers

A

increased PSA

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9
Q

Benign prostatic hyperplasia - treatment (and mechanism)

A
  1. a1 antagonists (terazosin, tamsulosin) –> relaxation of SMC
  2. 5α-reductase inhibitors (eg. finasteride
  3. tadalafil (PDE-5 inhibitor)
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10
Q

Prostatitis - divided to/due to

A
  1. acute: bacterial (eg. E.coli)

2. chronic (bacterial or abacterial)

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11
Q

Prostatitis - symptoms

A
  1. dysuria
  2. frequency
  3. urgency
  4. low back pain
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12
Q

Prostatitis - physical examination

A

warm, tender, enlarged prostate

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13
Q

Prostatic adenocarcinoma - age/location

A

men over 50

often posterior lobe (peripheral zone) of prostate gland

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14
Q

Prostatic adenocarcinoma - diagnosis

A

increased PSA and suvsequent needle core biopsies

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15
Q

Prostatic adenocarcinoma - markers

A

Prostatic acid phosphate (PAP)

PSA

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16
Q

PSA - in Prostatic adenocarcinoma

A

increased total with decreased fraction of free

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17
Q

PSA - normal range

A
  • increases in age by BPH
  • under 2.5 ng/ml in 40-49
  • under 7.5 ng/ml in 70-79
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18
Q

Prostatic adenocarcinoma - complication

A

osteoblastic metastasis (late stages)

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19
Q

Prostatic adenocarcinoma - osteoblastic metastasis - sympotms/labs

A
  1. lower back pain

2. increased ALP and PSA

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20
Q

Tunica albuginea?

A
  1. penis –>connective tissue that surrounds the corpora cavernosa
  2. testicles –> connective tissue covering the testicles
  3. ovaries –>the connective tissue covering of the ovaries
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21
Q

Penile pathology - 3 diseases

A
  1. Peyronie disease
  2. iscemic priapism
  3. SCC
  4. penile fracture
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22
Q

Peyronie disease - definition/mechanism

A

abnormal curvature of penis due to fibrous plaque within tunica albuginea (goes up)

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23
Q

Peyronie disease - symptoms

A
  1. pain
  2. anxiety
  3. erectile dysfunction
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24
Q

Peyronie disease - treatment

A

surgical repair once curvature stabilizes

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25
Q

penile fracture - definition/mechanism

A

rupture of corpora carvenosa due to force bending

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26
Q

Ischemic priapism - definitim

A

painful sustained erection lasting more than 4 hours

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27
Q

causes of ischemic priapism

A

1 sickle cell anemia (trapped RBCs in vascular channels)

2. drugs (sildenafil, trazodone)

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28
Q

ischemic priapism - management

A

treat immediately with corporal aspiration, intracavernosal phenylephrine, or surgical decompression to prevent ischemia

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29
Q

SCC of penis - epidimiology

A

more common in Asiam Africa, South America

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30
Q

SCC of penis - precursor in situ lesions

A
  1. Bowen disease
  2. erythroplasia Queyrat
  3. Bowenoid papulosis
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31
Q

SCC of penis - risk factors

A
  1. HPV

2. lack of circumcision

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32
Q

Bowen disease?

A

leukoplakia in penile shaft

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33
Q

erythroplasia Queyrat?

A

cancer of glans (IN SITU), presents as erythroplakia

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34
Q

Bowenoid populosis?

A

carcinoma in situ of unclear malignant protention, presenting as redish papules

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35
Q

SCC of penis - precursor in situ lesions/and their definition

A
  1. Bowen disease –> leukoplakia in penile shaft
  2. erythroplasia Queyrat –> in situ carcinoma of glans, presents as erythroplakia
  3. Bowenoid papulosis –> carcinoma in situ of unclear malignant protention, presenting as redish papules
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36
Q

Cryptorchidism - definition

A

undescended testis (one or both)

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37
Q

Cryptorchidism - sperm vs testosterone - mechanism

A
  • impaired spermatogenesis: sperm develops best at less than 37. sertoli are Q sensitive
  • normal Testosterone levels (Leyding unaffected to Q)
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38
Q

Cryptorchidism - complication

A

high risk of germ cell tumors

39
Q

Cryptorchidism - risk factor

A
  1. prematurity

2. Hypospandias

40
Q

Cryptorchidism - endocrine profile

A

low inhibin B, High FSH and LH

testosterone low in bilateral, normal in unilateral

41
Q

MCC of scrotal enlargement in adult males

A

Varicocele

42
Q

Varicocele - definition

A

dilated veins in pampiniform plexus due to hug venous pressure

43
Q

The pampiniform plexus is a

A

network of many small veins found in the human male spermatic cord.

44
Q

Varicocele - location

A

Most often on left because of high resistance to flow from left gonadal vein drainage into left renal vein

45
Q

Varicocele - complication

A

infertility because of high temperature

46
Q

Varicocele - diagnosis

A
  1. standing clinical exam (distention on inspection and bag of worms
  2. US with Doppler
  3. does not transilluminate
47
Q

Varicocele - treatment

A
  1. varicocelectomy

2. embolization

48
Q

Testicular tumors are divided to (proportions and behavioural)

A
  1. germ cell (95%) –> Mostly malignant, children mature teratoma benign
  2. non-germ cell (5%) –> mostly benign, but lymphoma is aggressive
49
Q

Testicular non-germ cell tumors - types and aggressiveness

A

Mostly benign
1. Leydig cells
2 Sertoli cells
3. Testicular lymphoma (aggressive)

50
Q

Sertoli cell tumor?

A

androblastoma from sex cord stroma

51
Q

Leydig celll tumor - appearance

A
  • golden brown color

- contains Reinke crystal (eosnophilic cytoplasmic inclusion)

52
Q

Leydig celll tumor - presentation mechanism)

A

produce androgens or estrogens –> gynecomastia in men. precosious puberty in boys

53
Q

MC testicular cancer in older men

A

Testicular lymphoma

54
Q

Testicular lymphoma - characteristics

A
  • Not 1ry –> arises from metastatic lymphoma to testes

- Aggressive

55
Q

Testicular germ cell tumors - epidemiology

A

Most often in young men

56
Q

Testicular germ cell tumors - risk factors

A
  1. Cryptorchidism

2. Klinefelter syndrome

57
Q

Testicular germ cell tumors - characteristics

A
  • can resent as a mixed germ cell tumor

- does not transilluminate

58
Q

Testicular germ cell tumors - types

A
  1. Seminoma
  2. Yolk sac (endodermal sinus) tumor
  3. Chroriocarcinoma
  4. Teratoma
  5. Embryonal carcinoma
59
Q

MC testicular tumor

60
Q

seminoma - behavior/age

A

malignant

not in infancy

61
Q

seminoma - clinical characteristics

A

painless, homogenous testicular enlargment

62
Q

seminoma - prognonis (why)

A

excellent –> 1. Radiosensitive 2. late matastasis

63
Q

seminoma - marker

A

high placental ALP

64
Q

seminoma - histology

A

large cells in lobules with watery cytoplasm and fried egg appearance

65
Q

tests - Yolk sac (endodermal sinus) - behavioral

A

aggressive malignancy

66
Q

tests - Yolk sac (endodermal sinus) - appearance

A
  • yellow mucinous

- Schiller Duval bodies resemble primitive glomeruli

67
Q

tests - Yolk sac (endodermal sinus) - marker

A

high AFP is highly characetristic

68
Q

MC testicular in boys under 3

69
Q

MC tumor in male infants

70
Q

male teratoma - behaviour

A

unlkie in females. mature teratoma in adults males may be maligntn. Benign in children

71
Q

testicular choriocarcinoma - marker

72
Q

testicular choriocarcinoma - histology

A

disordered syncytiotrophoblastic and cytotrphoblastic elemetns

73
Q

testicular choriocarcinoma - spreading

A

lungs and brain (heterogeneously)

74
Q

testicular choriocarcinoma - presentation

A

gynecomastia
symptoms of hyperthyroidism
(hCG is stracturally simillar to LH, FSH, TSH)

75
Q

testicular cancer that is painful

A

Embryonal carcinoma

76
Q

Embryonal carcinoma - special clinical characteristic

77
Q

Embryonal carcinoma - gross appearance

A

hemorrhagic mass with necrosis

78
Q

Embryonal carcinoma - prognosis

A

worse than seminoma

79
Q

Embryonal carcinoma - histology

A

glandular papillary morphology

80
Q

Embryonal carcinoma - markers

A 
if pure (rare) --> high hCG, normal AFP
if mixed with other tumors --> high hCG, increased AFP
81
Q

Scrotal masses?

A

benign scrotal lesions presents as testicular maasses thatn cen be transilluminated

82
Q

Scrotal masses vs solid testicular tumors according to transillumination

A

only scrotal can be transilluminated

83
Q

Scrotal masses - types

A
  1. congenital hydrocele
  2. Acquired hydrocele
  3. Spermatocele
84
Q

congenital hydrocele?

A

Common cause of scrotal swelling in infants due to incomplete obliteration of processus vaginalis

85
Q

Acquired hydrocele?

A

scrotal fluid collection usually 2ry to infection, trauma, tumor (if bloody –> hematocele)

86
Q

bloody hydrocele –>

A

hematocele

87
Q

Spermatocele?

A

cyst due to dilated epididymal duct or rete testis –> paratesticular fluctuant nodule

88
Q

Extragonadal germ cell tumors - location

A

MIDLINE location:

  • adults –> MC retroperitoneum, ediastinum, pineal, suprasellar regions
  • young childrens: sacroccygeal teratomas are MC
89
Q

Extragonadal germ cell tumors - adults vs young children according to location

A
  • adults –> MC retroperitoneum, ediastinum, pineal, suprasellar regions
  • young childrens: sacroccygeal teratomas are MC
90
Q

Painful testicular tumor and its markers

A

embryonal carcinoma
if pure (rare) –> high hCG, normal AFP
if mixed with other tumors –> high hCG, increased AFP

91
Q

testicular tumor with Reinke crystals (and what is that)

A

Leyding cells tumor –> eosinophilic cytoplasmic inclusions

92
Q

testicular germ cell tumors can present as

A

mixed germ cell tumor

93
Q

seminoma in female

A

dysgerminoma (but rarer

94
Q

Paratesticular fluctant nodule

A

Spermatocele

Reproductive (20 decks)

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