Male Pathophys 2- Handorff

Question 1

Seminomas are what percent of germ cell tumors?

Answer 1

50%…and remember that germ cell tumors make up the VAST MAJORITY of testicular neoplasms

Question 2

Microscopic appearance of Seminoma?

Answer 2

Fried egg. Abundant cytoplasm, distinct cell membrane

Question 3

15% of seminomas produce what?

Answer 3

HCG

Question 4

Embryonal carcinoma is what type of tumor

Answer 4

Mixed germ cell/ occasionally pure.

whereas the seminoma is most commonly a pure cell tumor

Question 5

Germ cell tumors are very sensitive to?

Answer 5

Chemo and radiation, because they are fast growing

Question 6

What is the third type of germ cell tumor we discussed?

Answer 6

Yolk Sac Tumor

Question 7

Yolk sac tumors are almost exclusively tumors of who?

Answer 7

Infants and children up to 3 years of age.

Question 8

In adults, yolk sac tumors are…

Answer 8

most commonly mixed with other germ cell tumor patterns

Question 9

Main distinguishing feature of yolk sac tumor

Answer 9

Production of alpha fetoprotein which serves as a serum marker

Question 10

Alpha fetoprotein is important for…

Answer 10

Evaluation of metastasis, if you remove the tumor and alpha fetoprotein doesn’t decrease to zero….you have a metastasis somewhere.

Question 11

Which germ cell tumor is “placenta like”?

Answer 11

choriocarcinoma…malignant tumor of syncytiotrophoblasts and cytotrophoblasts.

Question 12

choriocarcinomas are highly aggressive.

Answer 12

truth

Question 13

Choriocarcinomas produce what chemical?

Answer 13

HCG used as a tumor marker. Remember, hCG is very similar to LH, FSH, and TSH so pts may present with hyperthyroidism or gynecomastia

Question 14

Teratomas are commonly mixed with with other germ cell tumor types in adults. Very slow growing so they are hard to kill with radiation.

Answer 14

ok

Question 15

Pure teratomas are more common in who?

Answer 15

Children

Question 16

So what are the germ cell tumors

Answer 16

Teratomas, choriocarcinoma,yolk sac tumor, seminoma, embryonal carcinoma

Question 17

Benign prostatic hyperplasia is more likely to occur in what part of the prostate?

Answer 17

Transitional and periurethral zones

Question 18

Prostate cancer arises in what zones of the prostate?

Answer 18

peripheral zone

Question 19

Prostate glands have two types of epithelium and they are

Answer 19

basal and luminal.

Question 20

What do the luminal cells do?

Answer 20

they produce seminal fluid and express prostate specific antigen

Question 21

What is PSA

Answer 21

it is a serine protease which liquifies the seminal fluid coagulant. Basal cells do not produce PSA.

Question 22

BPH is driven by

Answer 22

androgens

Question 23

Main symptoms of BPH

Answer 23

bladder obstruction, urinary stasis….can be problematic as it can lead to UTIs which can cause sepsis. Therefore, BPH is not so benign as it is a cause of increased morbidity and mortality

Question 24

Prostate cancer is rare under age 50

Answer 24

At age 70 however, at least 70% of men have at least latent prostate carcinoma.
- most tumors never progress or do so very slowly

Question 25

Prostate screening recomendation

Answer 25

No screening for men under 40

• Individualized decisions about screening for men under 55 at higher risk (AA or positive family history)
• Greatest screening benefit ages 55-69
• Every two year screening may be preferred to annual screening
• No routine screening after age 70.

Question 26

What grading system is used in prostate carcinoma

Answer 26

Gleason grading system….1 is the best differentiated and 6 is the worst
Patients are given scores by adding together the grades from the two most prevalent patterns.

Question 27

Most common prostate carcinoma metastases

Answer 27

bone (osteoblastic, not lytic)

Question 28

Know that the prostate is a retroperitoneal gland that surrounds the neck of the bladder

Answer 28

ok

Question 29

Prostate is composed of glandular cells with produce secretions which constitute seminal fluid

Answer 29

mmk