Male Repro

Question 1

What is episadia and hypospadias and what is it associated w

Answer 1

Episadia- urethral opening on the dorsal surfacee of pen

Hypospadias- urethral opening on ventral surface

• associated w undescended testes
• increased UTI/infertility

Question 2

What are the 4 inflammatory conditions of the penis

Answer 2

Balantis- inflammation of the glans

Balonoposthitis- inflammation of the foreskin and glans in uncircumcised

Phimosis- Inability of foreskin to be retracted behind glans

Paraphimosis- Traped foreskin behind glans

Question 3

What is peyronie diisease

Answer 3

Penile fibromatpsos causing penile curvature

Question 4

What is penile malignancies associated w

Answer 4

Associated w squamous cell carcinoma
Infection HPV serotypes 16/18
Precancers (bowens disease/erythroplasia query)

Question 5

Mc cause of ED in 50+

Answer 5

Vasculogenic insufficient

• arterial narrowing in the basin of the internal pudendal artery (int iliac)
• DM associated w atherosclerosis

Question 6

WHat causes neurogenic ED

Answer 6

ED may be symptoms of MS, diabetic neuropathy, radical prostatectomy, spinal diseases etc

Question 7

Other causes of ED

Answer 7

• BPH
• meds
• smoking/alcohol
• aging (andropause)
• Pseudo ED (same sex attraction)

Question 8

What is cryptochidism

Answer 8

Condition is which one or both testes fail to descend
can lead to failure of full closure of the urethra
-leads to increased environmental temp for testes leading to a loss of germ cells and atrophy of spermatogenesis

Question 9

Histopathology of cryptochidism (seminiferous tubules/basement/ changes)

Answer 9

Seminiferous tubules- progressive loss of germ cell elements, low or absent foci of spermatogenesis

Tubular basement is thickened

hyalinization of tubules

interstitial stroma (increease in fibrobascular stroma and conspicous presents of leydig cells)

Question 10

When do symptoms become apperent in cryptochidism

Answer 10

2 years of age
(asymptomatic but becomes found during the physical exam)

-must undergo surgical correction before 2 years

Question 11

What happens if undescendied testes go untreated (3)

Answer 11

1. if bi- complete sterility, uni- infertility one side
2. Inguinal hernia
3. Malignancy (30-50 fold increase)

Question 12

pre testicular, testicular and post testicular causes of male infertility

Answer 12

pre testicular- prob w development of testicle

Testicular- Problem is inside parenchyma of test

post testicular- Normally developed testicle but something is blocking proper delivery of sperm

Question 13

Pre testicular causes of male infertility

Answer 13

Hormonal disorders are major cause

hypopituitarasim

Question 14

What hormonal excesses can cause pre testicular infertility

Answer 14

Estrogen excess

Glucocorticoid excess

Question 15

Testicular causes of male infertility

Answer 15

• Primary hypogondism (leydig cell or seminiferous tubule dysfunction)
• Agonadism (total absence of testis)
• Cryptorchidsm
• Hypospermatogenesis
• klienfleter
• mumps
• rratation damage

Question 16

Post testicular causes of male infertlity (and two types)

Answer 16

Obstructive
(have normal hormonal profile w normally descended testes but sperm can exit)

1. Congenital block- atresia of vas degrens
2. Aquired block- Previous gonococcal or urea plasmic or chlymadial infections

Impraired sperm motility

Question 17

Risk factors of testicular cancers

Answer 17

cryptochidism
testicular dysgenesis
positive fam hx
Caucasion

Question 18

testicular tumor random facts

Answer 18

1% of all tumors
more in white males
less common in africans and asians
trimodal age distribution (infancy/late adolescence/60+)

Question 19

Germ cell cancers- % and types

Answer 19

95%

• Seminoma
• spermatocytic seminoma
• Embryonal carcinoma (yolk sac tumor, choriocarcinoma, teratomas)
• Polyembryoma

Question 20

Sex cord stromal tumors- % anf types

Answer 20

5%

• leydig cell tumor
• sertolo cell tumor
• granulosa cell tumor
• mixed forms

Question 21

What is a combined germ cell sex stromal tumor

Answer 21

Gonadoblastoma

Question 22

Seminoatous (SGCT) tumors- look, metastisis, response to radiation, markers, prognosis

Answer 22

-larger (confined)
-Metastisis to regional lymph nodes
-radiosensitive
HCG generally low level marker
Better prognosis

Question 23

Non seminiferous (NSGST) germ cell tumors- look, metastisis, response to rad, serum markers, prob

Answer 23

Smaller
Heamategnous spread early
radioresistent
HCG, AFP or both high
Poor prog

Question 24

What are the common tumor markers

Answer 24

• Human chorionic gonadotropin
• Alpha foetoprotein
• Carcinoembryonic antigen
• Human placental lactogen
• Testerosterone estrogen + leutanizing hormone

Question 25

How does lymphatic dissemination work

Answer 25

Drains into anatomically nearest lymph nodes (centinal lobe) and then continues to drain into sequential nodes

For test cancer- retroperitoneal para aortic lymph nodes, mediastinal lymph nodes, supraclavicual ar lymph nodes

Question 26

Where does hamatongeonous metastisis go

Answer 26

metastasis to lungs/liver/brain/bones

Question 27

how does seminoma testis show up microscopically

Answer 27

lobules of monomorphic seminoma cells separated by delicate fibrous storm containing lymphocytic infiltration

Question 28

WHat do yolk sac tumors look like microscopically

Answer 28

contains chiller-duval bodies

Question 29

Leydig cell tumor age, what does it cause

Answer 29

20-50

-will cause adrenogenital syndrome- will result in abnormal production of adrenogeno-cortical hormones ( causes masculinization/feminization, precauctious puberty)

Question 30

Sertoli cell tumor (androblastoma) age, What do they produce/do

Answer 30

mc in infants/children

• produce estrogen + androgen
• Gyno in adults/ precocious sex development in child