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HD 3 > Male Reproduction (path) > Flashcards

Male Reproduction (path) Flashcards

1
Q

Hypospadias

A

opening of urethral canal on VENTRAL surface of penis (failure of urogenital folds to close correctly)
Cause: genetic and environmental, common
Complications: UTIs, infertility

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2
Q

Epispadias

A

opening of urethral canal on DORSAL side of penis
Cause: abnormal (low) positioning of genital tubercle
Complications: bladder exstrophy, UTIs, infertility

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3
Q

Phimosis

A

orifice of prepuce is too small for normal retraction.

= congenital, w/ inflammatory complications (infection/scarring, cancer)

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4
Q

condyloma accuminatum

A

= genital warts (benign)
from HPV 6 or 11 (low risk types)
–> koilocytic changes in nuclei of infected cells

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5
Q

Penile Intraepithelial Neoplasm (PIN)

A

benign squamous hyperplasia of penis, usually w/ HPV infection. *NOT invasive
grades I-III (III = “Bowen disease” - full thickness affected)

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6
Q

Squamous Cell Carcinoma (of penis)

A

malignant squamous neoplasm,
Risk factors: high risk HPV infection (16, 18, 31, 33), no circumcision, *Bowen disease = precursor
** high risk vascular spread!

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7
Q

Testicular torsion

A

twisting of the spermatic cord
–> venous obstruction, hemorrhagic infarction
* Dx: absent cremasteric reflex
Risk Factors: incomplete descent, absent scrotal lig, small testis

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8
Q

Lesions of tunica vaginalis

A

hydrocele (serous fluid build-up) - incomplete closure of process vaginalis, can be trans-illuminated.
Hemocele (blood build-up)
Lymphocele (chyle build-up)

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9
Q

Lesions of the ductus afferentes or rete testis

A

spermatocele - abnormal sperm drainage

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10
Q

varicocele

A

Dilation of spermatic vein bc impaired drainage.
“bag of worms” appearance,
** most often left side (bc drains into L renal v), & assoc. w/ renal cell carcinoma

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11
Q

Cryptorchidism

A

incomplete migration of testis (“undescended”);
most = inguinal, abdominal or suprascrotal less so.
Complications: tubular atrophy & fibrosis, increased risk torsion & testicular cancer.

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12
Q

testicular ectopia

A

when testicle(s) migrate to the WRONG place (not even along normal path of descent)

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13
Q

pre-testicular causes of infertility

A

hypopituitarism, testicular exhaustion (after prolonged FSH)

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14
Q

testicular causes of infertility

A

Genetic: Klinefelter (XXY)
Developmental: cryptorchidism, anorchia, ectopia
Systemic: Diabetes, cirrhosis, malnutrition
Other: atherosclerosis, varicocele, EtOH, chemo/radiation

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15
Q

Post-testicular causes of infertility

A

= lesion/blockage to excretory ducts (congenital, inflammatory or iatrogenic)

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16
Q

Acute Epididymitis

A

= neutrophilic, complication of UTIs (bacterial)
Path: neutrophil infiltrate, tissue destruction/fibrosis
*may spread to testes

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17
Q

Chromic Epididymitis

A

= lymphocytic, post-infection from mumps, influenza, varicella,.etc.

18
Q

Idiopathic Granulomatous Epididymitis

A

interstitial and intertubular granulomas, mimic neoplasms;
Cause: autoimmune (?)
* most common cause of granulomatous orchitis in USA

19
Q

Tuberculous granulomatous Epididymitis

A

epididymitis followed by orchitis, secondary to pulm. TB;

Path: caseous necrosis => post-inflamm. fibrosis

20
Q

Sperm granuloma => granulomatous epididymitis

A

granulomatous reaction to extravasated sperm (from trauma), in M <40.

21
Q

Classic Seminoma

A

= most common type of testicular germ cell tumor, Age: ~40s, mets to lymph nodes 1st
Histo: large, uniform cells w/ clear cytoplasm & lymphocytic infiltrate
* VERY radiosensitive!

22
Q

Intratubular Germ Cell Neoplasia (“ITGN”)

A

in situ lesion of testicle that typically preceeds malignant germ cells tumors.
* = isochromosome 12p (gene mut on short arm)

23
Q

Spermatocytic Seminoma

A

seminoma (germ cell tumor) NOT assoc. w/ i12p.
Histo: mix of 3 cell sizes
* mets = rare, very good prognosis

24
Q

Non-seminonatous germ cell tumor types (4)

A
  1. Embryonal carcinoma
  2. Yolk Sac tumor
  3. Choriocarcinoma
  4. Teratoma
    * most often = mised types, more aggressive.
    Peak age: 30 yrs old
25
Q

Emryonal Carcinoma

A

malignant germ cell tumor that forms glands

Histo: hemorrhagic necrosis, + epithelial markers (cytokeratin, epith. membrane Ag)

26
Q

Yolk sac tumor

A

malignant, most commoon childhood (1testicular tumor.

HIsto: schiller Duvall bodies, vascular “capsule,” makes AFP!!!

27
Q

Choriocarcinoma

A

VERY malignant germ cell tumor,
makes hCG.
* early spread, but may regerss too
** benign (NOT 12p) in PRE-pubertal boys.

28
Q

Teratoma

A

(testicular, from maternal fetal tissue.
Spreards early. Makes hCG draw from co,
- Mature:
- IMMature: worse prognosis,

29
Q

Acute Prostatitis

A

Bacterial infection of prostate, from urine reflux or surgery.
Sx: dysuria, fever, chills, perineal pain, tender prostate
Path: neutrophilic infiltrate & necrosis

30
Q

Chronic bacterial prostatitis

A

insidious/repeated infection of prostate, from urine reflux or local obstruction;
w/ Hx of repeated UTIs.
+ culture from prostatic secretions, >10 leuks

31
Q

Chronic Abacterial prostatitis (aka: Chronic Pelvic Pain Syndrome)

A

insidious suprapubic/perineal/low back pain,
w/ NO Hx of UTIs.
prostate secretion culture -, variable leuks

32
Q

Granulomatous Prostatitis

A

prostate infection caused (in USA) by Bacillus-Calmette-Guerin (attenuated mycobacterium) into bladder as urothelial tumor Tx;
* histo like TB! but not.

33
Q

Benign Prostatic Hyperplasia (BPH)

A

expansion of transitional zone (around urethra), bc increased DHT –> increased cell survival
*NOT pre-malignant

34
Q

Possible complications from BPH

A

cystitis, pyelonephritis, hydronephrosis, bladder hypertrophy/diverticula

35
Q

Prostatic Adenocarcinoma

A

Most common non-skin cancer in men.
= malignant neoplasia in peripheral zone
–> risk involving neurovascular bundle!
*use Gleason scale for grading.

36
Q

Gleason Scale

A

grading system for cancer, based solely on architecture of pattern.
Choose # (1-5) by MOST differentiated apparent.
*can give 2 part score (1st # = most predom. level)
1 = Uniform, NO invasion
3 = discrete glands, but varied & w/ infiltrates
5 = solid sheets of cells, central necrosis

37
Q

Risk factors for Prostatic Adenocarcinoma

A

1. Age (older = worse)

  1. Race (Af.Amer > caucasian > asian)
  2. Family Hx (BRCA2, etc)
  3. Environment (high fat diet, lycopenes & VitD decrease risk)
38
Q

Clinical approach to Prostatic Adenocarcinoma

A

To Dx: rectal exam, PSA, ultrasound, CT
Tx: surgery, radiation, anti-androgen meds
* very good prognosis if treated.

39
Q

PSA testing types

A
  • measures serine protease, is specific to prostate, but NOT necessarily cancer
  • Doubling time (<10 yrs = bad)
  • density (PSA/prostate volume)
  • velocity (PSA change/time)
40
Q

When use PSA for screening?

A

screen men >50 yo w/ life expectancy > 10 yrs

HD 3 (8 decks)

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