Male reproductive Flashcards
Cause:
-Testis do not descend normally into ______
-Usually retained in ______; sometimes in ______
-Germ cells require a ______-than-normal body temperature
-______ cells function normally at body temperature
Manifestations:
-______ destroyed at higher intra-abdominal temperature,
______ function normally
-Undescended testis more prone to developing ______
-Treatment : ______ replace testis in scrotum
Cryptorchidism scrotum abdominal cavity inguinal canal lower Interstitial Germ cells Interstitial cells testicular cancer Surgically
- development of penis takes place between 9 and 12 weeks of pregnancy occurs in 1 out of every 150-300 boys. It is a condition where the ______ does not form completely at the tip of the penis, instead it can be located ______ along the penis.
-Hypospadias is an anomaly in which the urethral meatus opens on the ____ surface of the penis
-Epispadias is an anomaly in which the urethral meatus opens on the ______ surface of the penis. It is less common than hypospadias.
-Causes: Less ______ production, No conversion of ______ from ______, Androgen receptor deficiency.
-______ – 16% also have Hypospadias
-Treatment: Never ______ a child without checking for hypospadias because the foreskin is essential for the repair.
It can be corrected ______ using the foreskin.
hypospadias/epispadias urethral opening anywhere ventral dorsal androgen DHT testosterone Cryptorchidism circumcise surgically
-description: it is a chromosomal disorder. Children are born with an extra sex chromosome, which is known as ______. These children present a significant ______ and ______ delay, which requires formalized speech and language program.
-Chromosome Variation: Normal male 46 XY and Klinefelter’s Syndrome has ______ (one in 600) and also called ______ (one in 900).
-it is more common the down’s syndrome and cystic fibrosis and very poorly understood
SYMPTOMS:
-Individuals are male with different degree of 1 ______
-Decrease secretion of ______ (FSH & LH).
-______ size gonads, which affect the ______ function.
-______ (breast development)
-______ (absence of sperm)
-Common symptoms with school age Children:
-______ 5th finger, decreased muscle tone, delayed ______ development, delayed speech & language skills, ______ legs and arms, hand tremors and mild to severe developmental delays.
-Treatment: ______ with Testosterone.
klinefelter's syndrome sex chromosome variations (SCV) speech language 47,XXY pseudohermaphrodite Hypogonadism gonadotropins Smaller testicular Gynecomastia Azoospermia Curved pubertal long Hormone replacement therapy (HRT)
cause:
-abnormal attachment of testis in scrotum
-predisposes to rotary ______ of _____ and _______
-shutting off _____ to testis
manifestations and treatment:
-acute onset of _____ pain and ______
-leads to ______ unless promptly untwisted
Testicular Torsion twisting testis spermatic cord shutting off blood testicular swelling hemorrhagic infarction
Scrotal Abnormalities
- ______:
- exces fluid accumulates in ______
- treated by ______ or ______ of tunica vaginalis
- ______:
- ______ in spermatic cord
- usually ______ side of scrotum involved
- may impair ______
- No treatment required unless causes ______ or impairs _______
hydrocele spermatic cord aspiration resection varicocele varicose veins left discomfort fertility
- defined as failure to achieve an erection of the penis. The causes of ED are still unknown.
- Erection is controlled by ______. Vasodilatation of penile arteries (______ and ______) builds up ______, which causes erection.
- Some of the factors responsible for Erectile Dysfunction:
1. Drugs (______) e.g. Digoxin
2. Psychological problems
3. Distortion of the ______ or tissue
4. ______ related liver damage, which interferes with ______ production.
5. Diabetic patients.
6. ______
erectile dysfunction or impotence parasympathetic nervous system Corpus Cavernous Spongiosum blood β-Blockers penile arteries Alcohol Testosterone Smoking
is a persistent and painful erection of penis. It is also caused by ______ of the soft erectile tissue. Drugs like ______ are known to cause this condition. Recreational of Viagra or Cilias will also cause this.
priapism
fibrosis
opium
______, is condition caused by ______, presents as a soft, painful ______. This ulceration makes the site more prone to ______ with other organisms or fungi, with the tendency to spread along the penis and groin areas.
Chancroid
Haemophilus ducreyi
ulcer
infection
Syphilis: clinical stages
- primary stage: ______, hard ______ (anindurated ulcer) often at the ______, or site of infection. Because this first stage is painless, the patient may not know he has the disease, and could proceed to infect other people.
- secondary stage: ______ number of organisms in the body, manifesting in a diffuse rash of ______, included on the ______, ______ and membranes.
- tertiary stage: ______ form (which are basically granulomas with giant cells, inflammation of the vessels and necrosis). If this stage is left untreated, the infection may progress to involve the ______ and ______; occurs 2 to 20 years later.
- diagnostic tests:
1. demonstration of ______ in chancre
2. ______ tests (antigen-antibody reactions in a test tube) - treatment: ______
painless chancre glans largest small red macules palms soles gummas heart nervous system treponemas/spirochetes Serologic antibiotics
sexually transmitted diseases: Gonorrhea
______ infection: one of the cause for pelvic inflammatory disease (PID).
clinical manifestations:
1. ______ (inflammation of passage through which urine is discharged from bladder)
2. ______ (inflammation of cervix)
3. ______ (inflammation of pharynx)
4. Infection of ______ (proctitis)
-diagnosis: ______ of organisms from sites of infection
-Treatment: ______
Neisseria gonorrhoeae Urethritis Cervicitis Pharyngitis rectal mucosa Culture Antibiotics
sexually transmitted diseases: Chlamydia
- ______ is the most common STD . #2 cause of PID.
- Clinical symptoms: ______ & ______. It can also cause epididymitis. Chlamydial infection should be suspected when bacteria are not demonstrated in a ______ discharge
- Diagnosis: Detection of chlamydial _______ cervical/urethral secretions or Cultures.
- treatment: ______
Chlamydia trachoma's Cervitis Urethritis purulent urethral chlamydial antibiotics
sexually transmitted diseases: herpes
- ______ infection accounts for the majority of genital herpes cases (although HSV type 1 is also capable of causing genital infections) and is spread by ______.
- HSV infection produces ______ and ______ that can involve the cervix, vagina, clitoris, vulva, urethra, and perianal skin.
- ______ with viral inclusions are found in cytologic smears from lesions.
- Pathologic/histologic findings are cells with the three “Ms”: ______, ______, and ______.
HSV type 2 sexual contact small vesicles shallow ulcers multinucleated giant cells multinucleation, nuclear molding, and margination of the chromatin
- The cause is Calymmatobacterium (Donovania) granulomatis, a gram-______ rod. Transmission is probably ______.
- ______, which are multiple organisms filling large histiocytes, are characteristic.
- an infection appears initially as a papule, which becomes ______. It progresses by adjacent lesions to form large______ or ______ ulcerations, sometimes with lymphatic obstruction or genital distortion.
Granuloma Inguinale negative sexual Donovan bodies superficially ulcerated genital inguinal
typical vulvovaginitis, with profuse, foul-smelling purulent frothy discharge
trichomoniasis (yeast infection)
- ______: When bacterial, it is often associated with epididymitis. may be caused by _____
- when viral, most often due to ______. Bilateral, orchitis may result in ______ due to atrophy of the ______. Serum testosterone is ______, whereas pituitary follicle- stimulating hormone and luteinizing hormone are ______.
- ______: Common than orchitis. Causes most often include: ______, ______, _______& ______
inflammation of testes orchitis syphilis mumps virus sterility seminiferous tubules decreased increased Epididymitis Neisseria gonorrhoeae Chlamydia trachoma's E.coli mycobacterium tuberculosis
tumors of the testis
- These are rare tumors but important because they affect men ______ years of age.
- most tumors are of ______ origin
- most tumors are ______ but can be successfully treated by ______ combined with ______ or ______ therapy.
- Mortality was high before, but now more than 90% of patients survive.
25 to 45 germ cell malignant surgery chemotherapy radiation
serum markers for testicular cancer
- ______, or HCG, is usually synthesized and secreted by the placental syncy- tiotrophoblast.
- ______ (AFP) is the major serum protein of the early fetus and is synthesized by the fetal ______, ______, and ______. It is usually undetectable after the first year of life.
- ______ is useful in following the tumor burden, since its level is proportional to the mass of tumor cells. However, it is produced in a number of tissues, so increased levels are not specific for testicular tumors.
Human chorionic gonadotropin Alpha-fetoprotein gut liver cells yolk sac LDH (lactate dehydrogenase)
germ cell tumors of the testis
- ______: These are the most common type of germ cell tumor. The occurrence peaks in men in their 30s, and account for about half of the germ cell tumors. Made of ______. Better prognosis than NSGCT. Seminomas are ______ tumors which can grow to ten times the size of a normal testicle. They do not secrete markers. It does not ______ on a flash light.
- ______ (NSGCT): are more malignant than seminmoas. ______ occurs in early stages. Secretes ______ & ______. Treatment includes surgery, abdominal ______ and chemotherapy.
Seminomas single cell large transiluminate Nonseminomatous germ cell tumor Metastasis AFP & hCG lymph node dissection
nonseminomatous germ cell tumor
- ______: These are more aggressive than seminomas and generally occur in 20-30 year olds.
- ______ are a highly malignant form of testicular tumor that is composed of ______. It is the most aggressive of the NSGCT. It is more likely to be found as a component of a mixed germ cell tumor. These tumors are usually ______ and are found by palpation of a ______. Testicular enlargement is rare, but ______ & ______ common.
Embryonal carcinomas Choriocarcinomas mixed germ cells small small testicular nodule hemorrhage necrosis
the tumor consists of a random arrangement of ______ (muscle, cartilage, adipose tissue), ______ (neural tissue, skin), and ______ (gut, bronchial epithelium) tissue. Mature teratomas are found in adults and immature teratomas are found in children.
teratoma
mesodermal
ectodermal
endodermal
sex cord tumors: not common
- ______: hormone synthesis increases
- ______: May produce androgen or estrogen which cause ______ or ______
leydig cell tumor
sertoli cell tumor
masculinization
feminization
clinical stages of testicular cancer
- stage I means the tumor is ______ to the ______, ______, or ______
- Stage II cancer means distant spread is limited to ______ below the diaphragm.
- Stage III cancer means there is metastasis outside the ______ or ______ the diaphragm
confined testis epididymis spermatic cord retroperitoneal lymph nodes peritoneal nodes above
- ______ is the most frequent cause of urinary tract obstruction. BPH is extremely common (almost universal) in older men.
- BPH is directly related to the action of ______, a testosterone metabolite. DHT is synthesized from testosterone by the action of ______, type __, and ______ of this enzyme is one approach to the treatment of BPH.
- BPH is characterized grossly by a ______ of the gland, affecting the inner groupings of glands (______ and ______ zones.)
- BPH may also be caused by an ______ in ______ (estrogens promote expression of receptors for DHT).
- Diagnosis: Increased total ______ with proportional increase in ______.
- Treatment: ______ (5α-reductase inhibitor) or ______, α-blockers, ______ (transurethal resection of prostate).
BPH (benign prostatic hyperplasia) dihydrotestosterone (DHT) 5α-reductase 2 inhibition rubbery, nodular enlargement periurethral transitional age-related increase estrogens PSA (prostatespecific antigen) free PSA Finasteride Cialis TURP
- This is the most common cancer of internal organs in males—more than 100,000 new cases per year.
- This is the third most common cause of cancer- related deaths in males.
- t is a tumor of old age, and the prolongation of human life has been accompanied by an overall increased incidence of prostate carcinoma.
- no effective treatment exists
carcinoma of the prostate
prostate carcinoma
-the cause remains ______
-no major risk factors have been identified
-hormonal influences: ______ plays a role in the pathogenesis
-Incidence among americans of various origin is as follows: African > European > East Asian.
-the course may be ______ or ______; this can be predicted by the very useful ______, based on differentiation. The tumor is often well differentiated with small invasive glands with prominent ______.
-The tumor arises most often from the ______ of glands. Diagnosis is most often by ______
DIAGNOSTIC TEST:
-Prostate cancer is associated at an early stage with an increase in serum ______. Elevations of PSA reflect a complexed form (bound to ______), which becomes elevated with prostatic cancer, and a free form, which increases with BPH. Thus, an increased ______ with a decreased fraction of ______ suggests malignancy.
-A number of approaches to PSA measurement (e.g., ______ PSA, PSA ______, PSA ______) are used to ______ the predictive value of this procedure.
-prostate cancer is characterized by increased ______ when the tumor penetrates the capsule into ______
-treatment: ______, radiotherapy, ______ system, ______, ______ and chemotherapy.
unknown testosterone indolent aggressive Gleason system of grading nucleoli peripheral group rectal examination PSA α1-anti-chymotrypsin total PSA free PSA serial velocity density increase serum prostatic acid phosphatase adjacent tissues Prostatectomy da Vinci Si robotic GnRH analogues anti-androgens
- This is rare in the US, affecting 1 to 2 men per 100,000.
- it is more common in some parts of the world, like south america
- tumors are ______ carcinomas
- metasteses occur first to ______
- prognosis depends on ______ of tumor
- treatment: ______
carcinoma of the penis squamous cell inguinal lymph nodes stage surgery
