Male Reproductive - Final Exam

Question 1

Functions of testes (2)

Answer 1

1. Production of sperm

2. Secretion of androgens by Leydig cells

Question 2

Spermatogenesis

Answer 2

Regulated by pituitary hormones FSH and LH

Question 3

Luteinizing hormone

Answer 3

Stimulates Leydig cells to produce testosterone and other androgenic hormones
Negative feedback to hypothalamus

Question 4

Cryptorchidism

Answer 4

Congenital malpositioning of testis outside of their normal scrotal location
3-4% of male newborns - retractile testes due to unclosed inguinal canal
1% males in first yol - do not have one or both testes in scrotum
Infertility if both are cryptorchid, and increased change of malignancy

Question 5

Balanitis

Answer 5

Inflammation of the glans penis

Question 6

Urethritis

Answer 6

Inflammation of urethra

Question 7

Prostatitis

Answer 7

Inflammation of prostate

Question 8

Epididymitis

Answer 8

Inflammation of the epididymis

Question 9

Orchitis

Answer 9

Inflammation of the testes

Question 10

Localized infections in young men

Answer 10

Usually sexually transmitted

Question 11

Localized infections in older men

Answer 11

Related to urinary retention - secondary to prostatic enlargement

Question 12

Genital herpes

Answer 12

HSV type 2
Virus invades skin, producing group vesicles filled with clear fluid
Genital lesions are located on glans or skin of penis or scrotum
No permanent cure, but antivirals

Question 13

Oral herpes

Answer 13

HSV Type 1

Question 14

Gonorrhea

Answer 14

N. gonorrhoeae
Burning urination and yellow urethral purulent discharge
Some strains are antibiotic resistant

Question 15

Nongonococcal urethritis

Answer 15

Caused by Chlamydia or Mycoplasma
Most common STD
Not accompanied by purulent discharge

Question 16

Syphilis

Answer 16

Sexually acquired disease caused by Treponema pallidum

Primary, secondary and tertiary stages

Question 17

Primary stage syphilis

Answer 17

Chancre and inguinal lymphadenopathy

Question 18

Chancre

Answer 18

Painless, indurated ulcer

Heals spontaneously

Question 19

Secondary stage syphilis

Answer 19

Systemic spread of spirochetes
Occurs 2 months to 2 years later
Systemic symptoms, fever, macular rash, condyloma latum (wart like lesions on genitals), hepatitis, other internal organ infammations

Question 20

Tertiary stage syphilis

Answer 20

CNS, cardiovscular lesions
Occurs approximately 20 years later
Incurable

Question 21

Tumors of testis (4)

Answer 21

Rare
Most common in men 25-45 yo
Mostly germ cell origin
Usually malignant but can be successfully treated by surgery and chemotherapy/radiation
>90% survive
1. Germ cell tumours: 90%
2. Sex cord cell tumours (Leydig or Sertoli cells)
3. Lymphomas
4. Metastasis

Question 22

Germ cell tumours of testis (adults) (3)

Answer 22

1. Seminoma
2. Malignant non-seminomatous germ cell tumour
3. Mixed germ cell tumour

Question 23

Seminoma

Answer 23

Can be cured and treated

Question 24

Malignant non-seminomatous germ cell tumour (NSGCT) (4)

Answer 24

Prognosis isn’t good

1. Embryonal carcinoma
2. Teratoma
3. Yolk sac tumour
4. Chroiocarcinoma

Question 25

Yolk sac tumour

Answer 25

Secretes alpha-fetoprotein (AFP) Endodermal sinuses, resembling primitive glomeruli (Schiller-Duvall bodies) In prepuberty - likely benign

Question 26

Choriocarcinoma

Answer 26

Secreted HCG

Question 27

Teratocarinoma mized NSGCT

Answer 27

AFP + hCG

Question 28

ITGCN

Answer 28

Intratubular germ cell neoplasm | Now germ cell neoplasia in situ

Question 29

Teratoma

Answer 29

Rare in pure form Prepubertal is usually benign More common mixed and malignant in adults Can kill in males Mixture of elements from more than one germ layer

Question 30

Embryonal carcinoma

Answer 30

20-30 yo More aggressive than seminomas Necrotic and hemorrhagic tumour composed of sheets of malignant cells

Question 31

Sex cord tumour of testes (2)

Answer 31

Rare - 5% of all testicular tumours 1. Leydig cell 2. Sertoli cell

Question 32

Leydig cell tumour

Answer 32

Produce excessive testosterone Can cause precocious puberty in preadolescent males 10% can be malignant

Question 33

Sertoli cell tumour

Answer 33

Usually benign

Question 34

Metastases of testes (1 + 3)

Answer 34

``` Lymphoma Carcinoma of 1. Prostatic adenocarcinoma 2. Renal cell carcinoma 3. Colonic adenocarcinoma ```

Question 35

Testicular lymphoma

Answer 35

``` Rare Most common testicular cancer in old men Non-Hodkin's Lymphoma - large cell Usually disseminated, rarely confined to testis Uncertain prognosis ```

Question 36

Diseases of the prostate (2)

Answer 36

1. Benign prostatic hyperplasia | 2. Carcinoma of the prostate

Question 37

Benign prostatic hyperplasia

Answer 37

Reactive enlargement of periurethral portion of prostate gland Nodular hyperplasia that compresses urethra, making urination difficult Pathogenesis is not fully understood

Question 38

Complications of nodular prostatic hyperplasia (5)

Answer 38

1. Hydronephritis 2. Reflux nephropathy 3. Hydroureter 4. Muscular hypertrophy of bladder 5. Urine stasis, bladder dilation, infections

Question 39

Carcinoma of prostate

Answer 39

Most common cancer if internal organs in males Cause is unkown No major risk factors Testosterone plays roll in pathogenesis Racial differences in incidence (African > European > East Asian) >100000 new cases per year Third most common cause of cancer-related deaths in males Tumor of old age

Question 40

Clinicopathologic features of prostate cancer (4)

Answer 40

1. Most often located in peripheral parts of prostate 2. Prostate specific antigen is good marker of prostate carcinoma (low specificity) 3. Metastases to local lymph nodes, vertebrae, other bones, internal organs 4. Bone metastases may be osetolytic or osteoblastic (serum alkaline phosphatase increase)

Question 41

Primary carcinoma of penis

Answer 41

``` Rare is USA (1-2 of 100000) Most common in other parts of the world Circumcision may reduce risk Metastases to inguinal lymph nodes first Prognosis depends on stage of tumour ```

Question 42

Most common penile primary tumours (1)

Answer 42

Squamous cell carcinoma | Some associated with HPV or poor hygiene