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MD3001 > male reproductive pathology > Flashcards

male reproductive pathology Flashcards

1
Q

what symptoms might present with male reproductive pathology

A 
vomiting
penile pain
penile ulceration 
scrotal swelling
urinary frequency 
haematuria
acute/chronic abdominal pain
abdominal swelling
rectal pain
testicular pain 
incontinence
urinary retention
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2
Q

what is benign prostatic hyperplasia

A 
common 
associated with hormonal imbalance
hyperplasia of glands and stroma 
not premalignant
obstructs urine flow 
associated with infection 
treatable 
may be acute or chronic
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3
Q

how might BPH present compared with prostatic carcinoma

A

BPH commonly presents with urinary symptoms

by the time carcinoma is found the patient may already have metastatic disease or local invasion

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4
Q

what might a prostatic carcinoma feel like on rectal exam

A 
loss of median sulchus
hardy, rocky prostate 
rather that smooth and elastic 
subcapsular invasion
asymmetry
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5
Q

what problems do clinicians have with prostatic cancer

A

hard to tell whether it is indolent or aggressive so hard to know how to treat
tend to underestimate the extent of the disease with needle biopsy
false positives and negatives with PSA

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6
Q

what is the biggest risk factor for testicular cancer

A

cryptorchidism, 10 x risk

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7
Q

what is a common cause of orchitis

A

mumps

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8
Q

what age group tend to get testicular cancer

A

under 35s and old men

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9
Q

what are the two types of germ cell testicular tumour

A

teratoma(always malignant features in males) and seminoma (most common)

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10
Q

what are the features of seminoma

A

cells look like spermatagonia
low level of necrosis usually
peak age approx 40
lumpy and white

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11
Q

what are the features of male teratomas

A

germ cell origin
more agressive than seminoma
may be differentiated, undifferentiated or trophoblastic (placenta like)
may secrete hCG- tumour marker

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12
Q

what chemical is an important cancer biomarker

A

Alpha fetoprotein (AFP)

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13
Q

what are the histological features of BPH

A 
transitional zone of prostate plus peri urethral glands (glands around the urethra) 
nodules of glands and stroma
compression and elongation of urethra
interferes with urethral sphincter 
palpable median groove
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14
Q

what are the complications of BPH

A 
Bilateral hydronephrosis
hydroureter 
pyelonephritis
calculi
septicaemia
bladder:diverticulum, hypertrophy, trabeculation, urethral compression 
nodular enlargement
acute or chronic urinary retention
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15
Q

what is the precursor to prostate cancer

A

prostatic intraepithelial neoplasia

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16
Q

what age group usually get prostate adenocarcinoma

A

over 50 years

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17
Q

what are the features of prostate cancer

A

adenocarcinoma often metastasises to bone

latent carcinoma: microscopic, common in old age, dormant lesions, 30% rate of metastases after 10 years

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18
Q

what is the gleason score

A

way of measuring differentiation in prostate cancer -1 to5 score

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19
Q

what does prostate cancer present with

A

urinary symptoms
incidental findings on rectal exam
bone metastases
lymph node metastases

20
Q

how is prostate cancer diagnosed

A

imaging, cytology, biochemistry(PSA), haematology, bone marrow involvement, biopsy

21
Q

how is prostate cancer treated

A

oestrogens, gnrh analogues, orchidectomy, radiotherapy, radical prostatectomy

22
Q

what is hypospadias and epispadias

A

hypo- urethral opening on inferior aspect

epi- opening on superior aspect and often accompanied by bladder malformations

23
Q

what is phimosis

A

a congenital narrowing of the opening of the foreskin so that it cannot be retracted

24
Q

what is a paraphimosis

A

foreskin becomes trapped behind the glans penis and cannot be reduced

25
Q

what is Bowen’s disease

A

early form of skin cancer which is easily treatable
may affect the penis
persistent red scaly patch on the skin , may be sore and red
intraepithelial carcinoma
keratotic surface

26
Q

what skin diseases can affect the penis and scrotum

A

Bowen’s disease and squamous cell carcinoma

27
Q

what is Peyronie’s disease

A

bent penis and pain when errect due to scar tissue

may occur with Dupytren’s

28
Q

what can cause invasive squamous cell carcinomas of the penis

A

HPV

29
Q

what are the features of SCC of the penis

A

glans penis or prepuce
nodule or plaque
metastasises to inguinal lymph nodes

30
Q

what is fournier gangrene

A

a type of necrotising fasciitis or gangrene that affects the perineum

31
Q

what is balantitis

A

inflammation of the head of the penis

32
Q

what is scrotal carcinoma

A

nodular ulcerated mass

spreads to inguinal nodes

33
Q

what might causes urethral obstruction

A

rupture
stricture
congenital valves

34
Q

what might causes urethritis

A

gonorrhoea

non gonococcal

35
Q

what can gonococcal urethritis cause

A

urethral stricture
epididymitis
prostatitis

36
Q

what is a haematocele

A

collection of blood in the tunica vaginalis usually caused by trauma

37
Q

what testicular cancers affect which age groups

A

teratoma- 30 yrs
seminoma- 40 yrs
lymphoma- 70yrs

38
Q

what are the symptoms of testicular tumours

A

painless unilateral enlargement
hydrocele
metastatic disease
gynaecomastia

39
Q

name some other germ cell tumours

A

intratubular germ cell neoplasia
yolk sac tumour (children)
combined germ cell tumour

40
Q

name some non germ cell tumours

A

malignant lymphoma
leydig cell tumour
sertoli cell
metastatic tumour

41
Q

what is stage 1 testicular tumour

A

confined to testes and coverings

42
Q

what is stage 2 testicular tumour

A

testis and para aortic lymph nodes

43
Q

what is stage 3 testicular cancer

A

lymph nodes in mediastinum and/ or supraclavicular region

44
Q

what is stage 4 testicular cancer

A

visceral metastases

45
Q

what can cause male infertility

A 
endocrine
gnrh deficiency 
oestrogen excess
cryptorchidism
abnormal spermatogenesis 
obstruction of efferent ducts
46
Q

what can affect the epididymis and spermatic cord

A 
 Congenital abnormalities
 Epididymal cysts and spermatocoeles
 Varicocoele
 Torsion of the spermatic cord and
testis
 Inflammatory lesions
– Epididymo-orchitis
 Tumours - rare
47
Q

what marker might a teratoma secrete

A

hCG

MD3001 (33 decks)

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