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Pathophys Final Exam (semester 2) > Male Reproductive- Witwer > Flashcards

Male Reproductive- Witwer Flashcards

1
Q

spermatogenesis:

  • testosterone is produced by _____
  • sertoli cells provide nutrition/support for developing ______
A

leydig cells

sperm cells

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2
Q

T/F: posterior urethral valve is not a valve

A

true. actually just folds of membrane

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3
Q

Epispadias=

A

Abnormal opening on dorsum of penis
-Probably genetic malformation of
development of urethral groove

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4
Q

Hypospadias=

A

Abnormal opening on ventral surface of penis

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5
Q

acornitis=

-an infection of ______

A

balantitis**
-Infection of glans

  • Balanoposthitis= Infection of foreskin and glans
  • seen in BOTH cicumcised and uncircumsized
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6
Q

Phimosis predisposes to _____

A

infection*

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7
Q

Nonspecific urethritis= aka ____

-MC organisms?

A

Non-gonococcal Urethritis=NGU

  • Men>women
  • Sx: dysuria, discharge, need to urinate. In women, may be asymptomatic and lead to PID
  • organisms: **Chlaymdia trach., **trichomonas vaginalis, ureaplasma urealyticum, mycoplasma genitalium, viral, miscellaneous other organisms and non-determinate infection
  • Work-up: Gram stain, culture and sensitivity
  • Remember reactive arthritis: Urethritis, arthritis and conjunctivitis
  • you can palpate the superficial temporal artery
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8
Q

T/F: venereal warts are an ex of an STD

A

true

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9
Q

Fournier’s Gangrene=

A

Necrotizing Perineal Infection

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10
Q

Peyronie Disease=

-characterized by?

A
  • Fibromatosis
  • Painful contracture

-**Priapism= Persistent and painful erection.Thrombosis with fibrous replacement

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11
Q

Peyronie Disease:

-which demographic?

A

Sickle Cell Anemia

& Trauma

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12
Q

Urethral Strictures can occur 2/2:

A

Injury, instrumentation, infection (GC),
chronic urethritis, congenital

Severe pelvic fractures:
15% damage urethra

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13
Q

Cryptorchidism= lack of _____

A
  • *descent of testicles
  • **MC developmental defect of the male genitalia.
  • Eighty percent (80%) will descend by one year.
  • 2/3 unilateral, 1/3 bilateral.

-Ninety (90%) percent will be found in inguinal canal, the rest are truly cryptic, and can be along path of descent or even ectopic.

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14
Q

Intra-abdominally, the testes descend from below kidneys to the ________

A

deep inguinal ring–> then they descend into the scrotum

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15
Q

Cryptorchidism:

  • complications ?
  • tx?
A
  • Infertility
  • Increased risk for developing Seminoma – 5-10x > normal

tx:
Watchful waiting
**Orchiopexy

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16
Q

True hernias= (true cryptorchidism)

A
  • abdominal
  • Inguinal
  • suprascrotal
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17
Q

what is the MC cause of scrotal enlargement in children?

A

**Hydrocele

=Tunica vaginalis fails to close–> Fluid accumulates in tunica vaginalis

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18
Q

Hydroceles are associated with?

dx?

A

indirect inguinal hernias**

-US

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19
Q

Varicocele:

  • MC side?
  • pathogenesis?
A

-15-20% of all males, 15-25 yo
-**MC cause of left sided scrotal enlargement in adults
(Left spermatic vein drains into left renal vein)

-**Incompetent valves in left spermatic vein

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20
Q

Aching pain, dragging sensation, “bag of worms” –> THINK?

A

varicocele**

21
Q

Orchitis: causes?

-sx?

A
  • mumps, chlamydia, gonorrhea
  • usually unilateral

Sx:

  • hematuria, severe pain, swelling
  • +/- epididimytis, or epidydimo-orchitis
22
Q

Epididymitis:

-MC pathogens= in young men, vs old?

A

-Chlamydia and Gonococcus in < 35 years (younger)

-E.coli and Pseudomonas aeruginosa >35 years
AIDS – CMV, Toxoplasmosis, Salmonella

Sx: PAIN and swelling

23
Q

hydrocele and increased blood flow to epididymis—>

A

**Epidydimitis

24
Q

Testicular Torsion:

  • demographic?
  • MC causes?
  • Which deformity is present?**
A
  • 12 and 18 years
  • MC causes= violent movement or physical trauma, cryptorchid testis, testicular atrophy

-**Bell Clapper Deformity: Testis inadequately affixed to the scrotum

25
Testicular torsion: | -DANGER due to?
Sx: Absent cremasteric reflex + PAIN imaging: large avascular, hypoechoic left Testis **Danger of hemorrhagic infarction of testicle. Surgery within 12 hours imperative
26
Bell clapper deformity=
**The Tunica Vaginalis surrounds the testicle in the Bell Clapper Deformity. Normally the Tunica Vaginalis only partially surrounds the testicle
27
increased blood flow | to the epididymis and normal flow to the Testis=
Epididymitis
28
diffusely increased blood flow to the Testis=
Epididymo-orchitis
29
Blue dot sign=
exquisitely tender in that 1 spot of the testis !!!! In testicular torsion!!!
30
75% of prostate cancers found in ______
* *peripheral zone | - 20% in Central zone, 5% in transitional zone
31
BPH--> MC arises in the _____
* transitional zone (TZ) | - glandular component is in TZ
32
BPH demographic:
- Approximately 80% of men by 80 years - African-Americans > whites - **Transitional and Periurethral zones, hyperplasia of glandular and stromal elements, especially stromal >> nodules
33
BPH: | -clinical sx?
-Obstructive Uropathy - Difficulty urinating -Post Renal Azotemia Bilateral Hydronephrosis Bladder wall hypertrophy Bladder infections Elevated PSA -NOTE: hyperplastic **median bar** that grows up out of the transitional zone--> up into the bladder-> which causes blockage of the internal urethra area and as the bladder fills, the
34
BPH: tx?
**TURP= Transurethral Resection of the Prostate -enlarged Prostate Sparing of the Verumontanum where the Ejaculatory Ducts enter the Urethra -Sparing of the External Urethral Sphincter
35
what is the MC CA in adult males?
*prostate CA --> usually peripheral zone Risk factors: -AGE
36
Prostate CA: - clinical sx: - Dx?
- none - obstructive uropathy - INCREASED Alk phos suggests bone mets** - PSA>10 highly predictive, 70% - MRI/ US
37
Prostate CA: MC mets to?
**Bone MC, also lungs and liver
38
Prostatitis: -acute etiology? chronic etiology?
- common - Reflux of urine into prostate, Associated with acute cystitis chronic= abacterial bike riders
39
Prostatitis: - MC organisms for <35 yo? - >35 yo?
<35: Clamydia, GC | >35: E coli, Pseudomonas, Klebsiella
40
Prostatits: sx? dx?
Dysuria, urgency, frequency - Low back pain, perineal or suprapubic pain - Painful gland on rectal exam - Hematuria dx: -urine analysis, 20 WBC/HPF in third and fourth samples suggests acute prostatitis - -Increased bacterial count in third and fourth confirmatory
41
Testicular tumors: | -2 types?
MC malignancy b/w 15-35 yo -whites>> -Types: Malignant most often have -Germ Cell origin (95%) -Benign stromal tumors 5%
42
Germ cell tumors: classified as ____
Seminomas or Non-Seminomas - Can be one cell type (40%) or mixed (60%) - Seminoma: 1 cell type MC -MC mixture w a seminoma= teratoma, embryonial cell, choriocarcinoma
43
Germ cell tumors: - risk factors? - clinical Sx? -Dx?
**Cryptorchidism – MC risk Greatest risk is intraabdominal cryptorchidism -Unilateral painless enlargement of testis -Dx: US, CT, MRI Spreads to para-aortic lymph nodes
44
Germ Cell Tumors: tumor markers: - AFP elevated in _____ - HCG elevated in ______ - Lactate dehydrogenase elevated proportional to _____
-Alpha fetoprotein elevated in yolk sac tumors -Human Chorionic Gonadotrophin elevated In Choriocarcinoma -Lactate Dehydrogenase elevated, proportional to tumor mass.
45
Penile neoplasia: | Bowen Disease=
**leukoplakia of shaft
46
Bowen disease is associated with ____
* *HPV-16 | - Precursor of Squamous cell CA
47
Penile neoplasia: Squamous Cell Carcinoma: -demographic? -2/3 associated with _____
-Almost all are uncircumcised, circumcision protects against developing carcinoma, Older men >40 yrs -****HPV 16 and 18
48
Primary testicular failure=
- this occurs BEFORE puberty | - testis- no androgen produced
49
Secondary Testicular Failure=
this happens AFTER puberty

Pathophys Final Exam (semester 2) (5 decks)

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