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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
Q

Testicular torsion:

-DANGER due to?

A

Sx: Absent cremasteric reflex + PAIN
imaging: large avascular,
hypoechoic left Testis

**Danger of hemorrhagic infarction of testicle. Surgery within 12 hours imperative

26
Q

Bell clapper deformity=

A

**The Tunica Vaginalis surrounds the testicle in the Bell Clapper
Deformity.

Normally the Tunica Vaginalis only partially surrounds the testicle

27
Q

increased blood flow

to the epididymis and normal flow to the Testis=

A

Epididymitis

28
Q

diffusely increased blood flow to the Testis=

A

Epididymo-orchitis

29
Q

Blue dot sign=

A

exquisitely tender in that 1 spot of the testis !!!! In testicular torsion!!!

30
Q

75% of prostate cancers found in ______

A
  • *peripheral zone

- 20% in Central zone, 5% in transitional zone

31
Q

BPH–> MC arises in the _____

A
  • transitional zone (TZ)

- glandular component is in TZ

32
Q

BPH demographic:

A
  • Approximately 80% of men by 80 years
  • African-Americans > whites
  • **Transitional and Periurethral zones, hyperplasia of glandular and stromal elements, especially stromal&raquo_space; nodules
33
Q

BPH:

-clinical sx?

A

-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
Q

BPH: tx?

A

**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
Q

what is the MC CA in adult males?

A

*prostate CA –> usually peripheral zone
Risk factors:
-AGE

36
Q

Prostate CA:

  • clinical sx:
  • Dx?
A
  • none
  • obstructive uropathy
  • INCREASED Alk phos suggests bone mets**
  • PSA>10 highly predictive, 70%
  • MRI/ US
37
Q

Prostate CA: MC mets to?

A

**Bone MC, also lungs and liver

38
Q

Prostatitis:
-acute etiology?

chronic etiology?

A
  • common
  • Reflux of urine into prostate, Associated with acute cystitis

chronic= abacterial bike riders

39
Q

Prostatitis:

  • MC organisms for <35 yo?
  • > 35 yo?
A

<35: Clamydia, GC

>35: E coli, Pseudomonas, Klebsiella

40
Q

Prostatits:
sx?
dx?

A

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
Q

Testicular tumors:

-2 types?

A

MC malignancy b/w 15-35 yo
-whites»
-Types:
Malignant most often have -Germ Cell origin (95%)

-Benign stromal tumors 5%

42
Q

Germ cell tumors: classified as ____

A

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
Q

Germ cell tumors:

  • risk factors?
  • clinical Sx?

-Dx?

A

**Cryptorchidism – MC risk
Greatest risk is intraabdominal cryptorchidism

-Unilateral painless enlargement of testis

-Dx: US, CT, MRI
Spreads to para-aortic lymph nodes

44
Q

Germ Cell Tumors: tumor markers:

  • AFP elevated in _____
  • HCG elevated in ______
  • Lactate dehydrogenase elevated proportional to _____
A

-Alpha fetoprotein elevated in yolk sac tumors

-Human Chorionic Gonadotrophin elevated
In Choriocarcinoma

-Lactate Dehydrogenase elevated, proportional to tumor mass.

45
Q

Penile neoplasia:

Bowen Disease=

A

**leukoplakia of shaft

46
Q

Bowen disease is associated with ____

A
  • *HPV-16

- Precursor of Squamous cell CA

47
Q

Penile neoplasia:
Squamous Cell Carcinoma:
-demographic?
-2/3 associated with _____

A

-Almost all are uncircumcised, circumcision
protects against developing carcinoma, Older men >40 yrs

-**HPV 16 and 18

48
Q

Primary testicular failure=

A
  • this occurs BEFORE puberty

- testis- no androgen produced

49
Q

Secondary Testicular Failure=

A

this happens AFTER puberty

Pathophys Final Exam (semester 2) (5 decks)

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