Path: Male Repro

Question 1

What is hypospadias and epispadias and a common association?

Answer 1

Hypo: abnormal opening on the ventral surface of the penis, malformation of the rethral groove and canal Epi: abnormal opening on the dorsal side of the penis Both are associated with failure of normal descent of testes and malformation of the urinary tract

Question 2

What is Phimosis?

Answer 2

Orifice of the prepuce is too small to permit normal retraction around the glans penis. Results in repeated attacks of infection

Question 3

Etiology of Condyloma Acuminatum.

Answer 3

HPV infection

Question 4

Most frequent serotype of HPV that causes warts.

Answer 4

HPV 6 (11 is less common)

Question 5

Characteristic Morphological change of cells in an HPV infection.

Answer 5

Koilocytic change: cytoplasmic vacuolization of the squamous cells

Question 6

Name the two types of morphology of squamous cell carcinoma of the penis.

Answer 6

1. Papillary: similar to condyloma acuminata
2. Flat: epithelial thicening, graying of mucosal surface, ulceated papule

Question 7

What is a major complication of squamous cell carcinoma of the penis?

Answer 7

Metastasis to the inguinal lymph nodes.

(drops the prognosis of 5 year survival from 66% to 27%)

Question 8

What is cryptorchidism?

Answer 8

Failure of descent of one or both testes from the abdominal cavity.

Question 9

Major complications of cryptorchidism.

Answer 9

Thickening (hyalinization) of the seminiferous basement membrane leading to infertility along with impaired sperm maturation.

Also greater risk of developing testicular cancer.

Question 10

Which infections attack the epididymis before the testes?

Answer 10

Gonorrhea

TB

Question 11

Which infections attack the testes before the epididymis?

Answer 11

Mumps

Syphilis (doesn’t actually infect testes)

Question 12

What is testicular torsion?

Answer 12

Twisting of the Spermatic Cord cutting off venous drainage, however, the arteries remain patent.

Question 13

Etiology of neonatal testicular torsion.

Answer 13

No anatomic defect, just associated with growth in the uterus.

Question 14

Etiology of Adult Testicular Torsion.

Answer 14

Results from bilateral anatomic defect.

Question 15

Name the two broad categories of germ cell tumors.

Answer 15

1. Seminomatous: resemble germ cells
2. Non-seminomatous: resemble embryonic stem cells

Question 16

What do non-seminomatous tumors that become malignant differentiate into? (3 categories)

Answer 16

1. Yolk sac tumors
2. Choriocarcinomas
3. Teratomas

Question 17

Most common germ cell tumor in males.

Answer 17

Seminoma

Question 18

Gross morphology of a seminoma.

Answer 18

Bulky testicular mass, 10x the normal size

Question 19

Marker used to differentiate classic seminomas from other seminomatous tumors.

Answer 19

Elevated HCG levels from syncytiotrophoblast formation.

Question 20

Microscopic characteristic of Spermatocytic Seminomas.

Answer 20

Contain three cell populations (small, medium, scattered giants)

Question 21

Microscopic morphology of Embryonal Carcinomas of the testes.

Answer 21

Mitotic Figures with giant cells

Question 22

Most common testicular tumor.

Answer 22

Yolk Sac Tumor

Question 23

Characteristic microscopic morphology of Yolk Sac Tumors.

Answer 23

Schiller-Duval Bodies

-structures resembling endodermal sinuses and primitive glomeruli

Question 24

Non-seminomatous tumor that may cause increased levels of HCG.

Answer 24

Choriocarcinoma (syncytiotrophoblastic cells produce it)

Question 25

Which non-seminomatous tumor has organoid structures like neural tissue, muscle bundles, islands of cartilage, clusters of squamous cell, etc.?

Answer 25

Teratomas (tumors derived from multiple embryonic germ layers)

Question 26

Which teratomas are most likely malignant?

Answer 26

Those that arise after puberty