Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro-Endo > Path of Male Repro Tract > Flashcards

Path of Male Repro Tract Flashcards

This lecture has a lot of overlap with the male gonad physiology lecture, esp the infertility stuff. Trying to focus on new material.

1
Q

Review-ish: What affect does FSH have on Sertoli cells’ handling of androgens?

A

Causes increase in adrogen binding protein

Causes increase in aromatase -> conversion of T -> estradiol for release in periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

For party trivia: How many sperm does each testis make per day?

A

about 100 x 10^6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What’s one really important thing that seminal vesicles add to the ejaculate?

A

Fructose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 main regions for infertility?

A

Pre-testicular (HPT axis), testicular, post-testicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hyperprolactinemia? What might cause it? What might it cause related to infertility?

A

May be caused by pituitary microadenoma.
May cause azoospermia (found in 13% of azoospermic men).
(may also cause gynecomastia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Review: What’s azoospermia?

A

No sperm in the semen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A defect in what enzyme can cause Congenital Adrenal Hyperplasia (CAH)? What happens to affected males?

A

Defect in 21-hydroxylase (which shunts an androgen precursor toward cortisol) -> increased T.
Males with CAH develop secondary sex characteristics early, but excess T impairs gonadotropin release necessary for testis maturation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What blood test can you do for CAH?

A

Can test for increased 17-hydroxyprogesterone, which is 21 hydroxylase’s substrate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What tumors are males with CAH predisposed to?

A

Testicular adrenal rest tumors….. whatever those are.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Review: Genetic causes of male infertility?

A 
Mostly chromosome abnormalities:
XXY (Klinefelter's) <- probs most important
XYY
Yq loss
Autosomal chromosome abnormalities too.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Bad things about cryptorchidism..?

A

Infertility due to impaired spermatogenesis.
If unilateral, descended testis can still have problems.
Increased risk for neoplasia.
(interestingly, Leydig cells still seem to work)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 physical testicular causes of infertility? (other than cryptorchidism)

A

Varicocele - impaired veins drainage of testes, esp. left.
Torsion
(and trauma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2 broad categories of infectious causes of infertility?

A

Granulomatous (esp. TB)

Non-granulomatous (esp. Mumps… but that’s not very common nowdays)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 causes of post-testicular infertility?

A

Congenital (esp. CF)
Diethylstilbestrol (DES) exposure
Epididymitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What the heck is diethylstilbestrol (DES)?

A

Similar to thalidomide, it’s a synthetic hormone that was given do lots of pregnant women that turned out later to have terrible effects. (probably not that important these days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 causes of epididymitis?

A

STDs (gonorrhea and chlamydia)
E. coli (in older men with prostatism -> reduced integrity of all sorts of tubes -> E. coli get into places they shouldn’t)
TB and others.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

3 causes of ejaculatory dysfunction?

A

Neurogenic (spinal cord injury, MS)
Diabetes
Surgery (esp. prostatectomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

5 histologic patterns seen in infertility?

A 
Hypospermatogenesis
Maturation arrest (no spermatids)
Germ cell sloughing
Atrophy and fibrosis
Sertoli cell only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

3 ways to have Sertoli cell only syndrome?

A

Deficiency of FSH / LH
Dysgenetic Sertoli cells
Failure of migration / loss of PGCs

20
Q

What are 5 male germ cell tumors we looked at?

A 
Seminoma
Embryonal Carcinoma
Yolk Sac Tumors
Choriocarcinoma
Teratoma
(we didn't talk about Spermatocytic Seminoma)
21
Q

Why is important to destinguish seminoma vs. non-seminoma GC tumor?

A

Seminomas are very radiosensitive

22
Q

Are more GC tumors of one type (pure) or mixed?

A

60% are mixed. Keep that in mind when agonizing over what type of tumor you’re looking at.

23
Q

4 risk factors for GC tumor?

A

Cryptorchidism
Prior testicular GC tumor
Family Hx
Infertility

24
Q

What’s the most consistent chromosome change in GC tumors?

A 
isochromosome 12p
(this seems to be an important point)
25
Q

Which GC tumor is most like a germ cell?

A

Seminoma.

26
Q

What type of process stains positive for Placental Alkaline Phosphatase (PLAP)?

A

Intratubular Germ Cell Neoplasia (ITGCN)

27
Q

What’s the significance of Intratubular Germ Cell Neoplasia (ITGCN)?

A

It’s a precursor lesion that very often progresses to GC tumor.

28
Q

What do seminoma cell look like histologically?

A

Uniform cells with abudant clear cytoplasm (like a fried egg). Prominent nucleoli.
Lymphocytic infiltration.

29
Q

How do seminomas usually present?

A

Painless testicular mass (70% of time)

30
Q

What do seminomas look like grossly?

A

Homogenous, gray-white.
No necrosis or hemorrhage.
Relatively well-demarcated.

31
Q

What are hCG and AFP staining and serum levels like in seminoma?

A

Seminoma does not stain for hCG and AFP.

Serum hCG may be slightly elevated.

32
Q

Prognosis for seminoma?

A

Excellent, for stage I and II. (98% cure rate)

33
Q

Appearance of embryonal carcinoma, grossly?

A

Variegated, poorly demarcated.
Foci of necrosis and hemorrhage.
Exta-testicular involvement common.

34
Q

What does embryonal carcinoma look like histologically?

A

Large, anaplastic cells in sheets.
No well-formed glands.
Nuclei large, hypochromatic, with prominent nucleolus.
Lots mitosis. Giant cells common.
(the slide says hyperchromatic… but that’s wrong)

35
Q

Yolk sac tumor gross appearance / presentation?

A

Rapid testicular enlargement.
Non-encapsulated.
Yellow-white, hemorrhagic, gelatinous.

36
Q

Histological buzz-words for yolk sac tumors?

A

Lace-like, Schiller-Duval Bodies
A mess of cells - lots of white, open spaces,
Intercellular eosinophillic globules

37
Q

What do yolk sac tumors stain positive for? Is it in serum?

A

AFP, strongly

Yes, elevated AFP in serum too.

38
Q

Choriocarcioma presentation?

A

Unfortuately, often doesn’t get big enough in testis to notice before metastasizing.

39
Q

Gross appearance of choriocarcinoma?

A

Hemorrhagic and necrotic, may be scarred.

40
Q

Immunostain and serum signs of choriocarcinoma?

A

Very very high hCG, often > 100,000 mlU/ml

41
Q

Which GC tumor has the worst prognosis?

A

Choriocarcinoma.

42
Q

Histological features of choriocarcinoma?

A

Large anaplastic cells (pretty similar to embryonal carcinoma).
Main feature is prominent syncytiotrophoblastic giant cells.

43
Q

Teratoma definition?

A

Tumor with cells from more than one germ cell layer.

44
Q

Gross appearance of teratoma?

A

Well-circumscribed.
Nodular, firm, cystic.
Mature tissue often present (hair, bone)

45
Q

Mature vs. immature teratoma histological appearance?

A

Mature has more organized tissue - glands, epithelium vs. sheets of spindle-shaped cells in immature.

46
Q

What can make a teratoma get worse?

A

When epithelial structures differentiate more and become carcinomas /adenomas/ sarcomas.

47
Q

Difference in aggressiveness in children vs. adults with teratomas?

A

In children, almost always benign.

In adults, malignant with high recurrence / metastases.

Repro-Endo (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions