Pathology 3

Question 1

What is the main purpose of the corpus spongiosum?

Answer 1

corpus spongiosum doesn’t expand as much as corpus cavernosum during an erection - keeps the urethra open and doesn’t allow it to collapse

Question 2

Which invasion is worse in cancer?

Answer 2

Corpus cavernosum - as it has more vasculature

Question 3

What is balanitis xerotic obliterans(BXO)/ lichen sclerosis?

Answer 3

very common
usually young patients
even neonates and kids & very old men
phimosis (foreskin that is stuck - red and swollen =, leading to painful urination)
paraphimosis –> can’t bring down the retracted foreskin

Question 4

Histology of BXO

Answer 4

chronic inflammation/ scar tissue beneath the epithelium, hyalinisation and the foreskin in less pliable

Question 5

What are the HPV viruses that cause benign genital warts?

Answer 5

HPV 6 and 11

Question 6

What are the HPV viruses that cause high risk ones?

Answer 6

HPV 16 and 18

Question 7

Neoplasia of the penis

Answer 7

PEiN - penile intraepithelial neoplasia

no grading

Question 8

Undifferentiated PEiN causes

Answer 8

HPV related

Question 9

Differentiates causes of PEiN

Answer 9

non HPV

Question 10

Is penile cancer common?

Answer 10

NO

Question 11

What is CIN?

Answer 11

Cervical intraepithelial neoplasia

Question 12

Features felt on the testis

Answer 12

Lots of lumps and bumps
paratesticular swellings
testicular swellings
Orchitis
Torsion

Question 13

What are the functional unit of the testis?

Answer 13

Semineferous tubule

Question 14

What are the germ cells vs sertoli cells?

Answer 14

Germ cells –> produce sperms
Sertolid cells –> nourishment and environment within the tubules
Leydig cells-

Question 15

What hormones stimulates the sertoli cells?

Answer 15

FSH

Question 16

Sertoli only syndrome

Answer 16

No germ cells hence can’t do IVF as there are no sperms produced

Question 17

What controls the Leydig cells?

Answer 17

LH

convert testosterone into the DHEA (dehydroepiandrosterone)

Question 18

What is measured in hormone tests in athletes?

Answer 18

DHEA levels

Question 19

Importance of DHEA

Answer 19

active form of testosterone

Question 20

Are lumps common in the testis?

Answer 20

Yes

Question 21

What is a hydrocoele?

Answer 21

Fluid accumulation btw the two layers of the tunica vaginalis - mesothelial lining

unicyctic, smooth and fluid filled

it is adjacent to the testis, not on it, so can palpate it superior to the testis

Question 22

Examination and transilumination of the hydrocoele

Answer 22

smooth, softish, circunscribed, lucent

Question 23

What is a spermatocoele?

Answer 23

Not in the trestis in the epidydimis

cystic change within the vas of the epidydimis
unknown cause and usually asymptomatic
feeling of fullness, full of sperm

Question 24

What is a varicocoele?

Answer 24

Varisoties of venous plexus thatdrains the testis
usually asymtpmatic
may present with the feeling of a lump –> bag of worms

Question 25

Guidance for examination

Answer 25

in the testis or seperate
epidydimal or other 
if you can get above it -hernia
solid of cystic (unicyctic - fost, - benign; if multicystic - malignant)
painful - can be a red herring

Question 26

Torsion

Answer 26

testis and cord rotate around the arterial blood supply
cell death exrtemely quick
after 6 hours - the testis is largely irretrievable

Question 27

Bell clamper deformity

Answer 27

insertion of the tunica vaginalis is high - hence the testis is free in the scrotum

the testic can thus rotate and even sit laterally

Question 28

PC of torsion

Answer 28

extreme excruciating pain
no particular precipitant
common in neonates and adolescents
can be in your sleep as much as in sports

Question 29

Neoplasia in the testis

Answer 29

Lumps present in the testis proper
common tumour - ypunger age groups and more associated with malignancy
good prognosis - even at an advanced stage
responsive to chemo

Question 30

What are the two types of tumours in the testis?

Answer 30

Seminoma and non-seminomatous

tumours of the germ cells

Question 31

Most common testicular malignancy?

Answer 31

Seminomatous tumours - potato tumour on cutting it (white)

germ cell tumour- inflammatory infiltrates

Question 32

What is the age group for seminomas?

Answer 32

20-40

Question 33

Risk factora for seminomas

Answer 33

RF - undescended testis

contralateral testis also at risk

Question 34

What is the cure rate for seminomas?

Answer 34

Excellent - 90%

surgery and extremely responsive to radiotherapy

Question 35

Non-seminomatous tumour

Answer 35

less common
rarely exist as pure tumours
mixed types is the most common
vascular and cystic appearance

Question 36

Age group for non-seminomatous tumours

Answer 36

30s

Question 37

Agressiveness of non-seminomatous tumours

Answer 37

aggressive and can metastasize
even with mets the outcome is reasonable - very chemosensitive

have to treat ASAP - as they grow very fast

Question 38

What is a mature teratoma?

Answer 38

Three germ layers
endoderm, ectoderm and mesoderm affected
all mallignant in testis (ovary –> benign)

Question 39

Yolk sac tumour

Answer 39

produce AFP

endodermal sinus character

Question 40

Embyonal

Answer 40

aggressive form, look high grade and is associated with freq mets

Question 41

Trophoblast

Answer 41

wacky looking cells, positive for HCG

positive pregnancy test

Question 42

What tells you if you got rid of the tumour or not?

Answer 42

tumour markers

Question 43

What are the 4 types of non-seminomatous tumours?

Answer 43

trophoblast, yolk-sac, embyonal, teratoma

Question 44

What is an inflammatory penile disease?

Answer 44

BXO