Pathology

Question 1

What is the main type of tumour of the penis?

Answer 1

Squamous

Question 2

Typical feature of Bowen’s disease

Answer 2

Dry, crusting appearance of skin

Question 3

Typical feature of Erythroplasia of Queyrat

Answer 3

Glans penis develops raised red velvety appearance

Question 4

Percentage of squamous tumours of the penis that develop invasive carcinoma?

Answer 4

5%

Question 5

Aetiology of squamous penis tumours

Answer 5

poor hygiene

HPV infection

Question 6

What causes benign nodular hyperplasia of prostate (BNH) ?

Answer 6

hormonal imbalance due to altered androgen/oestrogen ratio (^^ oestrogen)

Question 7

BNH complications

Answer 7

bladder hypertrophy

diverticulum formation

Question 8

complications of untreated BNH

Answer 8

hydroureter
hydronephrosis
infection

Question 9

Management of BNH

Answer 9

mainly drug tx: ALPHA BLOCKERS, 5 alpha reductase inhibitors

Question 10

Is BNH pre malignant?

Answer 10

no

Question 11

most common age group for prostate carcinoma?

Answer 11

60 - 80

Question 12

Does lymphatic spread occur early or late in prostate carcinoma?

Answer 12

Early

> sacral, iliac and para-aortic nodes

Question 13

What lobe does prostatic carcinoma most commonly occur?

Answer 13

Posterior

Question 14

How is prostatic carcinoma treated?

Answer 14

Hormonal treatment:
* oestrogens (have anti androgen effect)
* cyproterone
Radiotherapy if painful bony mets and if elderly man where surgery is contraindicated

Question 15

What increases risk x10 of testicular tumours?

Answer 15

testicular mal-descent

Question 16

What type of tumour is responsible for 90% of testicular tumours? what are the subtypes?

Answer 16

Germ cell tumours

• seminoma
• teratoma
• mixed

Question 17

What can be caused by Leydig cell stromal testicular tumours?

Answer 17

Gynaecomastia because they often give rise to secondary hormonal secretion

Question 18

Age group for seminoma

Answer 18

30 - 50

Question 19

What lymph nodes to seminoma spread to?

Answer 19

para-aortic (often massive)

Question 20

Is seminoma radiosensitive?

Answer 20

Yes :) 95% cure rate!!!!

Question 21

Age group of teratoma

Answer 21

20 - 30

kids can get it too

Question 22

Most malignant type of teratoma?

Answer 22

Malignant Teratoma Trophonlastic

Question 23

Tumour markers
bHCG?
AFP?
PLAP?

Answer 23

bHCG - trophoblastic components
AFP - yolk sac components
PLAP - seminoma

Question 24

Is glomerulonephritis usually infective cause?

Answer 24

No

Question 25

What does glomerulonephritis principally involve?

Answer 25

Filtration units of the nephron

Question 26

Commonest cause of pyelonephritis?

Answer 26

Bacterial - E Coli | can be other coliforms too

Question 27

Pyelonephritis commoner in M or F?

Answer 27

Females

Question 28

Risk factors for pyelonephritis?

Answer 28

``` Pregnancy Instrumentation/surgery VUR (vesico-ureteric reflux) Urinary tract obstruction Diabetes ```

Question 29

What is vesico-ureteric reflux?

Answer 29

Reflux of urine back up ureter due to ureters entering bladder perpendicularly rather than obliquely - can be congenital or acquired (from surgery)

Question 30

What is often associated with chronic pyelonephritis?

Answer 30

Hypertension | severe cases - might be uraemic

Question 31

Common pathophysiology for Tuberculous pyelonephritis?

Answer 31

haematogenous spread from site in the lung

Question 32

Commonest pathogens in cystitis?

Answer 32

Ecoli - mostly klebsiella proteus pseudomonas

Question 33

What are the reactive changes seen in cystitis?

Answer 33

Urethritis and cystitis cystic - multiple small fluid filled cysts extending into the lumen - can resemble tumours

Question 34

Can TB infection affect the bladder?

Answer 34

Yes, can spread from kidneys via urine

Question 35

What can prolonged bladder outlet obstruction cause?

Answer 35

Detrusor hypertrophy | diverticulum

Question 36

What is hydronephrosis

Answer 36

dilatation of pelvicalyceal system and parenchymal atrophy due to urinary tract obstruction and reflux of urine

Question 37

What is the name given to secondary infection from hydronephrosis?

Answer 37

Pyonephrosis | - pus rather than urinary sediment