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Renal > Pathology III > Flashcards

Pathology III Flashcards

1
Q

What cells line the penis and glans?

A

Squamous cells

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2
Q

What composes the erectile tissue of the penis?

A

Corpus cavernosum and corpus spongiosum = lots of blood vessels and neural innervation

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3
Q

What cell types are present in the urethra?

A

Squamous at the distal end and then urothelial more proximally

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4
Q

What are some skin conditions that affect the penis?

A

Balantitis xerotic obliterans, papilloma, neoplasia

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5
Q

What are some features of balantitis xerotic obliterans?

A

Also called lichen sclerosis, very common but cause not known, usually young males, phimosis or paraphimosis

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6
Q

What are some features of papillomas?

A

Caused by HPV = common, genital warts caused by HPV 6 and 11, HPV 16 and 18 high risk for cancer

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7
Q

What is penile neoplasia classed as?

A 
PEiN = penile intra-epithelial neoplasia 
Differentiated = non-HPV
Dedifferentiated = HPV related
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8
Q

What are some features of penile cancer?

A

Linked with chronic inflammation and HPV = not uncommon

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9
Q

What is the function of the testis?

A

Makes sperm in the seminiferous tubules

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10
Q

Where does sperm arise from?

A

Germ cells = until they mature into spermatozoa

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11
Q

What is the function of the Sertoli cells in the testis?

A

Stimulated by FSH = control environment within the tubule, eventually absorb excess cytoplasm

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12
Q

What cells are contained within the seminiferous tubules?

A

Germ cells, Sertoli cells, maturing sperm

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13
Q

What is the function of Leydig cells of the testis interstitium?

A

Under control of LH = produce dehydroepialdosterone (DHEA) converted from testosterone

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14
Q

Can hernias occur in the testes?

A

Yes

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15
Q

What are hydrocoeles?

A

Accumulation of fluid around the testes = between the two layers the tunica vaginalis (mesothelial lining)

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16
Q

What is the appearance hydrocoeles?

A

Unicystic, smooth, fluid filled, softish and lucent on examination

17
Q

What are spermatocoeles?

A

Cystic change in vas of epididymis = unknown cause and usually asymptomatic, may feel fullness, patients present after self examination

18
Q

What are variocoeles?

A

Varicosities of venous plexus that drains the testis = usually asymptomatic, may present after feeling lump (bag of worms)

19
Q

What are some important parts of the testis examination when there is a lump?

A 
In testes or separate?
Epididymal or other
Can you get above it?  = hernias 
Solid or cystic?
Painful etc
20
Q

Why is torsion an emergency?

A

Testis and cord rotate around arterial supply causing ischaemia then cell death = irretrievable after 6hrs

21
Q

What is the bell clapper deformity?

A

Insertion of the tunica vaginalis is high = testis can rotate and even sit laterally

22
Q

How does torsion present?

A

Excruciating pain with no precipitating cause

23
Q

What age group is torsion common in?

A

Neonates and adolescents

24
Q

What are some features of testicular neoplasia?

A

Lump in testes = not separate
Relatively common = younger age group
Generally good prognosis even when advanced
Often early stage but also responsive to chemo

25
Q

What are the two types of neoplastic testicular tumours?

A

Seminomatous and non-seminomatous = both are types of germ cell tumour

26
Q

What are some features of seminomatous testicular tumours?

A

Most common = look like potato
Patient age is around 40
Undescended testis is risk factor

27
Q

What is the prognosis of seminomatous testicular tumours?

A

95% cure rate = extremely responsive to radiotherapy even if advanced

28
Q

What are some features of non-seminomatous testicular tumours?

A

Less common than seminomas
Rarely exist as pure tumours = often mixed type
Patient age is about 30

29
Q

Why does non-seminomatous neoplasm need to be treated early?

A

More aggressive and can metastasise

Very chemosensitive = reasonable outcomes even with metastases

30
Q

What are the types of non-seminomatous tumours?

A

Mature teratoma = three germ layers, all malignant
Yolk sac = can produce alpha feto protein (aFP)
Embryonal = aggressive form
Trophoblast

31
Q

What are some features on embryonal non-seminomatous tumours?

A

Look high grade and associated with frequent metastases

32
Q

What are some features of trophoblast non-seminomatous tumours?

A

Cells are weird looking, positive for beta HCG, will give positive pregnancy test result

33
Q

What does the prognosis of non-seminomatous neoplasm depend on?

A

Subtypes present and relative proportions

34
Q

How are non-seminomatous neoplasms followed up and diagnosed?

A 
LDH = most types
aFP = yolk sac
bHCG = choriocarcinoma

Renal (36 decks)

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