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► Med - Pathology > Pathology of the Male GU I: Prostate > Flashcards

Pathology of the Male GU I: Prostate Flashcards

1
Q

What type of cells line the urinary tract?

A

Urothelium

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2
Q

What is the most common cause of hydronephrosis in

children?

A

Ureteropelvic Junction Obstruction

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3
Q
  • von Brunn’s nests with degenerated central cells to form small cystic cavities
  • Translucent, submucosal, pearly- yellow cysts, usually up to 5mm
A

Urethritis (AKA Cystitis Cystica)

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4
Q

Vesicoureteral Reflux

A

Valve defect that can lead to the reversal of the

urine - can cause pyelonephritis

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5
Q

Exstrophy

A

Developmental failure in the anterior wall of the abdomen and in the bladder

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6
Q

Interstitial Cystitis (Chronic Pelvic Pain Syndrome)

A

Non-bacterial form of cystitis seen mostly in females and is associated with allergies and autoimmune diseases and mast cells are often a hallmark

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7
Q

Malakoplakia

A

Recurrent fever, bladder irritability and pain, hematuria, pyuria, weight loss.

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8
Q

What is seen on cystoscopy with malakoplakia?

A

Multiple raised soft yellow to brown plaques and nodules

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9
Q

Michaelis-Gutmann Bodies

A

Blue targeted calcospherules seen on histology in malakoplakia

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10
Q

What is malakoplakia associated with?

A

Chronic bacterial infection

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11
Q

Leukoplakia

A

Long-term irritation or chronic infection which appears grossly as gray-white areas and has increased risk of carcinoma of bladder

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12
Q

What is a feature of the treatment of bladder cancer?

A

It has the highest cost per patient from diagnosis to death

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13
Q

What gender is more affected by bladder cancer?

A

Males 3:1 - usually older males

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14
Q

What is the clinical presentation of bladder cancer?

A
  • Painless hematuria
  • Frequency
  • Urgency
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15
Q

What are some major risk factors for bladder cancer?

A
  • Cigarette smoking
  • Arylamines
  • Chronic cystitis
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16
Q

What are the two pathways for the development of urothelial carcinoma?

A

Papillary and Non-papillary

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17
Q

What pathway is the most common for the development of urothelial carcinoma?

A

Papillary Pathway

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18
Q

Papillary Pathway

A

More common and develops with hyperplasia which is genetically stable with FGFR3 mutations. As it develops, it leads to a low grade carcinoma.

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19
Q

Non-papillary Pathway

A

Less common and develops with dysplasia and is genetically unstable with some having p53 mutations. It can develop into high grade carcinoma or carcinoma in situ.

20
Q

What mutation is more likely in a low grade urothelial carcinoma?

A

FGFR3

21
Q

What mutation is more likely in a high grade urothelial carcinoma?

A

p53

22
Q

BCG Vaccine

A

Bacillus Calmette-Guérin - Attenuated strain of Mycobacterium tuberculosis and is used to prevent recurrence of bladder cancer

23
Q

What is the prognosis of low grade bladder cancer?

A

VERY good

24
Q

What is the prognosis of high grade bladder cancer?

A

Pretty good - 75% 10 yr survival rate

25
Q

Most common cause of Nongonococcal urethritis…

A

E. coli

26
Q

What is the most common location for prostate cancer?

A

Posterior zone

27
Q

What is the most common location for benign prostatic hyperplasia?

A

Central Zone

28
Q

What cell layers it the prostate comprised of?

A
  • Secretory Cells

- Basal Cells

29
Q

Benign Prostatic Hyperplasia

A

Hyperplasia of prostatic glands and stroma - extremely common with increasing age

30
Q

What are some complications of BPH?

A
  • Compression of urethra – difficulties with urination

- Retention of urine in the bladder

31
Q

What are the main mediators of prostate growth?

A

Androgens - mainly DHT

32
Q

How is BPH treated?

A

Inhibitors of 5-alpha reductase

33
Q

Nodular Hyperplasia of Prostate

A

Prostatic enlargement due to presence of nodules in the preprostatic region

34
Q

What is the most common cancer in males?

A

Prostate Cancer

35
Q

Do most men with prostate cancer die from prostate cancer?

A

No

36
Q

What race is at increased risk of prostate cancer?

A

African Americans

37
Q

What are some mutations in the androgen receptors that increase prostate cancer risk?

A

X-linked AR gene contains a polymorphic sequence composed of CAG repeats - patients with shortest CAG repeats have the highest androgen sensitivity

38
Q

What mutation greatly increases prostate cancer risk?

A

BRCA2 germline mutation on Ch13 - 20 fold increased risk for PCA

39
Q

What is the most common epigenetic alteration in prostate cancer?

A

Most common epigenetic alteration in PCA hypermethylation of gluthation S-transferase

40
Q

What are some biomarkers of prostate cancer?

A
  • PSA

- AMACR

41
Q

Prostate Specific Antigen (PSA)

A

Secreted into seminal fluid where dissolves seminal
coagulum. Produced by epithelial cells of normal, hyper plastic and cancerous prostatic tissue and is elevated in prostate cancer.

42
Q

Prostatic Intraepithelial Neoplasia

A

Proliferation of neoplastic cells within large ducts

43
Q

What is the most common morphology of prostate cancer?

A

Most often - tumor is not grossly visible

44
Q

What is the best marker to predict prognosis of prostate cancer?

A

Gleason Score

45
Q

What is a common metastasis of prostate cancer?

A

Osteoblastic Tumor Metastases

46
Q

What is the treatment for localized prostate cancer?

A

Radical Prostatectomy

47
Q

What is the treatment for metastatic prostate cancer?

A

Androgen Deprivation

► Med - Pathology (203 decks)

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