Brainscape's Knowledge GenomeTM

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


See full index

imed3003 > Pathology of the Testis, Epididymis and Penis > Flashcards

Pathology of the Testis, Epididymis and Penis Flashcards

1
Q

What is cryptorchidism?

A

“hidden testis” caused by either absent, ectopic or undescended testis

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

How are ectopic and undescended testicles different?

A

Undescended stop short on their way to scrotum

Ectopic diverted to an aberrant position

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

What percentage of full term babies have cryptorchidism?

A

5% have undescended testicles

1% at one year old

10% are bilateral

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

What happens to testis if they are undescended?

A

They do not form spermatozoa and look irregular on histology

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

What are potential complications of cryptorchidism?

A

Inguinal hernia

Testicular torsion

Subfertility

Malignant transformation

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

What is epididymo-orchitis and what causes it?

A

Inflammation of testis or epididymis

Trauma

Autoimmune diseases

Most commonly caused by:

It is caused by infections mostly (neisseria gonorrhoeae and chlamydia trachomatis <35yo, Ecoli, other coliforms, and pseudomonas in >35)

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

What are the symptoms of epididymo-orchitis?

A

Localised testicular pain

Tenderness and swelling

Scrotal wall erythema

Hydrocoele

If untreated can form abscess and testicular infarction

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

How does tuberculosis manifest in the genital tract?

A

Forms a caseous mass

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

What happens if testicular torsion is left untreated?

A

Haemorrhagic infarction can result

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

What happens if testicular torsion is left untreated?

A

Haemorrhagic infarction can result

Can result in irreversible damage after 12 hours of ischaemia

Can also be damage the other testis as anti-sperm antibodies can form -> infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of testicular torsion?

A

Acute onset moderate to severe pain

Profound diffuse tenderness and swelling

Absent cremasteric reflex

Nausea and vomiting

Asymmetrically high rising testis

Long axis is transverse rather than horizontal

Testicular swelling with hydrocoele

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

How is testicular torsion confirmed?

A

Ultrasound and referred to surgeon urgently

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

What is the 5 year survival rate of testicular cancer?

A

In 2017 it was 95% which is an improvement from the 1970s where it was 64%

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

What ages is testicular cancer most common?

A

15 to 35

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

What are the most common types of tumours that arise in the testis?

A

Germ cell tumours (95% of all testicular tumours)

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

What are the types of germ cell tumours?

A

Seminoma and non-seminoma (embryonal carcinoma, yolk sac tumour, choriocarcinoma, and teratoma)

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

Where are germ cell tumours most common?

A

Increasing incidence seen in Western countries like Scandinavia and Switzerland

18
Q

What are the risk factors for germ cell tumours of the testis?

A

Caucasian men

Undescended testis

Previous germ cell tumour

Inguinal hernia

Family history

19
Q

How do germ cell tumours present?

A

Painless testicular swelling

Feels heavy

Hormonal manifestations like gynaecomastia

Symptoms of metastasis (abdominal pain, retroperitoneal metastases, haemoptysis, etc)

20
Q

What causes seminomas?

A

Strongly associated with cryptorchidism

21
Q

What ages are men more prone to seminomas?

A

30 to 50

22
Q

What is the most common type of germ cell tumour?

A

Seminoma

23
Q

How is a seminoma treated? What is its prognosis?

A

Orchidectomy

Sensitive to chemo and radiotherapy

Spreads to lymph nodes particularly para-aortic nodes.

24
Q

What does a seminoma look like on histology?

A

Background lymphocytes

Clear cells

Nuclear atypia

Nucleoli

25
Q

What percentage of testicular cancers are non-seminomatous germ cell tumours?

A

~33% of testicular cancers

They may also be combined with seminoma

26
Q

What aged people get non-seminomatous germ cell tumours?

A

20s to 30s

27
Q

What are the types of non seminomatous germ cell tumours? What hormones are they associated with?

A

Embryonal carcinoma

Teratoma

Yolk sac tumour: Associated with elevated serum AFP

Choriocarcinoma: Associated with elevated serum bHCG

28
Q

What do teratomas look like on histology?

A

Random cells of all types can appear here

29
Q

What work is done for suspected testicular tumour?

A

Scrotal ultrasound

Measurement of serum tumour markers (AFP, bHCG, LDH)

Abdominal CT scan and CXR looking for metastases to the retroperitoneal lymph nodes and lungs.

Orchidectomy

30
Q

How is a tumour staged?

A

TNM system.

T1 limited to testes
T2 limited to testes with LVSI or tumour spread into hiilar soft tissue/epididymis/tunica albuginea
T3 invades spermatic cord
T4 invades scrotum

N0 N1 or N2 presence or absence of regional lymph node metastasis and size of metastasis

M0 or M1 presence or absence of distant metastasis

31
Q

How are germ cell tumours treated?

A

Surgery

If early stage seminoma orchidectomy may be adequate

If early stage NSGCT treatment depends on presence of poor prognostic factors like LVSI, predominance of embryonal carcinoma, T3 or T4 disease

In advanced disease options are chemo, radiotherapy, surgery to metastatic deposits.

32
Q

Summary of testicular tumours:

A

Most are germ cell tumours

Most common malignancy in men 15 to 35

Very high cure rate

Present with painless testicular mass

33
Q

What is hypospadias/epispadias?

A

Malformation of the urethral groove and urethral canal (an abnormal urethral opening on the ventral surface of the penis (Hypospadias) or on the dorsal surface (epispadias)

Formed in 1:300 live births

34
Q

What is condyloma acuminata?

A

Caused by HPV infection. Usually low risk HPV subtypes. It is common and increased risk with immunosuppression.

35
Q

What is prognosis like in condyloma acuminata?

A

It tends to recur but only rarely can progress to malignancy

36
Q

What are the histological features of condyloma acuminata?

A

Papillomatosis

Acanthosis

Hyperkeratosis

Koilocytosis

37
Q

What is carcinoma of the penis? Which cancer type is most common?

A

A rare condition that presents as a painless lump or ulcer. SCC is most common

38
Q

Where is SCC of the penis most common? What age group?

A

Africa, Asia, and South America (can be up to 20% of cancers in men)

Older men, 60+

39
Q

What are the risk factors for SCC of the penis?

A

High risk HPV (16 and 18)

Phimosis

Men not circumcised in childhood (smegma)

HIV infection

Smoking

40
Q

What does carcinoma of the penis look like?

A

Red patches

Painless lumps

Ulcers

41
Q

What is the prognosis of carcinoma of the penis?

A

Often slow growing

They often metastasize to inguinal lymph nodes

Prognosis related to stage

imed3003 (48 decks)

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