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Path Spring Exam 1 > Penis > Flashcards

Penis Flashcards

1
Q

What is Hypospadias?

A

A congenital anomaly where the urethral opening is located on the underside of the penis instead of at the tip

Most common congenital anomaly of penile urethra, usually due to incomplete closure of urethral folds.

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2
Q

What is Epispadias?

A

A congenital condition where the urethra ends in an abnormal opening on the upper side of the penis

Less common than hypospadias and may be associated with bladder exstrophy.

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3
Q

Define Phimosis.

A

A condition where the foreskin cannot be retracted over the glans penis

Can be physiologic in childhood or pathologic in adults due to inflammation or scarring.

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4
Q

What is Chordee?

A

A congenital deformity characterized by downward or upward curvature of the glans

Often associated with hypospadias.

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5
Q

What is Balanitis?

A

Inflammation of the glans penis

Often caused by poor hygiene, infections, or irritants.

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6
Q

Define Balanoposthitis.

A

Inflammation of the glans penis and foreskin

Can occur due to infections, irritants, or allergic reactions.

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7
Q

What is Peyronie Disease?

A

A condition characterized by abnormal curvature of the penis due to fibrosis of the tunica albuginea

May cause pain during erection and is often idiopathic.

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8
Q

What are the clinical presentations of BXO?

A

Typically presents with painful urination, phimosis, and sometimes urinary obstruction

BXO stands for Balanitis Xerotica Obliterans, associated with chronic inflammation.

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9
Q

What is the female counterpart of BXO?

A

Lichen sclerosus

Can lead to similar symptoms in females, including vulvar pain and scarring.

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10
Q

List the two clinicopathologic patterns of penile CIS.

A
  • Bowen disease
  • Bowenoid papulosis

Both strongly associated with “high risk” HPV 16 & 18 infections
Both demonstrate “full thickness” epithelial dysplasia

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11
Q

What are risk factors for Carcinoma of the Penis?

A
  • Phimosis
  • HPV infection
  • Poor hygiene
  • Smoking

Circumcision reduces the risk by promoting hygiene.

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12
Q

What is significant about Verrucous Carcinoma variant of Squamous Cancer?

A

It is a well-differentiated variant that is locally aggressive but rarely metastasizes

Key word: exophytic (growing outward or away from surface of an organ or tissue)

Commonly associated with HPV infection.

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13
Q

Define Cryptorchidism.

A

A condition where one or both testes fail to descend into the scrotum

Associated with sterility, atrophy, and increased cancer risk if undetected.

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14
Q

What are the likely etiologies of Epididymitis in younger men?

A
  • Sexually transmitted infections
  • Trauma

In older men, it is often associated with urinary tract infections.

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15
Q

What is Orchitis?

A

Inflammation of one or both testes

Types include Gonococcal, Mumps, Tuberculous, Syphilitic, and Autoimmune.

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16
Q

What is the Bell-Clapper deformity?

A

A developmental condition that predisposes to testicular torsion

It allows the testis to rotate freely within the scrotum.

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17
Q

What are the complications of Torsion?

A
  • Infarction
  • Orchitis
  • Infertility

Torsion is a surgical emergency requiring prompt intervention.

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18
Q

List the three most common paratesticular lesions.

A
  • Hydrocele
  • Spermatocele
  • Varicocele

Each has distinct features and locations.

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19
Q

What are Germ Cell tumors?

A

Tumors that arise from germ cells in the testis

Includes Seminomas and Nonseminomatous tumors, with varying presentations and serum markers.

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20
Q

What is ITGCN?

A

Intra-tubular Germ Cell Neoplasia

Most germ cell tumors begin as an “in situ” precursor lesion

Exceptions: pediatric Yolk Sac tumors, Teratomas & adult Spermatocytic Seminoma

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21
Q

What is the most common cytogenetic abnormality in Intratubular Germ Cell Neoplasia (ITGCN)?

A

Isochromosome 12p - seen in 80% of invasive Germ Cell tumors

This abnormality is frequently seen in testicular germ cell tumors.

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22
Q

What are the serum markers used in Germ Cell tumors?

A
  • AFP
  • HCG
  • LDH

Each marker has specific associations with different tumor types.

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23
Q

What is the difference between Seminoma and Nonseminomatous tumors?

A

Seminoma is typically more responsive to radiation, while Nonseminomatous tumors are more aggressive and can be mixed

Nonseminomatous tumors include embryonal carcinoma, yolk sac tumor, and choriocarcinoma.

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24
Q

What is the function of Leydig cells?

A

To produce testosterone

Important for male sexual development and reproductive function.

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25
What is the significance of Sertoli cells?
They support and nourish developing sperm cells ## Footnote They also produce inhibin, which regulates FSH.
26
What is the age distribution for testicular torsion?
Most common in adolescents and neonates ## Footnote Torsion is a surgical emergency that requires immediate attention.
27
What is Peyronie Disease?
Presents as curved penis during erection Cause: Fibrosis of the Tunica Albuginea ## Footnote May be associated with Palmer (Dupuyten Disease) or Plantar fibromatosis
28
What is chordee?
Abnormal curvature of the glans at the junction with the shaft of the penis
29
What is ventral chordee?
A congenital malformation most commonly associated with hypospadias Glans curves downward
30
True or False: Ventral chordee is often associated with Peyronie disease.
False
31
What are atrophic whitish patches?
Areas of induration of the glans, urethra, or foreskin; prone to fissuring Balanitis Xerotica Obliterans (BXO)
32
What condition may prevent retraction of the foreskin?
Phimosis
33
What is Balanitis Xerotica Obliterans (BXO) characteristic findings on biopsy?
A condition characterized by homogenized collagen and band-like chronic inflammation
34
What are the histologic features of Carcinoma in situ (CIS)?
Hyperchromatic, pleomorphic cell nuclei, ↑ nuclear-cytoplasmic ratios, loss of polarity, ↑ mitoses
35
What is Bowen disease?
A clinical pattern of penile CIS in older patients, characterized by solitary, usually red-pink plaques High risk of progression to invasive SCC within 10 years
36
What is Bowenoid papulosis?
A clinical pattern of penile CIS in younger sexually active patients with multiple pink-brown papules May regress spontaneously; risk of invasive cancer is low
37
What is the risk of progression to invasive SCC in Bowen disease?
Approximately 10% within 10 years
38
What are the common risk factors for invasive squamous cell carcinoma of the penis?
* HPV infection with high-risk types * Phimosis/uncircumcised/poor hygiene * Cigarette smoking * Chronic inflammatory conditions
39
What is the 5-year survival rate for invasive squamous cell carcinoma without node metastasis?
66%
40
What is verrucous carcinoma of the penis?
A variant of SCC that is exophytic and very well differentiated
41
What hormones do FSH and LH influence in the male testis?
* FSH: Stimulates seminiferous tubules to produce sperm * LH: Stimulates Leydig cells to produce testosterone
42
What is the consequence of high levels of estrogen on spermatogenesis?
They disrupt normal Sertoli cell function
43
What is Cryptorchidism?
Failure of intra-abdominal testes to descend into the scrotal sac
44
What is the incidence of Cryptorchidism in neonates?
4-5%
45
What is the recommended treatment for Cryptorchidism?
Surgical Orchiopexy, preferably before 2 years of age
46
What is the most common cause of epididymitis in younger men?
Sexually transmitted infections like Neisseria gonorrhoeae and Chlamydia
47
What is the common pathogen causing epididymitis in older men?
Common enteric pathogens such as E. coli
48
What may result from prolonged epididymitis?
Scarring and potential infertility
49
What is the typical presentation of torsion of the testis?
Acute scrotal pain and swelling; nausea and vomiting
50
What physical examination finding confirms testicular torsion?
Color Doppler ultrasonography
51
What is the surgical emergency caused by rotation of the testis?
Torsion of the testis
52
What are the symptoms of testicular torsion?
Acute scrotal pain and swelling; nausea and vomiting ## Footnote Testicular torsion is a surgical emergency that requires immediate attention.
53
What diagnostic method confirms testicular torsion?
Physical examination; confirmed by color Doppler ultrasonography ## Footnote Doppler ultrasound assesses blood flow to the testicle.
54
What is the initial treatment for testicular torsion?
Immediate manual detorsion followed by surgical exploration ## Footnote Manual detorsion involves rotating the testis outward toward the thigh.
55
How does testicular salvage change over time after torsion?
Drops rapidly from 80-100% at 6 hours to near 0% at 24 hours ## Footnote Timely intervention is crucial for preserving testicular viability.
56
What is the classic sign associated with torsion of the appendix testis?
Classic blue-dot sign ## Footnote This sign is sometimes seen on the superior pole of the testicle.
57
What are the common causes of scrotal pain in pediatric patients?
Testicular torsion and torsion of testicular appendages ## Footnote Torsion of testicular appendages is a benign condition that mimics testicular torsion.
58
What is a hydrocele?
Accumulation of serous fluid between the visceral and parietal tunica vaginalis ## Footnote Hydroceles can be diagnosed through transillumination.
59
What is a varicocele?
Dilated veins of the pampiniform plexus in the spermatic cord ## Footnote It is often associated with infertility in males.
60
What defines a spermatocele?
Cystic dilation of the duct of rete testis/epididymis with sperm ## Footnote Spermatoceles are generally benign and can be asymptomatic.
61
What is the most common type of testicular tumor?
Germ cell tumors ## Footnote These account for approximately 88% of all testicular tumors.
62
What are the two main classifications of testicular tumors?
Seminomatous and non-seminomatous tumors ## Footnote Seminomatous tumors tend to be less aggressive and more responsive to treatment.
63
What is the peak incidence age for classic seminoma?
20’s ## Footnote Classic seminoma is the most common germ cell tumor.
64
What tumor markers are associated with testicular tumors?
* LDH: correlates with total tumor burden * AFP: differentiation toward yolk sac elements * hCG: differentiation toward placental chorion ## Footnote Elevated levels of these markers can indicate the presence of testicular cancer.
65
What is the typical presentation of testicular tumors?
Painless enlargement of a testicle ## Footnote Any solid mass in the testicle should be treated as malignant until proven otherwise.
66
What is the risk of testicular atrophy associated with varicocele?
Increases risk of testicular atrophy/infertility ## Footnote Found in one third of infertile males.
67
What is ITGCN?
Intratubular Germ Cell Neoplasia ## Footnote ITGCN is a precursor lesion for most germ cell tumors.
68
What are the common causes of testicular atrophy?
* Varicocele * Cryptorchidism * Endocrine diseases * Major organ disease * Genetic diseases ## Footnote These factors can lead to diminished blood supply and overall testicular health.
69
What is the most consistent mutation necessary for invasion in germ cell tumors?
Isochromosome 12p ## Footnote Seen in 80% of invasive germ cell tumors.
70
What is the most common germ cell tumor?
Classic Seminoma ## Footnote Accounts for approximately 50% of germ cell tumors.
71
What is the peak incidence age for Classic Seminoma?
20’s
72
What is the counterpart of Classic Seminoma in the ovary?
Dysgerminoma
73
Which nuclear transcription factors are expressed in Classic Seminoma?
OCT 3/4 & NANOG ## Footnote These factors indicate stem cell characteristics.
74
What is the prognosis (Px) for Classic Seminoma?
Very good; survival rate > 95% ## Footnote 99% if confined to the testicle.
75
What are the histological features of Classic Seminoma?
Large monotonous cells with clear cytoplasm, central nucleus, prominent central nucleoli ## Footnote Often described as having a 'Fried egg' appearance.
76
What percentage of Classic Seminomas show scattered Syncytiotrophoblasts?
About 20%
77
What is the significance of elevated hCG levels in Classic Seminoma?
Does not change its classification or prognosis
78
What is the main characteristic of Spermatocytic Seminoma?
Rare (1-2%); occurs in older men (mean age 55) ## Footnote Essentially benign with excellent prognosis (< 1% malignant).
79
What is the most common age group for Embryonal Carcinoma?
20’s
80
What types of tissues can Embryonal Carcinoma differentiate into?
Fetal somatic tissues (endoderm, mesoderm, ectoderm); extraembryonic placental chorion; extraembryonic yolk sac tissue ## Footnote Teratoma, Choriocarcinoma, Yolk Sac Tumor.
81
What histological feature is characteristic of Yolk Sac Tumors?
Glomeruloid structures (Schiller-Duval bodies)
82
What is the most common testis tumor in infants and children?
Yolk Sac Tumor
83
What is the most aggressive non-seminomatous germ cell tumor?
Choriocarcinoma
84
What are the components of a Teratoma?
Disorganized tissues from all three germ cell layers: endoderm, mesoderm, ectoderm
85
What defines a Teratoma with Malignant Transformation?
Malignancy in one of the components of a Teratoma
86
What is the initial procedure of choice for diagnosing and treating a testicular mass?
Radical inguinal orchiectomy with high ligation of the spermatic cord
87
What markers should be measured prior to orchiectomy for testicular masses?
AFP, LDH, & hCG
88
What is the cure rate for seminoma patients?
Exceeds 90%
89
What is the behavior of pure Teratomas in prepubertal children?
Benign
90
What is the typical presentation of Leydig Cell Tumors?
As a testicular mass or due to hormonal effects (sexual precocity in children)
91
What percentage of Leydig Cell Tumors behave in a malignant fashion?
About 10%
92
What percentage of children behave in a malignant fashion?
About 10%
93
What are Crystalloids of Reinke and how frequently are they seen?
Seen in about half of cases
94
What is a common cause of estrogen production in children?
Leydig Cell Tumor
95
What is a common cause of androgens production in children?
Leydig Cell Tumor
96
What type of tumor is usually hormonally silent?
Sertoli Cell Tumor
97
What are the neoplastic cells in Sertoli Cell Tumors arranged in?
Glandular/tubular structures
98
What percentage of Sertoli Cell Tumors are malignant?
About 10%
99
What is the most common testicular tumor in men aged 60+?
Non-Hodgkin Lymphoma
100
What subtype of lymphoma is typically seen in older men?
Diffuse Large B-cell Lymphoma
101
What is the peak age of incidence for Seminoma?
Specific age group (not defined in the provided text)
102
Does an increased HCG level affect the diagnosis or prognosis of Seminoma?
Does NOT affect Dx or Px
103
Does an increased AFP level affect the diagnosis of Seminoma?
DOES change Dx (to nonseminomatous)
104
What stem cell marker is associated with Seminoma?
OCT 3/4+
105
What is a characteristic feature of Spermatocytic Seminoma?
Essentially benign tumor occurring in older men
106
What is the most common testicular tumor in children under 3 years?
Yolk Sac (Endodermal Sinus) Tumor
107
What histological feature is associated with Yolk Sac Tumors?
Schiller-Duval bodies
108
What serum marker is associated with Yolk Sac Tumors?
AFP
109
What is the most aggressive type of testicular tumor?
Choriocarcinoma
110
What marker is associated with Choriocarcinoma?
HCG
111
What is the classification of Teratoma in children?
Benign (even immature very likely benign)
112
What is the classification of Teratoma in postpubertal males?
Potentially malignant
113
What does the term 'Teratoma with Malignant Transformation' refer to?
Specific term (not defined in the provided text)
114
What are the stages of Germ cell tumors?
Stage I, II, or III
115
What percentage of Sex Cord-Stromal Tumors are malignant?
10%
116
What do Leydig cells secrete and what is their effect?
Androgens; cause precocity
117
What histological feature is associated with Leydig Cell Tumors?
Crystalloids of Reinke
118
What is the most common testicular tumor in men over 60?
Lymphoma

Path Spring Exam 1 (3 decks)

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