Penis Dx Flashcards
Are congenital anomalies of penis common
No
What is hypospadias
Urethra opens abnormally on the ventral surface of the penis
What is epispadias
Abnormal urethral opening on the dorsal surface of the penis
Why is there a almost all the time Urinary incontinence and recurrent infection and eventually infertility in epispadias
Because of defect in the urethral valve association
Can we correct surgically hypospadias and epispadias
Yes
What is phimosis
Foreskin or prepuce cannot be retracted over the glans because of abnormal small orifice
If acquired what is the cause of phimosis
Inflammatory scarring of the prepuce
What is the most common female Malformation
Phimosis
What is paraphimosis
Phimotic prepuce forcibly retracted over the glans and cannot be restored
Why is paraphimosis an emergency
Because there’s compromised blood flow with potential for grangrenous necrosis of the glans
Urethral constriction with acute retention of urine
What’s infectious disease can you see on the penis
Viral bacterial fungal protozoan
What are the type of transmission in infectious disease of the penis
Venereal
non-venereal
What is balanoposthitis
Nonspecific penile infection with inflammation of both the glands and the prepuce generally with phimosis or large redundant prepuce interfering with cleanliness
balanoposthitis organisms
staphylococcus
Streptococcus
candida albicans
Consequence of balanoposthitis
Frankie ulceration of the glans
What causes condyloma acuminatum
HPV type six or 11
Meaning of spread of condyloma acuminatum
Venereal or by last direct means
Main sites for condyloma acuminatum on penis
Inner surface of the prepuce
about the coronal sulcus
Gross morphology of condyloma acuminatum
Single or multiple
Sessile or pedunculated
Reds papillary excrescences Varying sizes
Micro findings in condyloma acuminatum
Fingerlike papillary connective tissue stroma
covered by thicken hyperplastic epithelium
excessive surface keratinization
koilocytes in superficial zone
in which disease do you see condyloma lata
Syphilis
Time between first chancre in syphylis and condyloma lata appearance
2 to 8 weeks
Gross morphology of syphilitic wart or condyloma lata
Gray whites to erythematous painless Broad Moist plaques smooth papules on the skin of the shaft and prepuce
Second name of Peyronie’s disease
Penile fibromatosis
Cause of Peyronie’s disease
Unknow
Presentation of Peyronie’s disease
Focal fibrous induration of shaft of penis with abnormal curvature and painful erection
This disease is seen in 25% cases of Peyronie’s disease
Dupuytren’s contractor also known as Palmar fibromatosis
Micro of Peyronie’s disease
Dense fiber collagenous tissue in tunica albuginea or between Tunica and penile fascia
Does the lesion records after surgical removal in Peyronie’s disease
Yes
What is Priaprism
Unwanted ,inappropriate ,unrelated to sexual activity ,persistent ,painful erection
In which disease do you see priapism
Sickle cell disease chronic granulocytic leukemia spinal cord injury injection of vasodilator agents into the penis drugs like trazodone thrombosis of penile veins
Can priaprism lead to impotence
Yes
Exclusive type of carcinoma seen in penis
Squamous cell type
What is squamous cell carcinoma in situ of penis
Precancerous lesion with epithelium having features of malignancy but still confined to the epithelium without penetration of the basement membrane
What is another name for carcinoma in situ of the penis
Bowens disease or Erythroplasia
When do you say that there’s Bowens disease of penis
Lesions are on the shaft
When do you say that there’s Erythroplasia
Lesions are on the glans and prepuce
What is bowenoid papulosis
Seen in younger patients on the shaft of the penis with smaller often multiple in micro lesions same as in Bowens disease
Which strains of HPV do you mostly see in bowenoid papulosis
16
Three variants of intraepithelial neoplasia of the penis
Bowenoid papulosis
Bowens disease
Erythroplasia
What is the second name of verrucous carcinoma
Giants condyloma of buschke lowenstein
What is verrrucous carcinoma
Extensive exophytic warty or cauliflower like tumor of the penis involving destruction of the glans and the prepuce
Histologic features a verrucous carcinoma
Like condyloma accunimatum but downward proliferation of epithelium as broad compressive fronts in underlying tissue, focal cytologic atypia of the epithelium
Is verrucous carcinoma considered a low-grade squamous cell carcinoma or a high grade one
Low grade squamous cell carcinoma with true invasion through basement membrane
Can you surgically remove tumor in verrucous carcinoma and cure the disease
Yes
Incidence of
squamous cell carcinoma
Low in countries with high circumcision rates
common in country where it’s not a norm
40-70 years old
Early lesions presentation of squamous cell carcinoma
Ulcer nodule or warty growth on the glans or inner surface of the prepuce
Late lesion presentation of squamous cell carcinoma of the penis
tumors is the large ulcerated and fungated
Michael morphology of squamous cell carcinoma of penis
Well differentiated
focal keratinization
really poorly differentiated
Prognosis of squamous cell carcinoma when limited to the penis
90 to 95%
Chronic prostatitis must be associated with what other disease
Nodular hyperplasia or prostatic hyperplasia
Age at risk of prostatic hyperplasia
Old age for people after 50 years
Over 70 years old percentage of male with prostatic hyperplasia at autopsy
95%
Is prostatic hyperplasia more common in the blacks or in the whites
The
Cause of prosthetic hyperplasia
Unknown
Why are old age most at risk of p prostatic hyperplasia
Imbalance of estrogen testosterone dihydrotestosterone due to old age
High estradiol levels in old age
Drug given to reduce size of the clones in case of nodular hyperplasia
5 a reductase inhibitor
Prostatic hyperplasia symptoms
Frequency of urinE Difficulty initiating urination and stopping overflow incontinence dysuria acute retention
Macro morphology of prostatic hyperplasia
Well defined nodules surrounded by fibrous pseudocapsule
main peripheral tissue compressed -> form thin rim
focal areas of infarction in large nodules
proliferation of epithelial cell of the glands and ductules
smooth muscle cells and stromal fibroblasts form nodules
morphology of glandular hyperplasia
Small to large cystically dilated glands
papillary projections and infoldings
Inner layer of the columnar and outer cuboidal or flatten cell
Is nodular hyperplasia benign or malignant
Completely benign
Is there a relationship between nodular hyperplasia and prostatic adenocarcinoma
No
Can you have distention and hypertrophy of the urinary bladder and urinary stasis and urinary tract infection due to chronic retention of urine in nodular hyperplasia
Yes
Common tumor of the prostate
Carcinoma because benign tumors are uncommon
Most frequently diagnosed carcinoma in males
Prostatic Adenocarcinoma
Age of incidence of adenocarcinoma of prostate
Old age mostly after 60 years old
In which race is adenocarcinoma of the prostate more common
In the blacks
Risk factors of prostatic adenocarcinoma
Dietary fats increasing testosterone level
Symptoms of prosthetic adenocarcinoma
Asymptomatic in both early and advance
Dysuria ,difficulty of micturition ,increasing urinary infection frequency ,generally in metastatic tumor
Morphology of prostate in adenocarcinoma
Firm Hard nodular irregular ill defined Gray to grayish-yellow nodules
Do you see prostatic intraepithelial new pleasure in most cases of prosthetic carcinoma
Yes
Precursor lesion for invasive carcinoma of prostate
Prostatic intraepithelial neoplasia
Micro morphology of adenocarcinoma of prostate
Well defined
glands small
Lined by single layer of cuboidal cells
papillary or cribiform patterns
Biochemical markers of prostate disease
Prostatic acid phosphatase ( only extraglandular disease. )
Prostatic specific antigen
Treatment of cancer of the prostate
Surgical resection of lesions
radiation therapy
androgen deprivation
