Rubin's 23: Lower Urinary/Male Reproductive Flashcards
Name the dx: Congenital defect; Absence of the anterior abdominal wall; Is associated with epispadias in some male infants; Increased risk of bladder carcinoma (squamous) later in life
Exstrophy of the urinary bladder
Name the dx: Developmental abnormality resulting in a vesicle-umbilical fistula or urachal diverticulum
Failure of the urachus to involute
Name the dx: Enlargement of the prostate gland leading to obstruction of urine flow; Proliferation of the glands and stroma; Repeated bouts of cystitis; Urinary retention leading to bladder diverticula and/or bladder stones
Nodular prostatic hyperplasia
T/F: The risk of acute cystitis in females is higher in pregnancy.
True
Acute cystitis involves what symptoms:
Pelvic pain; Hemorrhage; Stromal edema; Neutrophilic infiltrate on urinalysis
Name the dx; Most common primary tumor of the bladder; Painless hematuria; Epithelial tumor; Papillary fronds lined by urothelial epithelium; Minimal cytologic atypia on histology
Exophytic papilloma;
Most invasive urothelial cell carinomas arise from:
carcinoma in situ
What are the most common risks for developing urothelial cell carinoma of the bladder?
Smoking; Exposure to azo dyes; Infection with Schistosoma haematobium; Cyclophosphamide; Use of certain analgesics; Radiation therapy
Name the dx: Collection of serous fluid in the scrotal sac between two layers of the tunica vaginalis; Congenital version is often associated with inguinal hernia
Hydrocele
Name the dx: Accumulation of blood between the layers of the tunica vaginalis; May develop after trauma or hemorrhage into hydrocele; Can also be caused by testicular tumors and infections
Hematocele
Name the dx: Seen in children; Edematous, mucosal, polyploid masses with a “cluster of grapes” appearance;
Embryonal rhabdomyosarcoma aka sarcome botryoides
Name the dx: Polyploid inflammatory lesions near the urethral meatus that produce pain and bleeding; Occur exclusively in women;
Urethral caruncle
Parasitic infection of the bladder, such as with schistosomiasis, causes what kind of cancer?
Squamous cancer of the bladder epithelium (starts as metaplasia)
Name the dx: Verrucae or condylomata; Can be on the shaft of the penis; Epidermal hyperkeratosis, paraketasosis, acanthosis, papillomatosis
HPV (genital warts); Can cause penile cancer
Name the dx: Dysuria, urgency, urethral discharge; Suppurative urethritis; Acute onset, related to sexual intercourse
Gonorrhea (neisseria gonorrhoeae)
Name the dx: The orifice of the prepuce cannot allow retraction over the glans penis, and can strangulate the glans and impede the outflow of venous blood
Phimosis Complication when blood flow is obstructed is paraphimosis
Name the dx: Soft, shiny, erythematous plaques on the glans and foreskin
Erythroplasia of Querat A carcinoma in situ of the penis
Name the dx: Lesions on the penis - shiny, soft, erythematous plaques on the glans and foreskin; Neoplastic epitheliam cells connected by intercellular bridges, with invasion to the dermis
Squamous cell carcinoma of the penis
What is the complication of BPH untreated?
Hydroureter and hydronephrosis Can lead to renal failure
Name the dx: Pain in the scrotum; Small, tender nodule attached to the testis; Caused by infection (chlamydia in young men, E. Coli in old);
Epididymitis
Name the dx: Virilization of external genitalia; Still 46, XX; Often associated with CAH (21-hydroxylase deficiency); Adrenal hyperplasia; Ambiguous genitalia seen at birth
Female pseudohermaphroditism
Name the dx: Born 46, XY; External genital organs appear female or with signs of virilization
Testicular feminization syndrome aka male pseudohermaphroditism
What is the most common testicular tumor in children?
Mature teratoma
Microscopic examination of a yolk sac tumor would reveal:
Interlacing strands of epithelial cells surrounded by loose connective stroma; Glomeruloid structures called “Schiller Duval” bodies; These tumors are malignant; treat with orchiectomy; First 4 years of life; Tumors produce alpha-fetoprotein
Name the dx: Most common testicular cancer (germ cell tumor); Men 30-40; Additional fragment of chromosome 12 seen; Solid, rubbery, firm mass
Seminoma Neoplastic cells are arranged as nests that are separated by fibrous septae and infiltrated with chronic inflammatory cells (lymphocytes, plasma cells, macrophages) treat with radiation
Tumors composed exclusively of malignant chorionic epithelium are termed:
Choriocarcinomas - a kind of testicular cancer - a “nonseminomatous germ cell tumor” trophoblastic cells give rise to multinucleatied giant cells –> hemorrhage hCG levels high
Name the dx: Congenital abnormality in which one or both testes are not found in their normal position in the scrotum; Most common urologic condition in infants; Increased incidence of infertility AND germ cell neoplasia (ie seminoma)
Cryptorchidism (undescended testicle) Fix w surgery
Name the dx: Congenital absence of testes.
Anorchia
Name the dx: Finding in adults with fragile X syndrome
Macroorchidism
Malignant lymphoma of the testes occurs in what population?
> 60 years; usually in the context of systemic disease (not usually primary); poor prognosis
Name the dx: Precocious puberty in a male child (but can occur at any age); If in older age group, can be associated with feminization or gynecomastia Tumor secretes androgens, estrogens, or both
Leydig (interstitial) cell tumor;
T/F: A 46,XX karyotype is found in some patients with classical signs of Klinefelter syndrome.
True
In patients who develop adenocarcinoma of the prostate, what is the precursor?
Prostatic intraepithelial neoplasia
Name the dx: Inflammatory disorder; uncommon; Accumulation of macrophages; Often associated with UTIs caused by E. Coli; Soft yellow plaques on the mucosal surface of the bladder
Malakoplakia
What does malakoplakia show on histology?
Chronic inflammatory cell infiltrate composed mostly of large macrophages with abundant eosinophilic cytoplasm containing PAS-positive granules. Some of these macrophages exhibit laminated basophilic calcopherites called “Michaelis-Gutmann” bodies
Hunner ulcers are seen in what condition?
Chronic interstitial cystitis Hunner ulcer is an intense, acute, inflammatory reaction
Name the diagnosis: Long-standing suprapubic pain; Frequency and urgency; Can be with or withoug hematuria
Chronic interstitial cystitis
Name the dx: Congenital anomaly in which the urethra opens on the underside of the penis so that the meatus is proximal to its normal glandular location
Hypospadias Incomplete closure of the urethral folds of the urogenital sinus
Name the dx: Congenital anomaly in which the urethra opens on the upper side of the penis
Epispadias
Name the dx: A cyst formed by the protrusions of widened efferent ducts of the rete testis or epididymis; Manifests as a hilar paratesticular nodule or as a fluctuating mass with milky fluid containing spermatozoa in various stages of degeneration
Spermatocele
