STDs and Diseases of Penis Flashcards
What is torsion of the testes?
Torsion of the spermatic cord, if complete, produces severe pain and infarction of the testicular germ cells within a few hours
What is the most common etiology of torsion of the testes?
Presents shortly after vigorous physical exercise
What heralds the diagnosis of torsion of the testes?
Abrupt onset of scrotal pain followed by swelling.
What is the histologic effect of torsion of the testes?
Swollen, firm testes show both gross and microscopic features of hemorrhagic infarction
What type of cancer is carcinoma of the penis?
SCC
What are Bowen Disease?
Dysplastic epidermal lesions on the shaft of the penis, sharply demarcated, erythromatous, usually occurring in middle or older-aged men
What are dysplastic lesions of the the glans and prepuce termed?
Erythroplasia of Queyrat
In which men does Erythroplasia of Queyrat occur?
Uncircumcised men and appear as shiny, soft erythromatous plaque on the glans and foreskin
How frequent is carcinoma of the penis is the US?
Rare. Affect 1-2 men per 100,000 (.5% of cancers)
Why do other parts of the world have a higher rate of carcinoma of the penis?
Places where circumcision is not practiced and poor hygiene is present - this cancer is greater than 10% of male cancers
What is the average age of diagnosis of carcinoma of the penis?
60 years of age
What is the usual growth rate and spread of carcinoma of the penis?
Usually slow growing with local metastasis
What is smegma?
Product of penile coronal glands, desquamated cells of keratin debris.
What is a major risk factor of carcinoma of the penis?
Smegma, that accumulates under the prepuce of uncircumcised males, and it is believed to play a role in prolonged contact carcinogen for the mucosal cells of the glans
Which HPV types have been suggested for the pathogenesis of carcinoma of the penis?
HPV types 16 and 18
What does SCC of the penis present as?
An ulcerated and hemorrhagic mass on the glans or prepuce. May be ulcerated or exophytic-fungating grossly
What is the histological microscopic quality of carcinoma of the penis?
Most are well-differentiated, focally keratinizing, SCCs, that may or may not be invasive into the dermis
Where does the carcinoma of the penis spread?
Spreads locally to inguinal and iliac lymph nodes before spreading rarely to distant organs
Where do initial vesicular lesions of Herpes Genitalis appear?
Vagina, cervix, vulva, perineum, and glans and shaft of the penis
Where does the herpes virus travel and become latent?
Travels up the axon and becomes latent in sensory (lumbar or sacral) ganglion cells
T/F Treatment for HSV-2 is the same way as for HSV-1
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What is Peyronie’s Disease?
Malady of unknown etiology characterized by focal, asymmetric, fibrous induration of the shaft of the penis resulting in penile curvature and pain during erection
What is primary syphilis?
Lesion at site of inoculation, the spirochetes multiply and a local, non-tender ulcer called a Chancre usually forms in 2-10 weeks
How does the primary syphilis ulcer heal?
Spontaneously
What happens to primary syphilis after it heals spontaneously?
Spirochetes spread widely in tissues and 1-3 months later, secondary lesions may appear as a maculopapular rash
Where do secondary syphilis lesions occur usually after the primary syphilis heals spontaneously?
Appear on palms and soles, or as moist papules on the skin and mucous membranes
What is secondary syphilis?
Moist lesions on the genitals called condylomata lata.
What may result in secondary syphilis if there is organ involvement?
Meningitis, nephritis, or a hepatitis.
What are organ lesions from secondary syphilis rich in?
Spirochetes and are highly infectious.
What findings are often part of secondary syphilis?
Lymphadenopathy, arthritis and fever.
Will secondary syphilis heal spontaneously?
Yes.
What is tertiary syphilis?
Occurs years after the initial infection and most frequently involves the aorta (80-85%) with aneurysm formation or aortic regurgitation
How does Neurosyphlis occur?
Infection from tertiary syphilis involving the CNS (5-10%), from a chronic meningitis to Tabes Dorsalis
What is Tabes Dorsalis?
From tertiary syphilis, Spirochetal damage to the sensory nerves of the dorsal root resulting in ataxia, loss of pain sensation and absence of deep tendon reflexes
What is General Paresis? Which syphilis type causes it?
Caused by tertiary syphilis. Caused by invasion of the brain by spirochetes and manifested by progressive loss of physical and mental functions with mood alterations, terminating in severe dementia
What are Gumma granulomas?
Occurs with tertiary syphilis, granulomas in the skin, bones, and liver which grossly are gray-white and rubbery that heal by scarring
What is gonorrhea?
Causes the third most common STD (behind venereal warts and Chlamydia)
What species is affected by gonorrhea?
Disease only in humans, usually symptomatic in males but asymptomatic in females
What are additional sources of infection for gonorrhea?
Anorectal area and pharynx
What are the virulence factors of gonorrhea?
Pili (which allows adherence of the organism to host cells, also serves to prevent phagocytosis and IgA protease which hydrolyzes host secretory IgA
What is the pathogenesis of gonorrhea?
Penetrates the mucous membranes of the urethra, causing inflammation (urethritis)
What are the complications of gonorrhea?
Painful urination, purulent urethral discharge, epididymitis, prostatis, and urethral strictures
Can women develop gonorrhea?
Yes, but urethritis is more likely to be asymptomatic with minimal urethral discharge
How is the cervix affected by gonorrhea?
The columnar epithelium is infected becoming reddened and friable, with purulent exudate
What are the symptoms of gonorrhea in women?
Complaint of lower abdominal discomfort, pain with sexual intercourse (dyspareunia), and a purulent vaginal discharge
Can asymptomatic women transmit gonorrhea?
Yes,
What can a gonorrheal infection of the cervix progress to?
PID, endometritis, salpingitis, and oophoritis
What is the other major cause of PID besides gonorrhea?
Chlamydia
What is Trichomonas vaginalis?
A pear-shaped organism with a central nucleus and four anterior flagella. Exists only s a trophozoite with no cyst form
How is Trichomonas vaginalis transmitted?
Sexually and is found in the female vagina and male urethra
What percentage of women in the US harbor the Trichomonas vaginalis organism?
Roughly 25-50% and it is one of the most common infections worldwide.
What are the sequelae of Trichomonas vaginalis?
Water, foul-smelling greenish discharge accompanied by itching and burning.
Are men usually symptomatic if they gave Trichomonas vaginalis?
Usually asymptomatic - about 10% have urethritis
How is diagnosis of Trichomonas vaginalis done?
By wet mount prep of vaginal or prostatic secretions for moving trophozoites
