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DIT topics > testicular + penile + prostate pathology > Flashcards

testicular + penile + prostate pathology Flashcards

1
Q

painful upon palpation of epididymis
+/- testicular swelling
IMPROVES with elevation of testicles

A

epididymitis

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2
Q

treatment for male

A 
STD: gonorrhea/chlamydia
ceftriaxone IM (1 dose), doxycycline x 10 days
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3
Q

treatment for male > 35 yo or hx of anal intercourse with epididymitis/prostatitis think of:

A

UTI:enterobacteriaceae (E. coli, klebsiella, serratia, enterobacter, proteus)
fluoroquinolones x 10-14 days (vs prostatis x 1 mo)

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4
Q

acute onset of pain in testes
high-riding teste on affected side
+/- testicular swelling
absent cremasteric reflex (tickle teste and no movement of teste)

A

testicular torsion: twisting of spermatic cord → ischemia/necrosis of testicle
(medical emergency)

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5
Q

diagnosis of testicular torsion requires

A

US - blood flow in testicle

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6
Q

treatment of testicular torsion

A

surgery within 6 hrs to prevent ischemia to testes: bilateral orchiopexy (suture teste to scrotum to prevent happening again)

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7
Q

failure of teste to descend into scrotum is called

A

cryptochordism

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8
Q

complications of cryptochordism

A

↑ temperature (only sertoli cells affected by temp): → impaired spermatogenesis
↑ risk malignant germ cell tumors
prematurity ↑ risk of cryptochoridism

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9
Q

treatment of cryptochordism

A

infant: early orchiopexy to suture testes down into scrotum (↓ cancer risk since can palpate tumors now)
post pubertal tx: orchiopexy or orchiectomy

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10
Q

differential diagnosis for cryptochordism

A

androgen insensitivity: 46 X,Y with testes but no scrotum (female genitalia - in labia majora), treatment is orchiectomy
bilateral undescended: 46 X,Y without testes
CAH: 46 X,X with male external genitalia

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11
Q

testicular mass that doesn’t transluminate think

A

testicular cancer

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12
Q

testicular mass that transluminates think

A

hydrocele

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13
Q

“fried egg” appearance

A

seminoma

also koilocytes in HPV, oligodendroglioma

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14
Q

most common testicular cancer

A

seminoma

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15
Q

PAINLESS testicular mass in 15-35yo

malignant, excellent prognosis (late mets)

A

seminoma

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16
Q

schiller-duval bodies (resemble primitive glomeruli, central capillary)

A

yolk sac tumor

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17
Q

most common testicular cancer

A

yolk sac tumor

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18
Q

yellow, mucinous testicular mass
malignant
↑AFP

A

yolk sac tumor

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19
Q

malignant

↑ HCG due to synctiotrophoblasts present (also has cytotrophoblasts)

A

choriocarcinoma

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20
Q

hemorrhagic stroke can be the presentation for this testicular cancer

A

choriocarcinoma

hematogenous mets to lungs + brain (bleed into mets in brain)

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21
Q

↑HCG and may have ↑AFP
malignant tumor in adult males (not malignant in females)
hair, teeth - multiple tissue types

A

teratoma

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22
Q

PAINFUL testicular mass
malignant
↑ HCG with normal AFP
bad prognosis

A

embryonal carcinoma

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23
Q

glandular/papillary morphology of testicular cancer

A

embryonal carcinoma

24
Q

reinke crystals (rod-shaped, crystal like)

A

leydig cell

25
Q

secrete testosterone→ peripheral conversion to estrogen → gynecomastia if adult (esp if obese) or precocious puberty in boy (due to ↑ exposure to T)

A

leydig cell

26
Q

most common non-germ cell tumor

A

leydig cell

27
Q

most common type of testicular tumor

A

germ cell tumor

28
Q

germ cell tumor types (malignant)

A 
seminoma
yolk sac
choriocarcinoma
teratoma
embryonal carcinoma
29
Q

non-germ cell tumor (benign)

A

leydig cell
sertoli cell
testicular lymphoma

30
Q

secrete estrogen → gynecomastia

associated with: Peutz-Jeghers syndrome, Carney syndrome

A

sertoli cell

31
Q

testicular cancer in older man

A

testicular lymphoma:
lymphoma mets to testes
aggressive

32
Q

dilated epididymal duct

A

spermatocele

33
Q

incomplete fusion of processus vaginalis

A

hydrocele in infant

resolves on own

34
Q

treatment of prostatitis

A

treat like UTI: give 4 wks
fluoroquinolones
levofloxacin
TMP-SMX

35
Q

what can cause sexual dysfunction

A

drugs: antihypertensives, neuroleptics, SSRI (↓ libido), ethanol
disease: depression, diabetes, small vessel atherosclerosis
physiological: performance anxiety
hormones: low T, hyperprolactinemia

36
Q

types of erectile dysfunction

A

can have any combo (no morning erections):
failure to initiate (psychogenic, endocrinologic, neuro)
failure to fill (atherosclerosis)
failure to store adequate blood volume in lacunar network
80% older men with ED have: diabetes (35-75% DM men), atherosclerosis, drug-related

37
Q

types of bowen disease

A

bowen disease
erythroplasia of queyrat
bowenoid papulosis

38
Q

gray, solitary,crusty plaque on PENILE SHAFT or SCROTUM (or female genitalia)
usually >50 yo

A

bowen disease

39
Q

red, velvety plaque involving GLANS PENIS usually

A

erythroplasia of queyrat

40
Q

multiple papular lesions (not invasive)

younger patients

A

bowenoid papulosis

41
Q

benign genital warts (STD) caused by HPV types 6 + 11

A

condyloma acuminatum

42
Q

male with dysuria, increase in frequency/urgency, and low back pain think

A

prostatitis

43
Q

common cause of prostatitis by age

A

35 yo: UTI (E. coli, klebsiella, serratia, enterobacter, proteus)
chronic: can be bacterial or abacterial (chronic is hard to treat)

44
Q

hyperplasia of prostate gland due to DHT
smooth, firm nodular enlargement of periurthetral (middle + lateral lobes) which compresses the urethra into a vertical slit
↑PSA (but not premalignant)
clinical diagnosis: ↑ frequency (2-3 times), difficulty starting or stropping a stream, dsyuria, sensation of incomplete voiding, weak stream
size of lesion does not correlate with degree of obstruction or symptom severity

A

benign prostatic hyperplasia

45
Q

rectal exam will not highlight this pathology

A

BPH: occurs in middle + lateral lobes of prostate

46
Q

rectal exam will highlight this pathology

A

prostatic adenocarcinoma: occurs in posterior lobe

47
Q

treatment for BPH

A

α1 blocker (doxazosin, prazosin, terazosin)
α1ad blocker (tamulosin)
5αreductase (finasteride)

48
Q

inflammation of glans penis
40% due to candida albicans
other causes: local trauma, STDs, virus
more common in diabetic or non-circumscribed

A

balanitis

49
Q

associated with HPV and lack of circumcision
most common in Asia, Africa, South America
bowen disease can be a premalignant lesion of this

A

penile squamous cell carcinoma

50
Q

painful sustained erection not associated with sexual stimulation or desire
associated with sickle cell disease or spinal cord injuries
can get ischemia + blood clots in penis

A

priapism

51
Q

angulation of penis due to inflammatin + fibrous tissue formation in tunica albuginea
painful with erection

A

Peyronie disease

52
Q 
> 50 yo male
same symptoms as BPH
screening tool: ↑ PSA (high false positive)
diagnosis: needle core bx
prostate exam: asymemtric, hard nodule
A

prostatic adenocarcinoma

53
Q

treatment for prostatic adenocarcinoma

A

flutamide: inhibit testosterone at the receptor level

54
Q

osteoblastic bone lesions
low back pain
↑ alk phos

A

metastatic prostate cancer

55
Q

complications of BPH

A

UTI

bladder distention

DIT topics (115 decks)

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