Towmey Pathology Flashcards

1
Q

What is the normal weight of the prostate gland?

A

20 grams

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2
Q

What are the four anatomic zones of the prostate?

A

Central, peripheral, transitional, periurethral

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3
Q

Where do most cases of BPH arise?

A

Transitional zone

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4
Q

Where do most cases of prostate carcinomas arise?

A

Peripheral zone

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5
Q

How does acute bacterial prostatitis feel on exam? Causative organisms?

A

Extremely tender and boggy; gram neg rods

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6
Q

What is the most common form of prostatitis?

A

Chronic abacterial - unable to identify an organism

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7
Q

What is the cause of benign prostatic hyperplasia?

A

Hormones - dihydrotestosterone

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8
Q

If see trabeculated bladder muscles, what is the most likely cause?

A

BPH, due to increased straining to push urine out

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9
Q

If patient is taking finasteride for 5 years and you measure his PSA, what do you need to do to evaluate the level of the PSA?

A

Multiply by 2.3 (5 alpha reductase inhibitors can lower PSA)

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10
Q

Patient complains of scrotal pain, with discrete point tenderness at superior pole of testis, what is likely causing the pain?

A

Torsion of the appendix testis/epididymis

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11
Q

Testis drain into what lymph nodes?

A

Para-aortic nodes

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12
Q

Where does the prostate lymphatics drain?

A

Internal inguinal nodes

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13
Q

Where does the distal vagina drain?

A

Superficial inguinal nodes

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14
Q

Where does the scrotum drain?

A

Superficial inguinal nodes

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15
Q

Phase I of testicular descent is controlled by what? What is the pathway?

A

Controlled by mullerian-inhibiting substance; transabdominal descent-descend to lower abdomen/pelvic brim

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16
Q

Phase 2 of testicular descent is dependent on what? What is the pathway?

A

Dependent on androgens; inguinoscrotal-descends through the inguinal canal into scrotum

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17
Q

Cryptorchid testis puts patients at increased risk for what?

A

Infertility and germ cell tumors

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18
Q

What histologic changes are seen in cryptorchid testis?

A

Germ cell arrest, basement membrane thickening/hyalinization, decreased germ cells in contralateral testis

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19
Q

What drugs is known to cause male infertility?

A

Diphenylhydantoin, cyclophosphamide, diethylstilbestrol exposure in utero

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20
Q

Epididymo-orchitis under 35 yrs old are mostly due to what?

A

Sexually transmitted bacterial infections

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21
Q

If patient presents with epididymo-orchitis due to bacterial infection and is >35 yrs old, what is the likely cause?

A

Association with recurrent UTIs

22
Q

Caseating granuloma in the testis, is likely an infection with what?

23
Q

What type of neoplasms make up the germ cell tumors?

A

Seminoma, embryonal carcinoma, yolk sac tumor, teratoma, choriocacrinoma

24
Q

What type of neoplasms make up the sex cord stromal tumors?

A

Sertoli cell tumor, leydig cell tumor, granulosa cell tumor

25
What is the most common solid tumor in men 15-34?
Germ cell tumors
26
Germ cell tumors are more popular in what race?
Whites
27
Germ cell tumors usually have what mutation?
i(12p)
28
What is the most common testicular tumor?
Seminoma
29
During what age does the incidence of seminoma peak?
30s
30
What is the gross appearance of seminomas?
Homogenous white; no necrosis or hemorrhage
31
What is seen microscopically in a seminoma?
Very clear cytoplasm with bands through tumor that are filled with lymphocytes
32
During what age does an embryonal carcinoma appear?
20s-30s
33
What is the gross appearance of an embryonal carcinoma?
Pale, gray with regions of hemorrhage and necrosis
34
Microscopically, how do embryonal carcinomas appear?
Glandular/papillary appearance; sheets of undifferentiated cells with nuclear atypia
35
What is the most common testicular tumor in infants? Children under 3?
Yolk sac tumor most common in both age groups; teratoma is next most common
36
What is the gross appearance of a yolk sac tumor?
Yellow, mucinous
37
What is seen microscopically in a yolk sac tumor?
Schiller-duval bodies
38
What is elevated in the serum of a patient with yolk sac tumor?
AFP
39
How does choriocarcinoma spread?
Hematogenous
40
What serum marker is elevated in choricarcinoma?
HCG
41
What is seen microscopically in a choriocarcinoma?
Syncytiotrophoblastic and cytotrophoblastic elements
42
What is seen on gross section of a choriocarcinoma?
Hemorrhagic tissue
43
Testicular tumor with large multinucleated eosinophilic cytoplasm and mononuclear cells with clear cytoplasm. Grossly it appears small, hemorrhagic, and necrotic. Beta hCG is elevated. What is the likely diagnosis?
Choriocarcinoma
44
What testicular tumor can present with symptoms of hyperthyroidism?
Choriocarcinoma
45
In what population is a teratoma never benign?
Adult male
46
What is seen histologically in a teratoma testicular tumor?
>1 germ layers
47
If a seminoma metastasizes, where are you likely to find it?
Para-aortic nodes
48
If a choriocarcinoma metastasizes, where are you most likely to find it?
Lung, brain, liver
49
Elevated AFP is seen in what testicular tumor?
Yolk sac (endodermal sinus) tumor q
50
What testicular tumors have elevated hCG?
Choriocarcinoma; embryonal carcinoma
51
Elderly male with a testicular tumor, what tumor type is high on your differential?
Lymphoma
52
What cancers metastasize to the testis?
Lung and prostate