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(Duluth) HRM Final Review > Towmey Pathology > Flashcards

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?

A

MTb

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
Q

What is the most common solid tumor in men 15-34?

A

Germ cell tumors

26
Q

Germ cell tumors are more popular in what race?

A

Whites

27
Q

Germ cell tumors usually have what mutation?

A

i(12p)

28
Q

What is the most common testicular tumor?

A

Seminoma

29
Q

During what age does the incidence of seminoma peak?

A

30s

30
Q

What is the gross appearance of seminomas?

A

Homogenous white; no necrosis or hemorrhage

31
Q

What is seen microscopically in a seminoma?

A

Very clear cytoplasm with bands through tumor that are filled with lymphocytes

32
Q

During what age does an embryonal carcinoma appear?

A

20s-30s

33
Q

What is the gross appearance of an embryonal carcinoma?

A

Pale, gray with regions of hemorrhage and necrosis

34
Q

Microscopically, how do embryonal carcinomas appear?

A

Glandular/papillary appearance; sheets of undifferentiated cells with nuclear atypia

35
Q

What is the most common testicular tumor in infants? Children under 3?

A

Yolk sac tumor most common in both age groups; teratoma is next most common

36
Q

What is the gross appearance of a yolk sac tumor?

A

Yellow, mucinous

37
Q

What is seen microscopically in a yolk sac tumor?

A

Schiller-duval bodies

38
Q

What is elevated in the serum of a patient with yolk sac tumor?

A

AFP

39
Q

How does choriocarcinoma spread?

A

Hematogenous

40
Q

What serum marker is elevated in choricarcinoma?

A

HCG

41
Q

What is seen microscopically in a choriocarcinoma?

A

Syncytiotrophoblastic and cytotrophoblastic elements

42
Q

What is seen on gross section of a choriocarcinoma?

A

Hemorrhagic tissue

43
Q

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?

A

Choriocarcinoma

44
Q

What testicular tumor can present with symptoms of hyperthyroidism?

A

Choriocarcinoma

45
Q

In what population is a teratoma never benign?

A

Adult male

46
Q

What is seen histologically in a teratoma testicular tumor?

A

> 1 germ layers

47
Q

If a seminoma metastasizes, where are you likely to find it?

A

Para-aortic nodes

48
Q

If a choriocarcinoma metastasizes, where are you most likely to find it?

A

Lung, brain, liver

49
Q

Elevated AFP is seen in what testicular tumor?

A

Yolk sac (endodermal sinus) tumor q

50
Q

What testicular tumors have elevated hCG?

A

Choriocarcinoma; embryonal carcinoma

51
Q

Elderly male with a testicular tumor, what tumor type is high on your differential?

A

Lymphoma

52
Q

What cancers metastasize to the testis?

A

Lung and prostate

(Duluth) HRM Final Review (22 decks)

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