Wk3 Male Repro Path

Question 1

Acute bacterial prostatitis usual pathogen:

Answer 1

G - rods (same as UTI’s)

Question 2

PE and Dx for Acute bacterial prostatitis:

Answer 2

PE: tender, boggy on DRE

Dx: UCx

Question 3

Sx for chronic bacterial prostatitis:

Answer 3

low back pain

dysuria

pelvic pain

OR none

**may see recurrent UTI w/ same pathogen

Question 4

Dx for chronic bacterial prostatitis:

Answer 4

prostatic massage fluid with > 5 WBCs per HPF

or

increased UA WBCs post massage

Question 5

Most common form of prostatitis:

Answer 5

abacterial

culture neg

usually sexually active men

(Chlamydia, Mycoplasma, Ureaplasma)

Question 6

PSA in prostatitis:

Answer 6

Can increase

30% decrease

Question 7

Main idea with BPH epidimiologically:

Answer 7

COMMON

Question 8

Two causes of BPH:

Answer 8

1. Androgens: DHT production in prostate stromal cells increases with age –> stim growth
2. Estrogens: estradiol levels increase in men with aging –> increased androgen receptor in prostate

Question 9

Main urinary sx of BPH:

Answer 9

nocturia

Question 10

BPH Tx:

Answer 10

5-a-reductase inhibitors

a1 blockers

Question 11

5-a-reductase inhibitor for BPH:

Answer 11

Finasteride

Question 12

a1 blocker for BPH:

Answer 12

Tamsulosin – (Flomax)

Question 13

Phase 1 of testicular descent contolled by:

Answer 13

mullerian inhibiting substance

Question 14

Phase 2 of testicular descent controlled by:

Answer 14

androgen

Question 15

Clinical importance of detecting cryptorchid testis:

Answer 15

sterility if BL and uncorrected

oncogenic

Question 16

Age for correcting crytorchid testis:

Answer 16

before 2 for fertility

10 for neoplasm

Question 17

Four causes of infertility:

Answer 17

1. atherosclerosis
2. malnutrition
3. irradiation
4. female sex hormones

Question 18

Most common cause of post-testicular infertility:

Answer 18

obstruction

Question 19

Cause of bacterial epididymo-orchitis:

Answer 19

UTIs

Question 20

2 causes of granulomatous epididymo-orchitis:

Answer 20

1. TB

2. autoimmune?

Question 21

Commonest cause of viral epididymo-orchitis:

Answer 21

Mumps

Question 22

Vascular surgical emergency with risk of hemorrhagic infarction of the testes:

Answer 22

Torsion

Question 23

Dilation of veins within pampiniform plexus:

Answer 23

Varicocele

Question 24

More common side of varicocele:

Why?

Answer 24

left

drains through smaller spermatic/renal vein

Question 25

Less agressive germ cell tumor:

Answer 25

seminoma

Question 26

4 more aggressive germ cell tumors:

Answer 26

1. Embryonal carcinoma
2. Yolk sac tumor
3. Teratoma
4. Choriocarcinoma

Question 27

Clinical features of testicular cancer:

Answer 27

painless, progressive enlargment

Question 28

Most likely cause of testicular cancer in older males:

Answer 28

lymphoma

Question 29

50% of all germ cell tumors are:

Answer 29

seminomas

Question 30

Age for peak of seminoma:

Answer 30

30’s

Question 31

2nd most frequent type of pure Germ Cell Tumor:

Answer 31

Embryonal carcinoma

Question 32

Age for emryonal carcinoma:

Answer 32

20-30

Question 33

Most common tumor in children under 3:

Answer 33

Yolk sac

Question 34

Clear cells

Answer 34

Yolk sac

Question 35

Schiller-Duval bodies

Answer 35

Yolk sac

Question 36

aFP (alpha fetoprotein)

Answer 36

Yolk sac

Question 37

Highly malignant testicular tumor:

Answer 37

Choriocarcinoma

Question 38

BHCG

Answer 38

Choricarcinoma

Question 39

Almost universal finding at dx of choriocarcinoma:

Answer 39

distant mets

Question 40

Tumor that arrises from all types of embyologic tissue:

Answer 40

teratoma

Question 41

Never benign in older males:

Answer 41

Teratoma

Question 42

HCG can come from what other than choricarcinoma:

Answer 42

syncitiotrophoblast of seminoma

Question 43

Failure to obliterate inguinal canal:

Answer 43

Hernia/hydrocele