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37 Cards in this Set
- Front
- Back
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What is hypospadias? What doesn't form properly?
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when urethral folds don't completely fuse and there are openings on the ventral surface
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What is epispadias? Which is more common epi or hypo?
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If the openings are on the dorsal surface. Hypo is more common (1/300 live births)
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What is phimosis?
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When the orifice of the prepuce is too small to permit normal retraction. Tight foreskin.
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What is balanoposthitis? Common agents?
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Inflammation of glans and prepuce. Candida, anaerobes, gardenella, pyogenic bacteria. Often results from poor hygiene in uncircumcised men
STDs- syphillis, gonorrhea, chancroid, genital herpes, lyphopathia venerum (chlamydia buboes), granuloma inguinale |
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Findings in primary, secondary and tertiary syphillis?
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Treponema pallidum- dark field microscopy
Primary- red, nontender, raised lesion with shallow painless ulcer Secondary- widespread petechial rash on palms and soles Tertiary- dorsal column invasion, neurological involvement (Argyll Robertson pupils), changes in facial appearance, Gummas can be seen in a variety of different spots |
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Findings in chancroid?
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Infection caused by hemophilus ducreyi.
Tender erythematous papule, irregular painful ulcer. Not indurated |
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Findings in granuloma inguinale?
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Caused by calymmatobacterium donovani. Raised papule with ulceration and granulation tissue with indurated raised borders. Donovan bodies are seen in macrophages.
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Lyphagranuloma venerum
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Caused by chlamydia trachomatis. Granulomatous and inflammatory response to chlamydial infection. Found in buboes
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Findings in genital herpes
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In males, most are caused by HSV II. Vesicles that quickly become superficial ulcerations.
Microscopically cant distinguish from VZV. Cowdry type A inclusions and multinucleated giant cells |
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Condyloma acuminatum- cause? Transmission? microscopic features?
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Caused by HPV type 6 & 11. Mode of transmission is sexual contact (suspect sexual abuse if seen in child). Koilocytes (large vacuolated cells with raisinoid nuclei)
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What is bowenoid papulosis? What is bowen disease? How are the two related?
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Bowenoid- Small pigmented papules on the penis.
Bowen- squamous cell carcinoma in situ Both are strongly associated with HPV. (Bowen is more likely to develop into cancer) |
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which hpv is most often associated with squamous cell carcinoma?
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HPV 16
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What is cryptorchidism? What is it associated with? How is it treated?
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Failed descent of the testes into the scrotal sac.
May be associated with trisomy 13 (patau), inguinal hernias, infertility and neoplasms. Surgical correction |
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what is testicular torsion? Symptoms? When does irreversible damage occur?
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Twisting of spermatic cord resulting in decreased venous drainage and arterial supply. Seen in adults or in utero
Sudden onset of testicular pain (without inciting injury) After 6 hours. |
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Non-specific epidymitis causes in pediatric patients? sexually active men <35? Men older than 35?
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Peds- GU malformation and gram negative rod infection
<35- chlamydia trachomatis and neisseria gonrrhea >35- E. coli & pseudomonas (urinary tract pathogens) |
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Normal course of an untreated gonorrhea infection?
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Starts in posterior urethra > prostate > seminal vesicles > epididymis
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Who is most often affected by mumps? What is the presentation of the disease?
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School aged kids often present with swollen parotid glands, although orchitis is seen occasionally.
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What is affected first in a syphillis infection? How does it present?
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Testis. Gummas or perivascular cuffing of lymphoplasma cells.
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Two major categories of testicular tumors? Examples of each?
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Germ cells tumors- seminoma, spermatocytic seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma
Non-germ cell tumors- Leydig cell tumor, Sertoli cell tumor |
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Predisposing factors for germ cell tumors?
Specific chromosomal finding? |
Crytorchidism, genetic factors, testicular dysgenesis/feminization
Isochromosome or short arm of chromosome 12 is found in almost all germ cell tumors |
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Most common type of germ cell tumor?
Seen in what patients? What does it look like? Any specific microscopic findings? |
Seminoma.
Rarely kids, peak at age 30 Homogenous grey-white mass with no hemorrhage or necrosis. Micro- fibrous stroma with lymphocytic infiltrate. Large nuclei and prominent nucleoli. Cells are immunoreactive with placental alkaline phosphatase. May see giant cells. |
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Tumor seen in 65 year olds with excellent prognosis. Typically a white gray mass with no hemorrhage. Giant cells, secondary spermatocytic cells and cells with big nuclei and eosinophilic cytoplasm can be seen.
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Spermatocytic seminoma
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Features of an embryonal carcinoma? Staining?
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more aggressive than seminoma. Tumor is poorly demarcated with gray white cut surface. Cells are positive for HCG & some are positive for AFP.
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Yolk sac tumor? Staining?
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Young, yellow tumors. Cells may resemble primitive glomeruli. Schiller duval body- resumble endodermal sinuses.
Globules which react with AFP and alpha 1 antitrypsin |
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Choriocarcinoma. Cell types? Common?
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Very aggressive- cytotrophoblasts and syncytiotrophoblasts. Very rare.
Cytotrophoblasts- polygons with distinct borders and clear cytoplasm Syncytiotrophoblasts- large cells with irregular or lobular hyperchromatic nuclei and abundant eosinophilic vacuolated cytoplasm (immunoreactive to HCG) |
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Terratoma. What is a teratoma with malgnant transformation?
Are teratomas dangerous? |
Neoplasms with cellular components from multiple germ cell layers (neural tissue, brain, muscle, cartilage) Kids & adults.
In TWMT- a foci of tumor forms within 1 of the tissue types in the teratoma (ex- squamous cell carcinoma) In kids, teratomas are benign tumors. In post pubertal males, all teratomas are considered malignant and capable of metastasizing |
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Leydig cell tumor- unique byproducts? Appearance?
Most characteristic micro finding. |
Between 20-60 yr old patients. Capable of elaborating androgens/estrogens. May have testicular swelling but gynecomastia or sexual precocity may be first sx.
Tumors are circumscribed notdules with homogenous golden brown surface. Rod shaped crystalloids of Reinke in 25% of tumor, also see lipofuscin. |
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Sertoli cell tumor- appearance, unique byproducts?
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Firm, small nodules with grey-white-yellow appearance, tall columnar cells. May elaborate androgens (precocity is rare). Most are benign, but some (10%) can metastasize
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Causes of acute prostitis? Sx?
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From UTI bacteria- e. coli, G- rods, enterococci, staphylococci. Fever, chills, dysuria. Prostate is tender and swollen
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Chronic prostitis associations? Treatment?
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May or may not be associated with recurrent UTIs. Poor penetration of Abx into prostate --> difficult to treat
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Granulomatous prostatitis- causes?
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Most commonly related to BCG treatment of superficial bladder cancer. Fungal cause seen in immunocompromised hosts
May also be caused by ruptured prostatic ducts and acini |
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BPH- what causes it? Complications?
Management? |
DHT is the testosterone metabolite that mediates prostate growth
May cause difficulty with urinating, UTI Lifestyle management (limit EtOH, caffeine) Later may treat with alpha blocker, DHT inhibitor and surgical resection of prostate |
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Most common cancer in men? Prevalence in certain races?
What are the precursor lesions? |
Prostatic adenocarcinoma
More common in black people. Prostatic intraepithelial neoplasia (PIN) |
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Where in the prostate are most prostatic adenocarcinomas found? Why is this useful to know?
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They are found in the peripheral zone, posterior location.
This location is palpable on rectal exam. |
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What is the gleason score?
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Combined score which estimates the appearance, stage and prognosis of a mass. Determine the two predominant stages of the tumor an add them together. This is the score.
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What is serum PSA an estimate of?
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Estimates the amount of prostatic epithelium present.
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Lesions of tunica vaginalis often have what type of appearance?
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Inflamm. of serous covering of testes. Predominance of one particular type of fluid (serous, blood, lymph, semen)
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