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19 Cards in this Set

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Hypo/Epispadias
HYPOSPADIAS: opening of urethra on inf surface of penis. due to failure of urethral folds to close.
EPISPADIAS: opening of urethra on sup surface of penis. abnormal positioning of genital tubercle. assoc w bladder exstrophy.
Lymphogranuloma venereum
necrotizing granulomatous inflamm of inguinal lymphatics and lymph nodes.
STD caused by Chlamydia L1-L3 (obligate intracell)
Heals w fibrosis. rectal stricture.
Squamous cell carcinoma of penis
risk: HPV, lack of circumcision.
Precursor lesions:
Bowen disease- penile shaft or scrotum. leukoplakia.
Erythroplasia of Queyrat- glans. erythroplakia.
Bowenoid papulosis- doesnt progress to carcinoma.
Cryptorchidism
failure of testicles to descend into scrotal sac.
most common male repro abnormality.
resolve spontaneously or do orchiopexy before 2 yo.
get testicular atrophy w infertility and seminoma risk.
Orchitis
inflammation of testicle.
Due to...
ChlamydiaD-K, Neisseria (young people. leydig cells spared)
E cola, pseudomonas (older people)
Mumps- risk for infertility.
Autoimmune- granulomas in seminiferous tubules.
Testicular torsion
twisting of spermatic cord. thing walled veins get congested and result in hemorrhagic infarction bc blood goes in but cant get out.
due to failure of testes to attach to processus vaginalis.
testicular pain, absent cermasteric reflex.
Varicocele
dilation of spermatic vein due to impaired drainage.
scortal swelling looks like bag of worms.
Usually left sided bc left testicular vein drains into left renal vein (assoc w left sided RCC).
seen in lots of infertile males.
hydrocele
fluid collection in tunica vaginalis.
associated w incomplete closure of processus vaginalis leading to communication with peritoneal cavity and blockage of lymphatic drainage.
Testicular tumors general
germ cells (risk from cryptorchidism, kleinfelter) or sex cord stroma (sertoli, leydig).
painless testicular mass that cant be transilluminated.
usually not biopsied bc risk of seeding the scrotum.
Seminoma
malignant tumor w large cells w clear cytoplasm and central nuclei (like dysgerminoma of ovary).
form hemogenous mass with no hemorrhage or necrosis. most common teste tumor.
good prognosis. responds to radiotherapy.
embryonal carcinoma
malignant tumor of immature, primitive cells that can produce glands.
forms hemorrhagic mass w necrosis. aggressive, early hematogenous spread. chemo can cause differentiation into another type of germ cell tumor (teratoma).
increased AFP, BhCG.
yolk sac tumor
malignant tumor that resembles yolk sac. most common testicular tumor in children.
Schiller duval bodies- glomerulus like structures.
AFP elevated.
Choriocarcinoma
malignant tumor of syncytiotrophoblasts and cytotrophoblasts w absent villi.
massive METs via blood bc it resembles placenta.
BhCG elevated.
can lead to hyperthyroidism and gynecomastia (alpha subunit of hCG is similar to FSH, LH, TSH)
Teratoma
tumor of mature fetal tissue from 2 or 3 embryonic layers.
malignant in males. benign in females.
inc AFP, bhCG
Leydig and sertoli cell tumors
Leydig: produces androgens; causes precocious puberty in kids or gynecomastia in adults. Reinke crystals.
Sertoli: comprised of tubules. usually silent.
Prostate basic
posterior aspect palpable on DRE.
consists of glands and stroma maintained by androgens.
secretes milky alkaline fluid.
Prostatitis
ACUTE: chlamydia, neisseria (young), ecoli pseudomonas (old). dysuria, fever, chills. prostate is tender and boggy. secretion w WBC.
CHRONIC: dysuria w pelvic or low back pain. secretions w WBC, but negative culture.
Benign prostatic hyperplasia
hyperplasia of glands and stroma. no increased risk for cancer.
DHT acts on androgen receptor of stromal and epithelial cells resulting in hyperplastic nodules.
occurs in central periurethral zone.
impaired bladder emptying get inc risk for infection and hydronephrosis. micro hematuria, bladder diverticula. inc PSA slightly (<10) bc inc glands.
Tx: alpha antags. terazosin for ppl w HTN as well. tamsulosin in normotensive.
5alphareductase inhibitor to block conversion of testosterone to DHT.
Prostate adenocarcinoma
most common cancer in men. Risk from age, race, diet high in saturated fats. usually clinically silent.
In posterior peripheral part of prostate so dont see urinary symptoms.
Start screening at 50yo w DRE and PSA >10 is worrisome.
Decreased free PSA = cancer (cancer makes bound).
Need biopsy to confirm...small invasive glands, prominent nucleoli....Gleason grading based on architecture alone.
spread to lumbar spine and pelvis...osteoblastic mets so low back pain and inc serum alk phos., PSA, PAP.
Tx: prostatectomy for local. hormone supression for advanced (GnRH analogs shut down hypothalamus so no LH FSH so no androgens. Flutamide is comp inhibitor at androgen receptor.