Repro; Zaman - Male Genital Tract; Kek

Front 1

Name the term used to describe a congenital or acquired condition where the foreskin that is too small to permit retraction behind the glans.

Back 1

phimosis

Front 2

____ is a condition in which the retracted foreskin cannot be reduced. Usually from inflammation of the glans (balanitis), veneral dz, or trauma.

Back 2

paraphimosis

Front 3

____ is a nonspecific infection/inflammation of both the foreskin and the glans of the penis.

Back 3

balanoposthitis - usually associated with phimosis and may be caused by a number of organisms; smegma is usually present

Front 4

____ is a developmental arrest in which the urethral meatus is present on the underside of the penis as a result of imperfect closure of the urethral groove.

Back 4

hypospadias - may be anywhere from the glans to the perineum

Front 5

If the urethral meatus is located on the dorsal side of the penis it is called this.

Back 5

epispadias - much rarer and more severe; associated with other GU anomalies like absence of the prostate and exstrophy of the bladder

Front 6

Name some common STDs in males that cause inflammation.

Back 6

N.gonorrhea, chlamydia, syphilitic chancre, condyloma acuminatum (HPV 6,11), chancroid (H.ducreyi), others

Front 7

This pathology's etiology is unknown and is a disorder of middle aged men where the penis gets plaque-like fibrosis areas that cause scarring and curvature of the penis on erection; it is painful and difficult to have intercourse.

Back 7

Peyronie's Dz

Front 8

This pathology is an inflammatory atrophy of the epithelium most commonly seen on the glans but may extend into the urethra.

Back 8

Lichen sclerosis - also found on female and urethral scarring is a problem

Front 9

name the condition of a prolonged erection and reasons it may exist.

Back 9

priapism - trauma, neuro condition (spinal cord), medical conditions (sickle cell), drugs

Front 10

this premalignant lesion (CIS) is HPV 16 associated and is a precursor for invasive squamous cell carcinoma. It has a red velvety appearance usually on the glans.

Back 10

Erythroplasia of Queyrat - histiologically shows atypical cells with disorderly maturation

Front 11

This HPV 16, premalignant lesion is also a precursor for invasive SCC and has leukoplakia involving the shaft of the penis and scrotum.

Back 11

Bowen's Dz - associations with other visceral cancers

Front 12

Although penile cancer makes up <2% of CA in the US, what is the main risk factor for getting it?

Back 12

Lack of circumcision - most common CA is SCC; usually affects age 40-70 in the glans or coronal sulcus

Front 13

what is the most common symptom in a patient with a urethral stricture?

Back 13

urinary retention; which if left untreated may lead to hydronephrosis and renal failure

Front 14

Name the most common site for chlamydial and gonococcal infections in men and women.

Back 14

urethra - 90% of the non-gonococcal urethritis infections can't be identified (most commonly: chlamydia, mycoplasma, trichomonas, candida and coliform infections

Front 15

Name the common symptoms of urethritis.

Back 15

dysuria, discharge, and urinary frequency (if gonorrhea: purulent discharge)

Front 16

These two non-neoplastic scrotal masses are composed of fluid and enter the sac of the tunica vaginalis.

Back 16

Hydrocele and Hematocele

Front 17

This is a cyst of the epididymis.

Back 17

spermatocele

Front 18

Name the term to describe dilated veins of the pampiniform plexus that is a common cause of infertility.

Back 18

varicocele (bag of worms appearance)

Front 19

Which testicle is more likely involved in a varicocele and why?

Back 19

left side becomes enlarged because the left spermatic vein drains into the left renal vein and is more likely to be flowing against higher pressure vs. the right spermatic vein dumps directly into the IVC

Front 20

what is the most common cause of infertility in young men?

Back 20

infection caused by gonorrhea or chlamydia

Front 21

A patient comes in with orchitis. What is your differential?

Back 21

mumps, syphilis, HIV, extension of acute epidiymitis

Front 22

A patient comes in with epididymitis(scrotal pain with radiation into spermatic cord or flank, tenderness). what is your differential?

Back 22

Look at age: <35: gonorrhea, chlamydia; >35: E.coli, pseudomonas aeruginosa; also: Tuberculosis

Front 23

If a patient has epididymitis, name something that may give him some relief?

Back 23

Prehn's sign (elevate the scrotum - decreases pain)

Front 24

If the sperm break through the blood-testis barrier they get engulfed by macrophages and form these.

Back 24

spermatocytic granulomas - form giant cells

Front 25

This is a painful medical emergency where there is a defect in the anchoring of the testicle.

Back 25

Testicular Torsion

Front 26

what may cause scrotal edema?

Back 26

any systemic edema cause and/or lymphatic obstruction (ie. elephantiasis caused by a parasite)

Front 27

This term describes when testicles or one testicle doesn't descend. Name the most frequent complications.

Back 27

cryptorchidism; complications: Infertility; also is the most common risk factor for developing testicular germ cell cancer; also: torsion and infection

Front 28

name the surgery done to descend the testicle.

Back 28

orchidopexy - doesn't decrease any risks

Front 29

Histologically, describe the effects of cryptorchidism in prepubertal and postpubertal males.

Back 29

prepubertal: sertoli cell nodule called a Pick's adenoma (contains no leydig cells, just tubular cells); postpubertal: testes show fibrosis and tubular sclerosis; overall: progressive loss of germ cell elements with spermatogenesis failure

Front 30

Name some causes of testicular atrophy.

Back 30

atherosclerosis, end stage inflammatory orchitis, cryptorchidism, hypopituitarism, malnutrition, alcoholism, irradiation, administering female hormones, XXY

Front 31

Testicular tumors are the most common malignancy between the ages 15 and 35 and are more common in whites. 95% of the malignant cases are from what cell type?

Back 31

Germ cell - Seminoma

Front 32

If the tumor is benign (5%), what is most commonly its cell type?

Back 32

sex-cord stromal tumors

Front 33

Germ cell neoplasms are bound all along where in the body?

Back 33

mid-line: base of brain (near pituitary), mediatinum, midline of abdomen, gonads, and sacral region

Front 34

How are germ cell tumors classified?

Back 34

according to the normal tissue components they attempt to differentiate towards

Front 35

I'm going to give you the normal tissue and you tell me the germ cell tumor.

Back 35

okay

Front 36

Normal Tissue= trophoblast and germ mixed with other types.

Back 36

Germ cell tumor= choriocarcinoma

Front 37

Normal Tissue= primitive, undifferentiated embryonal cells.

Back 37

Germ cell tumor=non-seminoma embryonal carcinoma

Front 38

Normal Tissue= primitive germinative epithelium.

Back 38

Germ cell tumor=intratubular germ cell neoplasia (ITGCN or IGCNU) and Seminomas

Front 39

Normal Tissue= embyronic endoderm, mesoderm and ectoderm.

Back 39

Germ cell tumor=teratoma (usually malignant in adult men)

Front 40

Normal Tissue= extraembryonic endoderm-mesoderm (yolk sac).

Back 40

Germ cell tumor= yolk sac Endodermal Sinus Tumor

Front 41

name the precursors to invasive germ cell tumors.

Back 41

Intratubular Germ Cell Neoplasia (ITGCN)

Front 42

Name the comporable germ cell seminoma tumor in women.

Back 42

Dysgerminoma

Front 43

Histologically, describe the appearance of ITGCNU.

Back 43

Unclassified Intratubular Germ Cell Neoplasia show abundant clear cytoplasm with atypical pleomorphic nuclei and prominent nucleoli. No spermatogenesis is present

Front 44

Histologically, describe the appearance of a seminoma.

Back 44

slide contains nests of tumor cells with clear cytoplasm, mild nuclear pleomorphism, delicate fibrous trabeculae, and lymphocytic infiltrate with vascular invasion

Front 45

placental alkaline phosphatase reactivity or PLAP is strong in what types of tumors?

Back 45

Seminomas - PLAP is an immunohisto stain

Front 46

What is the significance of using a cytokeratin stain on testicular tissue?

Back 46

AE1/3 is an epithelial cell marker and doesn't normally stain testicular tissue, but it does stain a seminoma - see brown areas

Front 47

this pathology's histo stain contains cells that come in all sizes, small, med. and large. The nuclei show "spireme chromatin."

Back 47

Spermacytic seminoma (better prognosis than seminoma)

Front 48

Spermacytic seminomas are rare and unique. What is unique about the histo staining?

Back 48

none of the immunohistochemical markers used to identify other testicular tumors are positive.

Front 49

Name this germ cell tumor. Gland-like structure formed by cells with markedly pleiomorphic nuclei. Nuclei are crowded, prominent, and more vesicular than seminoma.

Back 49

Embyronal carcinoma

Front 50

This malignant tumor is a mix of predominately seminoma like germ cell and sex-cord stromal tumor and is associated with abnormal sexual development in 80% of cases.

Back 50

Gonadoblastoma - commonly calcifies- hyaline membrane material is also present

Front 51

This germ cell tumor as myxoid and cystic changes and has 12 histologic patterns. contains schiller-duval bodies.

Back 51

yolk sac tumor

Front 52

What is a Schiller-duval body?

Back 52

Found in yolk-sac tumors; central vessels rimmed by loose connective tissue which is lined by malignant epithelium

Front 53

Teratoma is always benign in _____.

Back 53

children; usually benign in women, usually malignant in adult men

Front 54

what proteins do most testicular tumors secrete?

Back 54

AFP and hCG - help measure, diagnose and manage tumor and therapy

Front 55

The germ cell tumor ____ does not occur in children.

Back 55

Choricarcinoma

Front 56

The testicular tumors of stromal origin generally are benign are come to the attention of clinicians because of what?

Back 56

endocrine effects - many secrete estrogens or androgens

Front 57

what is the most common secondary neoplasm of the testes and is the most common testicular tumor in men>60?

Back 57

Malignant Lymphoma

Front 58

this tumor has irregular nests with small nuclei vacuolated cytoplasm appearing like a spider web.

Back 58

adenomatoid tumor

Front 59

this inflammatory pseudotumor may involve the tunica, epidiymis and present with a testicular mass and possibly a hydrocele at any age.

Back 59

nodular fibrous periorchitis

Front 60

This lesion is usually seen post-vasectomy and may resemble adenocarcinoma.

Back 60

Vasitis nodosa

Front 61

this lesion is benign, may be related to ischemia or torsion and presents as swelling in inguinal area and has a nodular/diffusely thickened spermatic cord.

Back 61

Proliferative funiculitis

Front 62

this sarcoma can be anywhere and may arise in tunica, spermatic cord or epididymis and usually arise before age 10.

Back 62

Rhabdomyosarcoma

Front 63

____ is the most common paratesticular sarcoma in adults.

Back 63

liposarcoma