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63 Cards in this Set

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Name the term used to describe a congenital or acquired condition where the foreskin that is too small to permit retraction behind the glans.
phimosis
____ is a condition in which the retracted foreskin cannot be reduced. Usually from inflammation of the glans (balanitis), veneral dz, or trauma.
paraphimosis
____ is a nonspecific infection/inflammation of both the foreskin and the glans of the penis.
balanoposthitis - usually associated with phimosis and may be caused by a number of organisms; smegma is usually present
____ 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.
hypospadias - may be anywhere from the glans to the perineum
If the urethral meatus is located on the dorsal side of the penis it is called this.
epispadias - much rarer and more severe; associated with other GU anomalies like absence of the prostate and exstrophy of the bladder
Name some common STDs in males that cause inflammation.
N.gonorrhea, chlamydia, syphilitic chancre, condyloma acuminatum (HPV 6,11), chancroid (H.ducreyi), others
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.
Peyronie's Dz
This pathology is an inflammatory atrophy of the epithelium most commonly seen on the glans but may extend into the urethra.
Lichen sclerosis - also found on female and urethral scarring is a problem
name the condition of a prolonged erection and reasons it may exist.
priapism - trauma, neuro condition (spinal cord), medical conditions (sickle cell), drugs
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.
Erythroplasia of Queyrat - histiologically shows atypical cells with disorderly maturation
This HPV 16, premalignant lesion is also a precursor for invasive SCC and has leukoplakia involving the shaft of the penis and scrotum.
Bowen's Dz - associations with other visceral cancers
Although penile cancer makes up <2% of CA in the US, what is the main risk factor for getting it?
Lack of circumcision - most common CA is SCC; usually affects age 40-70 in the glans or coronal sulcus
what is the most common symptom in a patient with a urethral stricture?
urinary retention; which if left untreated may lead to hydronephrosis and renal failure
Name the most common site for chlamydial and gonococcal infections in men and women.
urethra - 90% of the non-gonococcal urethritis infections can't be identified (most commonly: chlamydia, mycoplasma, trichomonas, candida and coliform infections
Name the common symptoms of urethritis.
dysuria, discharge, and urinary frequency (if gonorrhea: purulent discharge)
These two non-neoplastic scrotal masses are composed of fluid and enter the sac of the tunica vaginalis.
Hydrocele and Hematocele
This is a cyst of the epididymis.
spermatocele
Name the term to describe dilated veins of the pampiniform plexus that is a common cause of infertility.
varicocele (bag of worms appearance)
Which testicle is more likely involved in a varicocele and why?
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
what is the most common cause of infertility in young men?
infection caused by gonorrhea or chlamydia
A patient comes in with orchitis. What is your differential?
mumps, syphilis, HIV, extension of acute epidiymitis
A patient comes in with epididymitis(scrotal pain with radiation into spermatic cord or flank, tenderness). what is your differential?
Look at age: <35: gonorrhea, chlamydia; >35: E.coli, pseudomonas aeruginosa; also: Tuberculosis
If a patient has epididymitis, name something that may give him some relief?
Prehn's sign (elevate the scrotum - decreases pain)
If the sperm break through the blood-testis barrier they get engulfed by macrophages and form these.
spermatocytic granulomas - form giant cells
This is a painful medical emergency where there is a defect in the anchoring of the testicle.
Testicular Torsion
what may cause scrotal edema?
any systemic edema cause and/or lymphatic obstruction (ie. elephantiasis caused by a parasite)
This term describes when testicles or one testicle doesn't descend. Name the most frequent complications.
cryptorchidism; complications: Infertility; also is the most common risk factor for developing testicular germ cell cancer; also: torsion and infection
name the surgery done to descend the testicle.
orchidopexy - doesn't decrease any risks
Histologically, describe the effects of cryptorchidism in prepubertal and postpubertal males.
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
Name some causes of testicular atrophy.
atherosclerosis, end stage inflammatory orchitis, cryptorchidism, hypopituitarism, malnutrition, alcoholism, irradiation, administering female hormones, XXY
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?
Germ cell - Seminoma
If the tumor is benign (5%), what is most commonly its cell type?
sex-cord stromal tumors
Germ cell neoplasms are bound all along where in the body?
mid-line: base of brain (near pituitary), mediatinum, midline of abdomen, gonads, and sacral region
How are germ cell tumors classified?
according to the normal tissue components they attempt to differentiate towards
I'm going to give you the normal tissue and you tell me the germ cell tumor.
okay
Normal Tissue= trophoblast and germ mixed with other types.
Germ cell tumor= choriocarcinoma
Normal Tissue= primitive, undifferentiated embryonal cells.
Germ cell tumor=non-seminoma embryonal carcinoma
Normal Tissue= primitive germinative epithelium.
Germ cell tumor=intratubular germ cell neoplasia (ITGCN or IGCNU) and Seminomas
Normal Tissue= embyronic endoderm, mesoderm and ectoderm.
Germ cell tumor=teratoma (usually malignant in adult men)
Normal Tissue= extraembryonic endoderm-mesoderm (yolk sac).
Germ cell tumor= yolk sac Endodermal Sinus Tumor
name the precursors to invasive germ cell tumors.
Intratubular Germ Cell Neoplasia (ITGCN)
Name the comporable germ cell seminoma tumor in women.
Dysgerminoma
Histologically, describe the appearance of ITGCNU.
Unclassified Intratubular Germ Cell Neoplasia show abundant clear cytoplasm with atypical pleomorphic nuclei and prominent nucleoli. No spermatogenesis is present
Histologically, describe the appearance of a seminoma.
slide contains nests of tumor cells with clear cytoplasm, mild nuclear pleomorphism, delicate fibrous trabeculae, and lymphocytic infiltrate with vascular invasion
placental alkaline phosphatase reactivity or PLAP is strong in what types of tumors?
Seminomas - PLAP is an immunohisto stain
What is the significance of using a cytokeratin stain on testicular tissue?
AE1/3 is an epithelial cell marker and doesn't normally stain testicular tissue, but it does stain a seminoma - see brown areas
this pathology's histo stain contains cells that come in all sizes, small, med. and large. The nuclei show "spireme chromatin."
Spermacytic seminoma (better prognosis than seminoma)
Spermacytic seminomas are rare and unique. What is unique about the histo staining?
none of the immunohistochemical markers used to identify other testicular tumors are positive.
Name this germ cell tumor. Gland-like structure formed by cells with markedly pleiomorphic nuclei. Nuclei are crowded, prominent, and more vesicular than seminoma.
Embyronal carcinoma
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.
Gonadoblastoma - commonly calcifies- hyaline membrane material is also present
This germ cell tumor as myxoid and cystic changes and has 12 histologic patterns. contains schiller-duval bodies.
yolk sac tumor
What is a Schiller-duval body?
Found in yolk-sac tumors; central vessels rimmed by loose connective tissue which is lined by malignant epithelium
Teratoma is always benign in _____.
children; usually benign in women, usually malignant in adult men
what proteins do most testicular tumors secrete?
AFP and hCG - help measure, diagnose and manage tumor and therapy
The germ cell tumor ____ does not occur in children.
Choricarcinoma
The testicular tumors of stromal origin generally are benign are come to the attention of clinicians because of what?
endocrine effects - many secrete estrogens or androgens
what is the most common secondary neoplasm of the testes and is the most common testicular tumor in men>60?
Malignant Lymphoma
this tumor has irregular nests with small nuclei vacuolated cytoplasm appearing like a spider web.
adenomatoid tumor
this inflammatory pseudotumor may involve the tunica, epidiymis and present with a testicular mass and possibly a hydrocele at any age.
nodular fibrous periorchitis
This lesion is usually seen post-vasectomy and may resemble adenocarcinoma.
Vasitis nodosa
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.
Proliferative funiculitis
this sarcoma can be anywhere and may arise in tunica, spermatic cord or epididymis and usually arise before age 10.
Rhabdomyosarcoma
____ is the most common paratesticular sarcoma in adults.
liposarcoma