Term
|
Definition
hypospadius: urethra too high
epispadius: urethra too low |
|
|
Term
|
Definition
| genital tubrical (forms glans) failure to position |
|
|
Term
|
Definition
| urethra fold (seals penis as grows out) fails to seal |
|
|
Term
| complications of epispadius and hypospaius (2 associated contisions, 1 complication) |
|
Definition
associated with other genital abnormalities: inguinal hernia, undescended testis
may constrict urethral oriface |
|
|
Term
| 3 inflammatory conditions of penis |
|
Definition
inflammations blantitis/blantophosphitis
inflammations phimosis
inflammations paraphimosis |
|
|
Term
| inflammations blantitis/blanoposhitis: location |
|
Definition
blantitis: glans
blanoposthitis: glans and prepuce |
|
|
Term
| inflammations blantitis/blanoposhitis: cause |
|
Definition
| under foreskin smegma (sweat, debris, epithelial cells) build up and allow infection |
|
|
Term
| inflammations blantitis/blanoposhitis: 4 infections |
|
Definition
candidia
anaerobic
garderella
pyogenic bacteria |
|
|
Term
| inflammations blantitis/blanoposhitis: signs 4 |
|
Definition
distal penis red
swollen
tender
purulent discharge |
|
|
Term
| inflammations phimosis: cause |
|
Definition
| secondary to blanophosphitis causes scaring and adhesions of foreskin to glans |
|
|
Term
| inflammations phimosis: signs 3 |
|
Definition
cannot retract foreskin
increased smegma
smegma accumulation increases risk for carcinoma risk |
|
|
Term
| inflammation paraphimosis: cause, complication |
|
Definition
inflammation and swelling causes forcable retraction of foreskin
severe cases have urinary retention |
|
|
Term
| what is the most common proliferation in penile neoplasm |
|
Definition
|
|
Term
| most common age of penile neoplasm |
|
Definition
|
|
Term
| 5 risk factors for penile neoplasm |
|
Definition
phimosis
poor hygiene
HPV 16/18
smoking
lack of circumcusion |
|
|
Term
| 3 carcinoma in situ penile neoplasm |
|
Definition
bowen disease
erythroplasia of queryat
bowenoid papulosis |
|
|
Term
| bowen disease: appearance, location, age, risk |
|
Definition
glossy, solitary, white, plaque
SHAFT of penis
>30yo
1/3 visceral cancer risk |
|
|
Term
| erythroplasia of queryat: origin, appearance, location |
|
Definition
varient of Bowen disease
red plaque
GLANS penis and other mucosa |
|
|
Term
| bowenoid papulosis: cause, location, age, risk, prognosis |
|
Definition
HPV16
penile SHAFT
younger than bowens disease
almost never invasive carcinoma
may spontaneously regress |
|
|
Term
| penile squamous cell carcinoma: high risk population (age, ethnicity, other) |
|
Definition
<1% of all cancer
20% of males in asia, S. america, africa)
40-70yo
rare in uncircumcised males |
|
|
Term
| why is penile squamous cell carcinoma rare in uncircumcised males 2 |
|
Definition
better hygiene
decreased HPV risk |
|
|
Term
| penile squamous cell carcinoma: prognosis, metastasis locations |
|
Definition
slow growing, locally invasive
early metastasis: inguinal and iliac nodes (25% chance 5y survuval)
late metastasis: widespread (uncommon, 66% chance 5y survuval) |
|
|
Term
| penile squamous cell carcinoma: 2 types, prognosis of each |
|
Definition
keratinizing squamous cell carcinoma (normal penile SCC prognosis depending on metastasis timing)
verrucous carcinoma: papillary variant, locally invasive, no metastasis |
|
|
Term
| penile squamous cell caricnoma: clinical signs, color, lesion type, location |
|
Definition
not painful unless ulcerates (means its infiltrating) and develops irregular margins, bleeding, and infection
glans or pupuce
gray, crusted, papular |
|
|
Term
| explain the normal timeline of testis descent |
|
Definition
3mo gestation: abdomen to pelvis
last 2mo gestation: descend through inguinal canal to scrotum (may not be complete at birth) |
|
|
Term
| cause of cryptoorchidism, location |
|
Definition
complete or incomplete failure of testicular descent into scrotal sac
usually right testis
25% bilateral |
|
|
Term
| how is cryptoorchism diagnosed |
|
Definition
| determine testies location AFTER 1YO (wait until descent complete) |
|
|
Term
| complicatins of cryptoorchidism 5 |
|
Definition
testicular atrophy
haylinization by puberty
sterility
focal intratubular germ cell neoplasia (4x risk of cancer) |
|
|
Term
| associated conditions with cryptoorchidism 3 |
|
Definition
normally isolated
hypospadius
prader willi |
|
|
Term
| most common cause of epididmitis/orchitis in kids 2 |
|
Definition
gram negative bacteria
congenital abnormalities |
|
|
Term
| most common cause of epididmitis/orchitis in sexually active men <35yo 2 |
|
Definition
|
|
Term
| most common cause of epididmitis/orchitis in men >35yo 2 |
|
Definition
|
|
Term
| most common pathological cause of epididmitis/orchitis 3 |
|
Definition
cystitis, genitorostatis, urethritis
spread to testis via vasdeferens, spermatic cord, lymphatics |
|
|
Term
| epididmitis/orchitis: clinical signs 5 |
|
Definition
hx urethritis
pyuria
tenderness
swelling
age <35 |
|
|
Term
| epididmitis/orchitis: complications |
|
Definition
| sterility if not resolved in time |
|
|
Term
| gonorrhea: pathway of infections, complications 3 |
|
Definition
| urethra > prostate > seminal vesicles > epididmitis > epididmis abscess > testis > supurrative orchitis |
|
|
Term
| mumps: epidemology, timeline, effects 5 |
|
Definition
20-30% of post-puberty males infected
1 week after parotid swelling
seminiferous epithelium loss
tubular atrophy
necrosis
fibrosis
sterility |
|
|
Term
| TB: infection location 4, 2 complications |
|
Definition
epididmis > prostate, testis, seminal vesicles
caseating granulomas
necrosis |
|
|
Term
| 7 causes of testicular atrophy |
|
Definition
progressive athlerosclerotic narrowing of blood supply with age
end stage inflammatory orchitis
cryptoorchidism
hypopituitarism
malnnutrition/cachexia
irridation
prolonged female sex hormones |
|
|
Term
| testicular torsion: physiology |
|
Definition
| twisting of spermatic cord cuts off VENOUS supply but NOT ARTERY causing HEMORRHAGIC INFARCT |
|
|
Term
| causes of neonatal testicular torsion 2 |
|
Definition
in utero
at birth
NOT ANATOMICAL DEFECT |
|
|
Term
| causes of adult testicular torsion |
|
Definition
bilateral anatomical defect (bell clapper abnormality: testis not connected to inner scrotum)
associated with higher morbitity |
|
|
Term
| testicular torsion: 5 signs |
|
Definition
sudden pain
elevated testicle
absent cremasteric reflex
>20yo
congestion
extravasion of blood |
|
|
Term
| prognosis of testicular torsion |
|
Definition
UROLOGIC EMERGENCY
resolve within 6h |
|
|
Term
| variocele: cause, location, why |
|
Definition
dilation in vein within SPERMATIC CORD due to inadequate valves in vein
if rapidly developing is caused by renal cell carcinoma
usually in left testicle (more vesicles between it and IVC) |
|
|
Term
| variocele: signs, complications |
|
Definition
infertility in affected testicle
tortous mass on scrotal surface |
|
|
Term
| hydrocele: cause in infant |
|
Definition
| incomplete closure of TUNICA VAGINALIS allows connection to peritoneium and allows SEROUS FLUID in enlarging scrotal sac |
|
|
Term
| hydrocele: cause in adult |
|
Definition
| blocked lymph drainage due to idiopathic, infection, tumor, filarias |
|
|
Term
|
Definition
transillumination: serious fluid
none: lymph or blood (hematocele) |
|
|
Term
| what type of cancer is associated with chimney sweeps |
|
Definition
| squamous cell carcinoma of scrotum |
|
|
Term
| what is the cause of most scrotal SCC |
|
Definition
95% come from germ cells and are malignant and agressive
5% from sex cord or stroma and are benign but secrete steroids |
|
|
Term
| how does a testicle SCC normaly feel to the patient |
|
Definition
|
|
Term
| his is a testicle SCC diagnosed |
|
Definition
| it isnt. if there is a mass just remove it. biopsy could seed scrotum |
|
|
Term
| 6 risk factors for scrotal SCC |
|
Definition
cryptoorchidism
family or selx hx
testicular dysgenesis (feminization, klinefelter)
20-54yo
caicasian
NO ASSOCIATION WITH SMOKING, OBESITY, ETC |
|
|
Term
| is a germ cell neoplasm translucent |
|
Definition
|
|
Term
| what are the 7 germ cell neoplasm and the ages their seen in |
|
Definition
seminoma 40-50yo
spermatic seminoma elderly
embryonal carcinoma 20-30yo
yolk sac tumor 3yo
choriocarcinoma 20-30yo
teratoma all ages
mixed germ cell tumor 15-30yo |
|
|
Term
| seminoma: size, texture, edges, necrosis/hemorrhage, cell composition, cell type |
|
Definition
large 10x normal
soft
well demacrated
coagulation necrosis
glycogen rich cells
synctotrophoblast giant cells in 25% |
|
|
Term
| seminoma: diagnostic factors |
|
Definition
| placental alkaline phosphatase |
|
|
Term
| what tumor is identical to ovarian dysgenesis |
|
Definition
|
|
Term
|
Definition
VERY RADIOSENSITIVE
chemosensitive |
|
|
Term
| seminoma: prognosis, metastasis |
|
Definition
excellent prognosis
late metastasis: bular germ cell neoplasia |
|
|
Term
| serpmatocytic carcinoma: size, color, texture, cell composition |
|
Definition
larger than seminoma
pale gray
soft
mucoid cyst |
|
|
Term
| spermatocytic carcinoma: prgonosis, metastasis |
|
Definition
best prognosis
not associated with other neoplasia |
|
|
Term
| embryonal carcinoma: size, edges, hemorrhage/necrosis, cell orientation, cell type, cell composition |
|
Definition
smaller than seminoma
poor demacration
focal hemorrhage and necrosis
pleomorphic sheets and cords
synctal cells (often mixed with other germ cell tumors and glands)
basophilic cytoplasm |
|
|
Term
| embryonal carcinoma: diagnostic markers |
|
Definition
|
|
Term
|
Definition
|
|
Term
| embryonal carcinoma: prognosis, metastasis |
|
Definition
more agressive than seminoma
early metastasis |
|
|
Term
| what is the most common testicular tumor in kids |
|
Definition
|
|
Term
| yolk sac tumor: cell color, composition, edges, cell type, cell orientation |
|
Definition
yellow white
mucinous, mycrocyst, papillae
poorly differntated
cuboidal, columnar, schiller duval bodies, mixed embryonal carcinoma in adults
reticular network |
|
|
Term
| yolk sac tumor: diagnostic fctors |
|
Definition
|
|
Term
| schiller dubal bodies: where are they found, what are they |
|
Definition
in yolk sac tumor
resemble primitive glomeruli |
|
|
Term
| what is the only testicular tumor that does not cause any enlargement |
|
Definition
|
|
Term
| choriocarcinoma: size, hemorrhage/necrosis, cell types, location |
|
Definition
small
hemorrhage and necrosis
eosinophil synctal cells (dark nuclei), crytotrophoblasts, synchiotrophoblasts
cells programmed to find vessels so form around but not in proper villi |
|
|
Term
| choriocarcinoma: diagnostic markers |
|
Definition
|
|
Term
| signs choriocarcinoma, why |
|
Definition
| synctiotrophoblasts make H0hCG which cause hyperthyroid and gynecomastic becase they cause release of FSH/LH/TSH |
|
|
Term
|
Definition
| not radio or chemosensitive |
|
|
Term
| choriocarcinoma: prognosis, why |
|
Definition
rapid hematologic metastasis due to location around blood vessels
poor prognosis due to lack of radio or chemosensitivity |
|
|
Term
|
Definition
| neoplastic germ cells differentiate along somatic cell line |
|
|
Term
| teratoma: size, cell type, cell composition |
|
Definition
large
cartiladenous, mesenchymal (immature and mature)
cyst, solid |
|
|
Term
| associated clinical conditions to teratoma 4 |
|
Definition
| similar structures in thyroid, bronchi, intestine, nervous tissue |
|
|
Term
|
Definition
child and female benign
adult male malignant but local resection curative |
|
|
Term
|
Definition
| local resectiion curative |
|
|
Term
| what is the most common germ cell tumor |
|
Definition
| mixed is 60% of testicle germ cell neoplasms |
|
|
Term
| mixed germ cell tumor: most common composition 3 |
|
Definition
teratoma
embryonal carcinoma
yolk sac tumor |
|
|
Term
| mixed germ cell tumor: prognisus |
|
Definition
| prognsis based on worst prognsis cancer in the mix |
|
|
Term
| 3 sex cord stromal neoplasms, which is not a primary neoplasm, age ranges |
|
Definition
leyig cell tumors 20-60yo
sertoli cell tumors any
testicular lymphoma (not primary) >60yo |
|
|
Term
| normal function of leydig cells |
|
Definition
|
|
Term
| normal function of sertoli cells |
|
Definition
|
|
Term
| sign of leydig cell tumor in adult, why |
|
Definition
gynecomastia
tumor secretes androgens, estrogens, and corticosteroids |
|
|
Term
| sign of leydig cell tumor in kids, why |
|
Definition
| sexual percoity (early puberty due to hormone increase in androgens, estrogens, and corticosteroids) |
|
|
Term
| how can leydig cell tumors be identified |
|
Definition
| reinke crystals inside cells |
|
|
Term
| prognosis leydig cell tumor |
|
Definition
|
|
Term
| cause of sertoli cell tumors |
|
Definition
| masculinization or feminization causes decreased estrogen or andeogens |
|
|
Term
| signs of sertoli cell tumors 2 |
|
Definition
gynecomastia
usually asymptomatic |
|
|
Term
| prognosis of sertoli cell tumors |
|
Definition
|
|
Term
| what is the most common composition of testicular lymphoma |
|
Definition
| diffuse large cell non-hodgkins B cell lymphoma |
|
|
Term
| location of testicular lymphoma |
|
Definition
|
|
Term
| what maintains the function and composition of a normal prostate |
|
Definition
|
|
Term
| location of normal prostate |
|
Definition
anterior to rectum and under bladder
prosthetic urethra runs through it |
|
|
Term
|
Definition
glands
stroma (CT)
alkaline milky liquid added to seminal vesicle |
|
|
Term
| 2 non cancerous conditions of prostate |
|
Definition
prostatitis
nodular hyperplasia (BPH) |
|
|
Term
|
Definition
|
|
Term
| what is the most common cause of cancer in men and second most common cause of death in men |
|
Definition
|
|
Term
|
Definition
acute bactrial
chronic bacterial
chronic non-bacterial/chronic pelvic pain syndrome
asymptomatic inflammatory
granulomatous |
|
|
Term
| acute bacterial prostatitis: cause, 5 symptoms |
|
Definition
UTI microbes
fever, chills, dysuria, sepsis, tender boggy prostate |
|
|
Term
| chronic bacterial prostatitis: cause, 3 signs |
|
Definition
UTI microbes
recurrent UTI, low back pain, dysuria |
|
|
Term
| chronic non-bacterial prostatitis/chronic pelvic pain syndrome: cause |
|
Definition
who knows
prostatitis wo bacteria |
|
|
Term
| asymptomatic inflammatory prostatis: cause, diagnostic sign |
|
Definition
who knows, prostatitis wo bacteria
increased leukocytes in prostatic secretions |
|
|
Term
| granulomatous prostatis: cause |
|
Definition
| usually caused by BCG treating bladder cancer that mimics TB in prostate |
|
|
Term
| granulomatous prostatitis: diagnosis |
|
Definition
| ONLY prostatitis that needs biopsy |
|
|
Term
|
Definition
|
|
Term
|
Definition
| hyperplasia of stroma, epithelial cells, glands due to excess androgens, corpora amylacea secretion |
|
|
Term
|
Definition
large nodules in PERI-URETHRAL (CENTRAL, INNER TRANSITIONAL ZONE AROUND URETHRA) region of prostate
may project into bladder lumen making pedunculated mass |
|
|
Term
|
Definition
POST-VOID DRIBBLING
urethra obstruction
no increased cancer risk |
|
|
Term
| why does BPH cause urethra obstruction |
|
Definition
| may project into bladder lumen and form pedunculated mass causing ball valve urethra obstruction |
|
|
Term
| what are the 5 areas of alteration that cause adenocarcinoma |
|
Definition
androgens
hereditary
enivornment
acquired somatic mutations |
|
|
Term
| how do androgens play a role in adenocarcinoma |
|
Definition
| always develop after puberty, tumors resistant to anti-androgen therapy and have auto-activating androgen receptors |
|
|
Term
| how does hereditary play a role in adenocaricnoma |
|
Definition
increased risk in 1st degree relatives
uncommon in asians
common in AA due to MYC oncogene mutation
common >60yo |
|
|
Term
| what are SOMATIC mutations involved in adenocarcinoma |
|
Definition
mutations in TMPRSS2-RTS and PTEN tumor regulators
(dont forget about MYC oncogene mutation in AA which is NOT somatic) |
|
|
Term
| how does environment play a role in adenocarcinoma |
|
Definition
| diet, location, carcinogens have all shown some association |
|
|
Term
| signs of adenocarcinoma clinical localized disease 3 |
|
Definition
NO URINARY SYMPTOMS (LIKE POST VOID DRIBBLING)
lesion felt on rectal exam
positive PSA test
proliferation of peripherial glands |
|
|
Term
| signs of clinically advanced adenocarcinoma 2 |
|
Definition
back pain
OSTEOBLASTIC BONE DISEASE usually in lumbar (virtually diagnostic) |
|
|
Term
| how is adenocarcinoma diagnosed 4, what is the rating on each |
|
Definition
digital rectal exam: low sensitivity and specificity
transurethral ultrasound: poor specificity and sensitivity
transperitoneal/transrectal biopsy: required for conformation
prostate specific antigen (PSA) |
|
|
Term
|
Definition
2.5 ng/mL normal at 40
3/5 ng/mL normal at 50
4.5 ng/mL normal at 60
6.5 ng/mL normal at 70
>0.75ng/mL above normal is concern |
|
|
Term
| how specific is PSA to prostate cancer |
|
Definition
specific to prostate but not nessesciarly cancer
2/3 with cancer have increase
95% have increase when metastic
increases with nodular hyperplasia, prostatitis, insturmentation, ejaculation |
|
|
Term
| regular screening PSA isnt encouraged, why |
|
Definition
screening does not reduce mortality
it increased due to SE of cancer tx |
|
|
Term
| prognosis of adenocarcinoma: |
|
Definition
microscopic cancer(nodular hyperplasia) often found at biopsy and was asymptomatic
30% of men >50yo
70% of men >70yo will have occult prostate cancer |
|
|
