Step 1 - Repro 3

denniskwinn's version from 2015-04-25 16:17


Question Answer
Prostate pathologyProstatitis - dysuria, frequency, urgency, low back pain, acute: bacterial (eg, E coli). .. Chronic: bacterial or abacterial (most common)
Benign Prostatic Hyperplasia-Common in men > 50 yrs. Hyperplasia of prostate gland
- May be related to age related increase in estradiol.
-Increased frequency of urination, nocturia, difficulty starting and stopping the stream of urine and dysuria.
-Increased PSA
BPH txAlpha 1 antagonists (terazosin, tamsulosin), which cause relaxation of smooth muscle
Prostatic adenocarcinoma-Common in men>50 years of age.
-Arises most often from the posterior lobe (peripheral zone) of the prostate gland and is most frequently diagnosed by digital rectal examination (hard nodule) and prostatic biopsy.
-Prostatic acid phosphatase (PAP) and PSA are useful markers (⇡ total PSA, with ⇣ fraction of free PSA)
- Osteoblastic metastases in bone may develop in late stages as indicated by lower back pain and an increase in serum alkaline phosphatase and PSA
Cryptorchidism-Undescended testis (one or both); lack of spermatogenesis due to ⇡ body temperature; associated with⇡ risk of germ cell tumors. Prematurity ⇡ risk of it

Testicular germ cell

Question Answer
Testicular germ cell tumors-95% of all testicular tumors
- Can present as mixed germ cell tumor
Seminoma-Malignant, painless, homogenous testicular enlargement
-MC testicular tumor, mostly affecting males age 15-35. -Large cells in lobules with watery cytoplasm and "fried egg" appearance.
- Radiosensitive, Late metastais, excellent prognosis
Embryonal carcinoma-Malignant; painful
-Worse prognosis than seminoma.
-Often glandular/papillary morphology.
-Can differentiate to other tumors.
-May be associated with ⇡AFP, hCG
Yolk sac (endodermal sinus) tumor-Yellow, mucinous, analogous to ovarian yolk sac tumor, -Schiller-duval bodies resemble "primitive glomeruli"
- (⇡ AFP)
Choriocarcinoma testicular-Malignant, ⇡ hCG
-Disordered syncytiotrophoblastic and cytotrophoblastic elements
- Hematogenous metastases
Teratoma-Unlike in females, mature version in males is most often malignant

Testicular non-germ cell tumors

Question Answer
Testicular non-germ cell tumors 5% of all testicular tumors - mostly benign
Leydig cell tumors-Contains reinke crystals
-Usually androgen producing
-Gynecomastia in men, precocious puberty in boys
-Golden brown color
Sertoli cell tumorAndroblastoma from sex cord stroma
Testicular lymphomaMC testicular cancer in older men

Tunica vaginalis

Question Answer
Tunica vaginalis lesions-Lesions in serous covering of testis
-Present as testicular masses
Varicocele-Dilated vein in pampiniform plexus
-Can cause infertility
- “Bag of worms
Hydrocele⇡ fluid secondary to incomplete fusion of processus vaginalis
SpermatoceleDilated epididymal duct

Penile pathology

Question Answer
Bowen’s disease-CIS
-Gray, solitary, crusty plaque
-Usually on the shaft of the penis or on the scrotum
-Peak incidence in 5th decade of life
-Progresse to invasive SCC in <10% of cases
Erythroplasia of Queyrat-CIS
-Red velvety plaques, usually involving the glans
-Otherwise similar to Bowen’s disease
- progress to SCC
Bowenoid papulosis-CIS
-Multiple papular lesions
-Affects younger age group than other subtypes
-Usually does not become invasive
Squamous Cell Carcinoma of the penis-More common in Asia, Africa and South America
-Commonly associated w/HPV, lack of circumcision
Peyronie’s diseaseBent penis due to acquired fibrous tissue formation

Control of reproductive hormones

Question Answer
Leuprolide mechanism-GnRH analog w/agonist properties when used in pulsatile fashion
- Antagonist properties when used in a continuous fashion
- Can be used in lieu of GnRH
Leuprolide clinical useInfertility (pulsatile), prostate cancer (continuous -use with flutamide), uterine fibroids
Leuprolide toxicityAntiandrogen, nausea, vomiting
Testosterone (methyltestosterone) mechanismAgonist at androgen receptors
Testosterone (methyltestosterone) clinical use-Treat hypogonadism and promote secondary sex characteristics -Stimulation of anabolism to promote recovery after burn or injury
Treat ER-positive breast cancer (exemestane)
Testosterone (methyltestosterone) toxicity-Causes masculinization in females; reduces intratesticular testosterone in males by inhibiting release of LH (via negative feedback), leading to gonadal atrophy.
-Premature closure of epiphyseal plates (⇡LDL, ⇣HDL)