Chapter 17 – male

Övningen är skapad 2019-12-16 av Deborahshako. Antal frågor: 60.




Välj frågor (60)

Vanligtvis används alla ord som finns i en övning när du förhör dig eller spelar spel. Här kan du välja om du enbart vill öva på ett urval av orden. Denna inställning påverkar både förhöret, spelen, och utskrifterna.

Alla Inga

  • The more common om the two most common malformations, the abnormal opening of the urethra is on the ventral aspect of the penis anywhere along the shaft hypospadias
  • The less common of the two most common malformations; the abnormal urethral orifice is on the dorsal aspect of the penis. epispadias
  • local inflammation of the glans penis. Caused by poor hygiene in uncircumcised men by C. albicans, anaerobic bacteria, Gardnerella & pyogenic bacteria Balanitis
  • local inflammation of theoverlying prepuce. Caused by poor hygiene in uncircumcised men by C. albicans, anaerobic bacteria, Gardnerella & pyogenic bacteria balanoposthitis
  • a sebaceous secretion in the folds of the skin occuring as a consequence of poor local hygiene in uncircumcised males, with accumulations of desquamated epithelial cells, sweat, and debris. smegma
  • a condition in which the prepuce cannot be retracted easily over the glans penis. May occur as a congenital anomaly or b.c.o. scarring of the prepuce secondary to previous episodes of balanoposthitis Phimosis
  • More than 95% of penile neoplasms arise on squamous epithelium
  • In the United States, squamous cell carcinomas of the penis are relatively___ , accounting for about ___ of all cancers in males. uncommon, 0.4%
  • In developing countries, however, penile carcinoma occurs at much higher rates. higher rates.
  • In which people does penile neoplasms usually arise in? In 40 + uncircumcised men living in developing countries
  • What are the risk factors for squamous cell carcinomas of the penis? Poor hygiene (with smegma), smoking, HPV infection (16 & 18)
  • Occurs in older uncircumcised males and appears grossly as a solitary plaque on the shaft of the penis. Histologic examination reveals malignant cells throughout the epidermis with no invasion of the underlying stroma. It gives rise to infiltrating squamous cell carcinoma in approximately 10% of patients. Squamous cell carcinoma in situ of the penis (Bowen disease)
  • Appears as a gray, crusted, papular lesion, most commonly on the glans penis or prepuce. Invasive squamous cell carcinoma
  • Mutation in prostate cancer BRCA1, BRCA2, TP53, CHECK2, PTEN
  • Benign prosthatic hyperplasia occurs in inner, transitional zone of prostate.
  • 40+ with incr. DHT age of those at risk for benign prosthatic hyperplasia
  • Binds to nuclear androgens receptors which regulate the expression of genes that support the growth & survival of prosthatic epithelium & stromal cells Dihydrotestosterone
  • enlarged, typically weighing between 60 and 100 g, and contains many well- circumscribed nodules that bulge from the cut surface. nodules may appear solid or contain cystic spaces. urethra is usually compressed by the hyperplastic nodules, often to a narrow slit. In some cases, hyperplastic glandular and stromal elements lying just under the epithelium of the proximal prostatic urethra may project into the bladder lumen as a pedunculated mass, producing a ball-valve type of urethral obstruction. morphology of Benign prostatic hyperplasia
  • The glandular lumina often contain inspissated, proteinaceous secretory material in BPH corpora amylacea
  • BPH preferentially involves the inner portions of the prostate, the most common manifestations are related to lower urinary tract obstruction often in the form of diffi- culty in starting the stream of urine (hesitancy) and inter- mittent interruption of the urinary stream while voiding
  • Androgens, Heredity, Environment, Acquired somatic mutations, causes of cancer formation in prostate
  • genes involved in prostate cancer RCA1, BRCA2, TP53, CHECK2, PTEN, MYC oncogene, TMPRSS2 gene, TMPRSS2-ETS fusion genes,
  • most lesions are moderately differentiated adenocarcinomas that produce well-defined glands. The glands typically are smaller than benign glands and are lined by a single uniform layer of cuboidal or low colum- nar epithelium, lacking the basal cell layer seen in benign glands. In further contrast with benign glands, malignant glands are crowded together and characteristically lack branching and papillary infolding. The cytoplasm of the tumor cells ranges from pale-clear (as in benign glands) to a distinc- tive amphophilic (dark purple) appearance. Nuclei are enlarged and often contain one or more prominent nucleoli. Morphology of adenocarcinoma of prostate
  • In approximately 80% of cases, prostatic tissue removed for carcinoma also harbors presumptive precursor lesions, referred to as high-grade prostatic intraepithelial neoplasia (HGPIN)
  • Luminal cells of prostate gland secrete this serine protease know as Prostate specific antigen which helps liquify semen after ejaculation and allow sperm to swim freely. This is measured and used in management of prostate cancers..
  • a congenital disor- der, results in hydronephrosis. It usually manifests in infancy or childhood, much more commonly in boys. It is the most frequent cause of hydronephrosis in infants and children Ureteropelvic junction (UPJ) obstruction,
  • an uncommon cause of ureteral narrowing or obstruction characterized by a fibrous prolif- erative inflammatory process encasing the retroperitoneal struc- tures and causing hydronephrosis. The disorder occurs in middle to old age. At least a proportion of these cases are related to the newly described entity in which elevations of serum IgG4 are associated with fibroinflammatory lesions that are rich in IgG4-secreting plasma cells Retroperitoneal fibrosis
  • consists of a pouchlike evagination of the bladder wall diverticulum
  • most commonly occurs in the bladder and results from defects in phagocytic or degradative func- tion of macrophages, such that phagosomes become overloaded with undigested bacterial products. The macrophages have abundant granular cytoplasm filled with phagosomes stuffed with particulate and membra- nous bacterial debris. In addition, laminated mineral- ized concretions resulting from deposition of calcium in enlarged lysosomes, known as Michaelis-Gutmann bodies, typically are present within the macrophages. Malakoplakia
  • an inflammatory condition resulting from irritation to the bladder mucosa in which the uro- thelium is thrown into broad bulbous polypoid projec- tions as a result of marked submucosal edema. Polypoid cystitis may be confused with papillary urothelial carci- noma both clinically and histologically Polypoid cystitis
  • Polypoid cystitis may be confused with papillary urothelial carcinoma both clinically and histologically
  • Various metaplastic lesions may occur in the bladder. Nests of urothelium Brunn nests, cystitis glandularis may grow downward into the lamina propria, and their central epithelial cells may variously differentiate into a cuboidal or columnar epithelium lining _
  • cystic spaces filled with clear fluid lined by flattened urothelium cystitis cystica (male urinary)
  • Bladder cancer (urothelial, sq. cell carcinoma, denocarcinoma) genes TP53, deletion of 9P & 9q, Ras, RB, FGFR3
  • (1) papilloma; (2) papillary urothelial neoplasm of low malignant potential (PUNLMP); (3) low-grade papillary urothelial carcinoma; and (4) high-grade papillary urothelial carcinoma types of noninvasive urothelilal carcinomas
  • Noninvasive papillary tumor & CIS types of urothelial carcinoma
  • Multifocal tumors, 50-70% progress to muscle-invasive cancer, defined by the presence of cytologically malignant cells within a flat urothelium, cells lack cohesive- ness. This leads to the shedding of malignant cells into the urine, where they can be detected by cytology. CIS morphology
  • Bladder tumors most commonly present with painless hematuria
  • a pro- liferative endarteritis with an accompanying inflamma- tory infiltrate rich in plasma cells. Though that the host immune response is responsible for the endothelial cell activation and prolifera- tion that is the hallmark of the endarteritis, which eventually leads to perivascular fibrosis and luminal narrowing Morphology of syphilis
  • Large areas of parenchymal damage in tertiary syphilis result in the formation of a gumma an irregular, firm mass of necrotic tissue surrounded by resilient CT
  • n microscopic examination, the gumma (3 syphilis) contains a central zone of coagulative necrosis surrounded by a mixed inflammatory infiltrate composed of lymphocytes, plasma cells, activated macrophages (epithelioid cells), occasional giant cells, and a peripheral zone of dense fibrous tissue.
  • “hard chancre,”the ulcer reveals the usual lymphocytic and plasmacytic inflammatory infil- trate and proliferative vascular changes Primary Syphilis
  • Soft chancre Haemophilus ducreyi
  • The manifesta- tions of secondary syphilis are varied but typically include a combination of generalized lymph node enlargement & mucocutaneous lesions
  • lesions during the secondary phase of the disease reveals the char- acteristic proliferative endarteritis, accompanied by a lympho- plasmacytic inflammatory infiltrate. Spirochetes are present and often abundant within these mucocutaneous lesions they are therefore contagious.
  • develops in approximately one third of untreated patients, usually after a latent period of 5 years or more.. Complications related to the tertiary syphilis include cardiovascular syphilis, neurosyphilis, and so-called benign ______ which may occur singly or in combination.
  • T. pallidum may be transmitted across the placenta from an infected mother to the fetus at any time during preg- nancy. The likelihood of transmission is greatest during the early (primary and secondary) stages of disease, when spirochetes are most numerous. Because the manifestations of maternal disease may be subtle, routine serologic testing for congenital syphilis is mandatory in all pregnancies
  • stillbirth, infantile _____, and late (tardive) congenital ______ Manifestations of congenital syphilis
  • Among infants who are stillborn, the most common manifestations of congenital syphilis are hepatomegaly, bone abnormalities, pancreatic fibrosis, and pneumonitis
  • congenital syphilis in liveborn infants that is clinically manifest at birth or within the first few months of life. Affected infants present with chronic rhinitis (snuffles) and mucocutaneous lesions similar to those seen in secondary syphilis in adults. Visceral and skeletal changes resembling those seen in stillborn infants also may be present Infantile syphilis
  • cases of untreated congenital syphilis of more than 2 years’ duraion. Classic manifestations include the Hutchinson triad Late, or tardive, congenital syphilis
  • Seen in congenital syphilis (late) and includes – notched central incisors, interstitial keratitis with blind- ness, and deafness from eighth cranial nerve injury Hutchinson triad
  • saber shin deformity caused by chronic inflammation of the periosteum of the tibia, deformed molar teeth “mulberry molars”
  • N. gonorrhoeae provokes an intense, suppurative inflammatory reaction. In males this manifests most often as a purulent urethral discharge, associated with an edematous, congested urethral meatus. Gram-negative diplococci, many within the cytoplasm of neutrophils, are readily identified in Gram stains of the purulent exudate
  • The classic Cowdry type A inclusion appears as a light purple, homogeneous intranu- clear structure surrounded by a clear halo and is seen in Genital Herpes Simplex
  • Microscopic examination of active lesions reveals marked epithelial hyperplasia at the borders of the ulcer, sometimes mimicking carcinoma (pseudoepitheliomatous hyper- plasia). A mixture of neutrophils and mononuclear inflam- matory cells is present at the base of the ulcer and beneath the surrounding epithelium is seen in Chancroid (Soft Chancre)
  • may present as nonspecific urethritis, papular or ulcerative lesions involving the lower genitalia, tender inguinal and/or femoral lymphadenopathy that typically is unilateral, or proctocolitis. The lesions contain a mixed granuloma- tous and neutrophilic inflammatory response; vari- able numbers of chlamydial inclusions may be seen in the cytoplasm of epithelial cells or inflammatory cells with special staining methods Lymphogranuloma Venereum
  • irregularly shaped foci of necrosis and neutrophilic infiltration seen in v stellate abscesses
  • testicular cancer responding best to radiation therapy seminoma
  • most common cause of non – gonococcal urethritis in males? Chlamydia trachomatis

Alla Inga

Utdelad övning

https://glosor.eu/ovning/chapter-17--male.9449933.html

Dela