Male reproductive

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What is Klinefelter syndrome?

A condition in which a male has an extra X chromosome: characteristic features include small testicles, infertility, gynecomastia, long legs, and abnormally low intelligence

What is term used for calcifications commonly seen in the central zone

Corpora amylacea

Blood is supplied directly to the epididymis through which artery

Cremasteric

Gonadoblastoma occurs majority with

Cryptorchidism and hypospadia

Which RARE congenital malformation is frequently seen with renal agenesis or dysplasia

Cystic dysplasia

Lyedig cell tumor

Foun in younger boys and produce increased levels of testosterone

Granulosa cell tumor

Found in younger boys and are associated with chromosomal abnormalities

Sertoli cell tumor

Found in younger boys and produce estrogens that results in Gynecomastia

Microlithiasis is seen with

Germ cell tumors, Cryptorchidism, trisomy 21, klinefelter syndrom, previous radio therapy

What is used to score prostate cancer

Gleason score 1-10 with 10 as the most aggressive

Choriocarcinoma can cause

Gynecomastia due to high level of beta hCG

USA of prostatitis

Heterogenous peripheral gland, hypoechoic halo at teh periurethra area, abscess formation can occur, marked hypervascularity

What is the most common cause of painless swelling

Hydrocele

Peripheral zone appears______ ______ to adjacent parenchyma

Hyperechoic slightly

USA of epi Dermoid cysts

Hypoechoic mass, thickened or calcified wall , onion appearance, Avascular, the cyst contains keratin

Labs for choriocarcinoma

Increased levels of beta hCG, AFP level usually normal

What is prehn sign

Is used to differentiate epididymo-orchitis from torsion lifting the painful scrotum above the level of the symphysis pubis will relieve pain when infection is the cause for symptoms no redacted in pain with torsion

Normal prostate volume

Less than 30mL

What is the most common bilateral testicular tumor

Lymphoma

What is the most common secondary malignancy of the testes

Lymphoma

4-10ng.ml is suspicious for

Malignancy

TRUS is used to

Measure the prostate volume, guide biopsy and guide therapy

What is the most common non-seminomatous germ cell tumor

Mixed germ cell tumor

USA of EMbryonal cell carcinoma

More heterogenous than seminoma , can have solid and cystic portions along with coarse calcification

Viral orchitis is most commonly caused by

Mumps

Do all prostate cancers cause an elevated PSA level ?

No

Penile cancer is usually identifies

On the glans penis or on the foreskin in uncircumcised men

Lyedig cell tumors b or m?

Over 85 % are benign

What is measured to assess prostate health

PSA

70% of prostate ca originate where

Peripheral zone

What is teh less common sight for BPH

Peripheral zone

Development of scar tissue and fibrous plaque formation that usually involves the tunica albuginea

Peyronie disease

Unwanted, persisten, painful erection that lasts more than 4 hours is termed

Priapism

What are the two types of Varicocele

Primary- often found on teh left and are palpable during a physical exam Secondary- found on the right which is associated with hepatic mass, marked hydro, hepatomegaly or a retroperitoneal neoplasm like a right sided renal mass

Testicular mets most commonly comes from? (2)

Prostate Lung primary

prostatic acid phosphatase is elevated with ?

Prostate cancer

Peyronie disease causes

Restriction and curvature of teh affected side of the penis during erection

Seminoma spread to the

Retroperitoneal lymph nodes first

Acute epididymitis commonly results from

STI in males 14-35 and UTI in men over 35

What presents as recurrent epididymitis

Sarcoidosis

Most common cancer to affect the penis is

Squamous cell carcinoma

The base of the prostate is located

Superior portion of the gland that is situated below the inferior margin of the urinary bladder

Is is used for infertility screening of teh prostate to try to locate prostate anomalies that may contribute to the problem

TRUS

What is the 2nd most common testicular tumor in infants and young children

Teratoma ( usually benign but can be malignant )

Leydig cell tumros produce

Testosterone and sometimes estrogen can cause endocrine imbalance with estrogen and testosterone leading to precocious puberty, impotence, and gynecomastia

Contraindications for prostate biopsy

UTI

Symptoms of BPH

Urinary frequency, nocturnal, weak urine stream, incomplete emptying

Most common testicular tumor in patients less that 2 yo

Yolk sac tumor

Labs of embryonal cell carcinoma

AFP and beta hCG

Seminomatous tumor afp and bhCG levels

AFP levels normal, cause cause elevated bhCG

Tubular ectasia is usually

Bilateral and seen with a spermatocele

What therapy is used in non-aggressive in situ cancers

Brachytherapy

The penis is covered with a dense fibrous tissue termed

Buck fascia

Normal levels of PSA range from

0-4 ng/ml

Age for choriocarcinoma

20-30

Age for seminomatous tumor

30-50 yr

Extra-capsular carcinoma locations

70% peripheral 20% transitional 10% central

INR levels for biopsy should be

<1.5 to prevent increased risk of hemorrhage from teh biopsy

What level of PSA is usually related to malignant

>10 ng/ml

What cells produce PSA

Acinar cells

What is the most common cause of acute scrotal pain in postpubertal men

Acute epididymitis is

What is the most common benign extratesticular tumor

Adenomatosis tumore

What tumor is associated with Cushing syndrome and adrenal hyperplasia

Adrenal rest

Extra-capsular carcinoma is most common after

Age 65 yrs and in AA men

Hydrocele occurs

Between the two layers of the tunica vaginalis

The majority of blood supplied to the prostate gland is throught the

Capsular artery

What is the rarest type of germ cell tumor

Choriocarcinoma

Which germ cell tumor has the worst prognosis

Choriocarcinoma

Fournier gangrene is usually seen in

Diabetic patients

Labs of yolk sac tumor

Elevated AFP and Beta hCG are usually normal

Teratomas lab

Elevated AFP and beta hCG level with malignancy

What is the most aggressive testicular malignancy

Embryonal cell carcinoma

Postvasectomy changes

Epididymal enlarment , tubular ectasia of the epididymis, spermatocele and cysts, dilated vas deferens

Tubular ecstasia of the rete testis is associated with

Epididymal inflammation or trauma

When the epididymal head measures >17 mm its a sign of

Epididymitis

What else would you evaluate with benign prostatic Hypertrophy

Evaluate the kidney- an enlarged prostate can cause urine retention in teh bladder an associated hydro

What is the most frequently diagnosed malignancy in a male

Extra-capsular carcinoma

Are you able to differentiate the transition and central zones of the prostate via ultrasound?

False

There is no glandular tissue with which region of the prostate?

Fibromuscular region-therefore not affected by cancer, inflammation, or BPH bc it is not functional prostate tissue

What stores sperma no secrete fructose for ejactulation ?

Seminal vesicle

Bacterial orchitis is most commonly caused by ?

Sexually transmitted disease

What is teh Eiffel Tower sign

Shadowing created by dense tissues in the area of the urethra and verumontanum

What are contraindications of TRUS ( Transrectal ultrasound)

Significatn rectal abnormalities that prevent tolerable probe insertion: fissures, neoplasms, hemorrhoids, or prostatitis

Seminal vesicle cyst may be associated with

Sinner syndrome - consists of unilateral renal agenesis, ipsilateral. Seminal vesicle cyst, and ejaculatory duct obstruction patients with sinner syndrome present with perineal pain, recurrent prostatitis, painful ejactualaiton and infertility

The fibromuscular region is made up of

Smooth muscle and fibrous tissues

Seminoma USA

Solid round or oval tumor, uniform low level echoes, WITHOUT calcification , hypoechoic to surrounding tissue , tumors greater thats 1.6cm usually show hypervascularity RARELY become necrotic or cystic

What is the most common scrotal mass

Spermatocele

Seminal vesicles secrete fructose for?

To provide an energy source for sperm and alkalinity to enhance sperm mobility

Seminomas have been associated with

Trisomy 21, Klinefelter syndrome, smoking

Nodule formation within the epididymis is termed

Tuberculosis

95% of BPH's occur where?

transitional zone


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