Reproductive Pathology

1. Which structure is likely involved in Peyronie disease and penile fracture mechanisms?

Abnormal dilatation of penile veins>Venous leakage leading to penile curvature.

*Chronic inflammation of TUNICA albuginea>ABNORMAL curvature of penis due to FIBROUS plaque within TUNICA ALBUGINEA.vs*Forced bEnding>rupture of corpora cavErnosa in the case of penile fracture.

Ectopic calcification of penile shaft>Corneal plaques formation within erectile tissue.

Smooth muscle hypertrophy of penis>Congenital abnormal curvature due to penile ossification.

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Peyronie disease is characterized by chronic inflammation of the tunica albuginea leading to abnormal curvature of the penis, while penile fracture involves a rupture of the corpora cavernosa due to forced bending. The incorrect answers do not accurately describe the mechanisms involved in either of these conditions.

Explanation

Peyronie disease is characterized by chronic inflammation of the tunica albuginea leading to abnormal curvature of the penis, while penile fracture involves a rupture of the corpora cavernosa due to forced bending. The incorrect answers do not accurately describe the mechanisms involved in either of these conditions.

2. Patient presents with PAINFUL erection that lasts MORE than 4 hours. BOARD FAV. drug that is tested as a cause of this condition? BOARD FAV Disease that is tested as a cause of this condition?

Sildenafil

Phenylephrine

PAINFUL erection that lasts MORE than 4 hours is giveaway for ISHCHEMIC PRIAPISM, board fav drug tested in this context is TRAZODONE(TCA used for anxiety/depression)but Sildenafil is another frequently tested cause, Sickle cell disease is the board fav disease that causes this condition as Sickled RBCs obstruct small vessels blocking the venous outflow of corpus CAVERNOSUM, thus treatment primarily targets this region and involves corporal aspiration, intracavernosal phenylephrine(a1 agonist)

Viagra

Ischemic priapism is characterized by a prolonged painful erection that lasts more than 4 hours. Trazodone and Sildenafil are commonly tested drugs associated with causing this condition. Sickle cell disease is a common underlying disease predisposing to priapism due to the obstruction of small vessels by sickled RBCs.

Explanation

Ischemic priapism is characterized by a prolonged painful erection that lasts more than 4 hours. Trazodone and Sildenafil are commonly tested drugs associated with causing this condition. Sickle cell disease is a common underlying disease predisposing to priapism due to the obstruction of small vessels by sickled RBCs.

3. What is the most common type of penile cancer in America and which region of America is it most common in?

Melanoma is the most common type of penile cancer and it is most common in CENTRAL America.

Adenocarcinoma is the most common type of penile cancer and it is most common in NORTH America.

*SCC is most common type of penile cancer SOUTH America(like in Brazil).Other important associations include HPV (Double-stranded circular Non-enveloped DNA virus)and being uncircumcised also seems to put you at higher risk of SCC.

Sarcoma is the most common type of penile cancer and it is most common in WEST America.

Penile cancer is relatively rare, with Squamous cell carcinoma (SCC) being the most common type of penile cancer, specifically in SOUTH America like Brazil. Other important associations include HPV infection and being uncircumcised.

Explanation

Penile cancer is relatively rare, with Squamous cell carcinoma (SCC) being the most common type of penile cancer, specifically in SOUTH America like Brazil. Other important associations include HPV infection and being uncircumcised.

4. What type of lesion is depicted in the image that you must DRAW because it is ILLEGAL?

*CARCINOMA in Situ with unclear malignant potential, note the reddish papules characteristic for bowenoid papulosis....

Melanoma in situ with low malignant potential.

Squamous cell carcinoma with high malignant potential.

Benign nevus with no malignant potential.

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5. What is ERYTRHOPLASIA of QUEYRAT usually associated with?

Seborrheic Keratosis

Psoriasis

*ERYTRHOPLASIA of QUEYRAT note that it is SCC of GLANS of penis and presents as ERYTHROPLAKIA(smooth, velvety, granular or nodular lesions often with a well-defined margin that can't be described as any other lesion)...

Genital Warts

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ERYTRHOPLASIA of QUEYRAT is a type of squamous cell carcinoma (SCC) that specifically affects the glans of the penis, presenting as erythroplakia. It is important to differentiate this condition from other benign lesions like Genital Warts, Psoriasis, and Seborrheic Keratosis for appropriate diagnosis and treatment.

Explanation

ERYTRHOPLASIA of QUEYRAT is a type of squamous cell carcinoma (SCC) that specifically affects the glans of the penis, presenting as erythroplakia. It is important to differentiate this condition from other benign lesions like Genital Warts, Psoriasis, and Seborrheic Keratosis for appropriate diagnosis and treatment.

6. How do inhibin B, FSH, LH, and testosterone levels differ in Bilateral vs Unilateral cryptorchidism (Testes in abdomen) and their association with spermatogenesis?

Bilateral cryptorchidism leads to normal testosterone levels and decreased LH levels. Unilateral cryptorchidism leads to increased LH levels and decreased testosterone levels.

FSH levels remain constant in both Bilateral and Unilateral cryptorchidism. Testosterone levels are significantly lower in Unilateral cryptorchidism compared to Bilateral cryptorchidism.

*First of all in both cases FSH goes up because Inhibin B goes down(Because Sertoli cells are affected by increased temperature in the abdomen)...Now testosterone levels are decreased with BIlateral cryptoorchidism while Testosterone levels are usually NORMAL with unilateral cryptoorchidism(because leyding cells secrete Testosterone and they are relatively insensitive to temperature changes)As we remember T serves as negative feedback on LH secretion so if bilateral cryptoorchidism is present low T will lead to High LH vs in unilateral case LH levels are usually normal.*Cryptoorchidism increases risk of testicular GERM cell tumors(can present as testicular mass that doesn't transilluminate)

In both cases, FSH levels decrease due to increased inhibin B levels. Testosterone levels are increased in Bilateral cryptorchidism and decreased in Unilateral cryptorchidism.

In both cases, FSH levels increase due to decreased inhibin B levels. Testosterone levels are decreased in Bilateral cryptorchidism and usually normal in Unilateral cryptorchidism. Testosterone serves as negative feedback on LH secretion.

Explanation

In both cases, FSH levels increase due to decreased inhibin B levels. Testosterone levels are decreased in Bilateral cryptorchidism and usually normal in Unilateral cryptorchidism. Testosterone serves as negative feedback on LH secretion.

7. What is the likely congenital abnormality associated with Testicular torsion?

Abnormal growth of testicular tissue

Insufficient blood supply to the testes

Failure of the cremaster reflex

*The condition described is known as Testicular torsion-abnormal rotation of testicle around spermatic cord and vascular pedicle.*Testicular torsion can be due to congenital failure of testes to attach to INNER lining of the scrotum, basically you have Inadequate fixation of LOWER pole of the testis to TUNICA vaginalis.*They love the fact that Gonadal arteries arise from ABDOMINAL aorta at the L2 level Below renal arteries and this card gives you good idea of how they can test you on this one.You should know everything about this condition because this is EMERGENCY and this condition is common in young people(12-18 year old boys),it is emergency because if there is no correction within 6 hours the tesicle basically dies so you don't want to miss this and leave young boy without testicle, so surgical correction (ORCHIOPEXY-where you attach testes to scrotum properly) should be done within first 6 hours(Untill blockade of venous outflow from the testicle due to compression of the vein results in hemorrhagic infarction of the testes) another important thing is that orchipexy should also be done on the other side too(even if another testicle isn't affected) because those patients are at higher risk of developing torsion on that side as well

Testicular torsion is often caused by inadequate fixation of the lower pole of the testis to the tunica vaginalis, not by insufficient blood supply, abnormal growth of testicular tissue, or failure of the cremaster reflex.

Explanation

Testicular torsion is often caused by inadequate fixation of the lower pole of the testis to the tunica vaginalis, not by insufficient blood supply, abnormal growth of testicular tissue, or failure of the cremaster reflex.

8. What is the most common cause of scrotal enlargement?

*Varicocele is MCC of scrotal enlargement-Dilation of PAMPINIFORM plexus>Bag of worm appearance.*More common on left side(Left gonadal vein drains into left renal vein instead of draining to IVC directly like right gonadal vein would)*INCREASED temperature>Decreased spermatogenesis>INFERTILITY*Use Doppler ultrasound and remember that variocecele does NOT transilluminate(No fluid present,contrast this with hydrocele)*Retroperitoneal high ligation and embolization of vessels can be used for treatment(Embolization has LESS recurrence rate) we do treatment primarily to prevent infertility.

Testicular torsion is MCC of scrotal enlargement

Epididymitis is MCC of scrotal enlargement

Hydrocele is MCC of scrotal enlargement

Varicocele is the most common cause of scrotal enlargement due to the dilation of the pampiniform plexus, leading to a 'bag of worm' appearance in the scrotum. It is more commonly found on the left side and can result in infertility due to increased temperature affecting spermatogenesis. Treatment options include retroperitoneal high ligation and embolization of vessels to prevent infertility.

Explanation

Varicocele is the most common cause of scrotal enlargement due to the dilation of the pampiniform plexus, leading to a 'bag of worm' appearance in the scrotum. It is more commonly found on the left side and can result in infertility due to increased temperature affecting spermatogenesis. Treatment options include retroperitoneal high ligation and embolization of vessels to prevent infertility.

9. What is the origin of Sacrococcygeal teratoma?

Sacrococcygeal teratoma arises from the lungs.

Sacrococcygeal teratoma originates from the liver.

Sacrococcygeal teratoma originates from the kidney.

*Remember sacrococcygeal teratoma is EXTRAgonadal germ cell tumor that grows at the base of the coccyx and develops from primitive streak....contrast this with usual mediastinal/retropertoneal locations of extragonadal germ cell tumors in adults.

Sacrococcygeal teratoma is a unique extragonadal germ cell tumor that specifically grows at the base of the coccyx, developing from the primitive streak, which contrasts with the usual locations of extragonadal germ cell tumors in adults such as mediastinal or retroperitoneal regions.

Explanation

Sacrococcygeal teratoma is a unique extragonadal germ cell tumor that specifically grows at the base of the coccyx, developing from the primitive streak, which contrasts with the usual locations of extragonadal germ cell tumors in adults such as mediastinal or retroperitoneal regions.

10. What is the difference in transillumination between congenital hydrocele caused by failure in complete obliteration of processus vaginalis and acquired hydrocele due to infection with scrotal blood collection?

Both conditions will transilluminate equally due to the fluid accumulation in the scrotum.

Both conditions will not transilluminate due to the presence of blood in the scrotum.

Second one will transilluminate due to the presence of fluid vs first one does not transilluminate due to blood collection.

*First one will TRANSIlluminate due to presence of fluidvssecond one is classic description of hematocele and blood is too dense to transilluminate so it does NOT transilluminate.

11. What is the mechanism behind a PARAtesticular fluctuant nodule and what specific finding would you expect in the accumulated fluid?

*PARAtesticular fluctuant nodule on step1 should make you think of Spermatocele which is result of cyst formation due to dilation of epididymal duct or RETE TESTES....*You expect to find Spermatozoa in accumulated substance.

Hydrocele is caused by fluid accumulation around the testicle.

Varicocele is the result of swollen, twisted veins in the scrotum.

Orchitis is inflammation of one or both testicles.

Spermatocele is a cystic structure resulting from dilation of the epididymal duct or RETE TESTES. Hydrocele is fluid accumulation around the testicle, Varicocele refers to swollen, twisted veins in the scrotum, and Orchitis is inflammation of the testicles.

Explanation

Spermatocele is a cystic structure resulting from dilation of the epididymal duct or RETE TESTES. Hydrocele is fluid accumulation around the testicle, Varicocele refers to swollen, twisted veins in the scrotum, and Orchitis is inflammation of the testicles.

12. A 2 year old boy presents with a solid, firm testicular mass that does NOT transilluminate. Pathology reveals a yellow, mucinous tumor with characteristic Schiller-duval bodies seen on imaging. What is the most likely diagnosis and what is the prognosis?

*First when you see testicular mass in a boy under age of 3(even age 5, genereally in a child)think of ENDODERMAL SINUS(Yolk Sact) tumor, now if you also see AFP you are lucky as it is characteristic findings, but they can be generous and give you complete giveaway which are Schiller-duval bodies(Can be described as GlomeruLOID like structures)..note that This Non-seminoma is overall most common cause of testicular tumor in CHILDREN(overall most common is seminoma).

The most likely diagnosis is a Leydig cell tumor. Leydig cell tumors are mostly seen in adults and rarely occur in children, especially under the age of 3.

The most likely diagnosis is a teratoma. Teratomas are rare in children and typically present with a different histological appearance on pathology.

The most likely diagnosis is a seminoma. Despite the boy's age, seminomas are still more common in children compared to endodermal sinus tumors.

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Endodermal sinus (yolk sac) tumors are the most common testicular tumors in children and are typically associated with elevated AFP levels and the presence of Schiller-duval bodies. These tumors have a variable prognosis depending on the stage at diagnosis.

Explanation

Endodermal sinus (yolk sac) tumors are the most common testicular tumors in children and are typically associated with elevated AFP levels and the presence of Schiller-duval bodies. These tumors have a variable prognosis depending on the stage at diagnosis.

13. Adult male presents with painless enlargement of the testicle...if we assume that he has MC testicular tumor what Histology would we expect? Analog in females? Why this malignant tumor has good prognosis?

Yolk Sac Tumor

Sertoli Cell Tumor

Teratoma

*Overall MCC testicular cancer is Testicular germ cell tumor known as SEMINOMA(important exceptions in children below age of 3 MCC is yolk sac tumor while in those older than 60 years mcc of testicular mass is DIFFUSE large B-cell lymphoma).*Classic histologic findings for seminoma include LARGE cells that grow in lobules and have CLEAR cytoplasm with central nuclei(Fried-egg appearance),someone said that on real deal they also mentioned GRANULOMA which is possible histological feature(along with lymphocytes), so don't get confused*SUPER HY:Gross findings inclue:HOMOGENOUS MASS with NO hemorrhage or necrosis.*Rare cases can produce B-hcg but more specific(Testable) finding is presence of Placental Alkaline phosphatase.*Analog of Seminoma in females is Dysgerminoma.*Seminoma has good prognosis because it responds well to radiotherapy and even though it is malignant it metastasizes LATE int he course of the disease.

Seminoma is the most common testicular germ cell tumor in adult males, with classic histologic findings as described. The analog in females is Dysgerminoma. Seminoma has a good prognosis due to its response to radiotherapy and late metastasis in the disease course.

Explanation

Seminoma is the most common testicular germ cell tumor in adult males, with classic histologic findings as described. The analog in females is Dysgerminoma. Seminoma has a good prognosis due to its response to radiotherapy and late metastasis in the disease course.

14. Tumor that can result in increased AFP and B-hcg levels and is tumor of MATURE fetal tissue is likely to be ____ in males and ____ in females.

Embryonal carcinoma which is malignant in both males and females.

Choriocarcinoma which is malignant in both males and females.

*This germ tumor is TERATOMA which is MALIGNANT in Males and is benign in females .

Fibroma which is benign in both males and females.

Teratoma is a germ cell tumor that can contain cells or tissues from all three germ layers (ectoderm, mesoderm, endoderm). In males, teratoma is typically malignant, while in females it is usually benign. The increased AFP (alpha-fetoprotein) and beta-hcg levels are associated with teratoma due to the presence of mature fetal tissue components.

Explanation

Teratoma is a germ cell tumor that can contain cells or tissues from all three germ layers (ectoderm, mesoderm, endoderm). In males, teratoma is typically malignant, while in females it is usually benign. The increased AFP (alpha-fetoprotein) and beta-hcg levels are associated with teratoma due to the presence of mature fetal tissue components.

15. What are two highly testable facts about the tumor characterized by a hemorrhagic/necrotic painful testicular mass, increased AFP and B-hcg levels, and multiple metastases?

1) It is a tumor of mature cells that do not form glands. 2) Surgery is the most effective treatment for this type of tumor.

1) Elevated AFP levels are a characteristic feature of this tumor. 2) The tumor is typically benign and does not require treatment.

1) This tumor rarely metastasizes. 2) It is most commonly a pure embryonal carcinoma without any mixed components.

*Hemorrhagic/necrotic painful testicular mass is suggestive of nonsmeinoma known as Embryonal carcinoma which tends to metastasize early, 2 highly testable facts about it:1)it is tumor of immature primitive cells but can form GLANDS(Often has glandular/papillary/Alveolar pattern on histology)2)CHEMOTHERAPY can result in DIFFERENTIATION of this tumor of IMMATURE primitive embryo like cells(Embryonal carcinoma can turn into TERATOMA for example)...elevation of both AFP and B-hcg indicated that it is likely mixed tumor not pure embryonal carcinoma(AFP levels would be normal in pure)

The correct answer highlights the unique characteristics of embryonal carcinoma and its response to chemotherapy. The first incorrect answer contradicts the fact that the tumor is composed of immature primitive cells, while the second incorrect answer inaccurately suggests surgery as the main treatment. The third incorrect answer confuses the typical metastatic behavior of the tumor and its mixed components with other types of testicular tumors.

Explanation

The correct answer highlights the unique characteristics of embryonal carcinoma and its response to chemotherapy. The first incorrect answer contradicts the fact that the tumor is composed of immature primitive cells, while the second incorrect answer inaccurately suggests surgery as the main treatment. The third incorrect answer confuses the typical metastatic behavior of the tumor and its mixed components with other types of testicular tumors.

16.

The boy developed precocious puberty due to adrenal hyperplasia

*Those crystals are giveaway for Leydig cell tumor, precocious puberty is possibility because those tumors can secrete androgens, also gynecomastia is possibility(they can also secrete estrogens)grossly these tumors are yellow-brown.

The boy developed precocious puberty due to pituitary adenoma secreting excess gonadotropins

The boy developed precocious puberty due to primary hypothyroidism

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17. Androblastomas of testicles are usually clinically silent and they arise from?

Epithelial cells

Interstitial cells

*SEX CORD STROMA, they are form of testicular NON-germ cell tumor of Sertoli cells.

Germ cell stroma

Androblastomas of testicles are a form of testicular NON-germ cell tumor that arises from SEX CORD STROMA, specifically Sertoli cells. They are usually clinically silent.

Explanation

Androblastomas of testicles are a form of testicular NON-germ cell tumor that arises from SEX CORD STROMA, specifically Sertoli cells. They are usually clinically silent.

18. What is the most common testicular cancer in older males (like over 60)?

Seminoma

Yolk Sac Tumor

Embryonal Carcinoma

*METASTASES of LYMPHOMA...this is usually NON-hodgkin lymphoma known as DIFFUSE LARGE B CELL LYMPHOMA....

Testicular cancer in older males over 60 is most commonly due to metastases of lymphoma, specifically non-Hodgkin lymphoma known as diffuse large B cell lymphoma. Seminoma, embryonal carcinoma, and yolk sac tumor are more common in younger males.

Explanation

Testicular cancer in older males over 60 is most commonly due to metastases of lymphoma, specifically non-Hodgkin lymphoma known as diffuse large B cell lymphoma. Seminoma, embryonal carcinoma, and yolk sac tumor are more common in younger males.

19. In general, are most NON-germ cell tumors benign or malignant?

It depends on the location of the tumor.

Malignant (have poor prognosis).

*Most of them are BENIGN(have good prognosis).

Some are benign while others are malignant.

NON-germ cell tumors refer to a wide range of tumors that can occur in various parts of the body. However, the majority of these tumors are benign, meaning they are not cancerous and have a good prognosis. It is important to differentiate between benign and malignant tumors for appropriate treatment and management.

Explanation

NON-germ cell tumors refer to a wide range of tumors that can occur in various parts of the body. However, the majority of these tumors are benign, meaning they are not cancerous and have a good prognosis. It is important to differentiate between benign and malignant tumors for appropriate treatment and management.

20. BPH Is due to increase in NUMBER vs Mass/Size of the cells? vs Increases in number vs increase in Mass/size of the cells - which one is expected in the bladder of patients with BPH? Other HY things that are must know for BPH?

*Increase in NUMBER of cells - HyperPLASIA vs *Decrease in Size/mass of the same cells

*Increase in Size/mass of the cells - HyperPLASIA vs *Increase in Number of cells - hypertrophy

*Increase in NUMBER of cells-HyperPLASIAvs*Increase in Size/mass of the same cells-hyperTROPHY.it is super HY to know that BPH is due to hyperPLASIA of PERIurethral LATERAL and MIDDLE lobes of the prostate(BOTH stroma and glands)>Compression of urethra>Signs of obstruction as your bladder can't empty properly because urethra is compressed, so your bladder muscle undergoes hyperTROPHY(Increase in SIZE/MASS of cells) as it has to push harder,obstruction of outflow can also lead to HYDROnephrosis of kidneys(Frequently tested complication they love to show dilated calyces and atrophied cortex of kidney and give you BPH as possible cause).*other 2 HY things to know about BPH is that it is NOT Premalignant(even though it can cause increased FREE PSA levels,remember PSA is produced by prostatic glands) and that BPH can cause POST-renal renal failure.this condition is more common in males over 50 years of age.FIRST line treatment: Alpha1 blockers(Nonselective TerAZOSIN is best if patient also has hypertension as you also relax smooth muscle of blood vessels and treat both conditions)while if patient is Normotensive you'd want to use more Selective alpha1 blocker known as TAMSULOSIN(alpha 1 A receptor blocker)to avoid hypotension.*5 alpha reductase inhibitors prevent formation of DHT from testosterone, BPH needs DHT for growth so we reduce its size but this needs MONTHS.*surgical intervention with Transurethral resection of the prostate and ablation are also possible treatments.

*Decrease in NUMBER of cells vs *Increase in Size/mass of the same cells

21. Why is DRE a good screening test for prostate cancer?

Because DRE can detect prostate cancer at a later stage when symptoms are more evident compared to other screening tests.

Because DRE provides immediate results without the need for additional confirmatory tests.

Because DRE is a painless and non-invasive procedure, making it more accessible for regular screenings.

*Because Prostatic adenocarcinoma affects POSTERIOR PERIPHERY of the prostate(region close to rectum), thus urinary obstruction isn't common unless cancer has grown so large that it extended to periurethral zone.

Digital rectal examination (DRE) is a good screening test for prostate cancer because it allows healthcare providers to physically feel the prostate gland and check for any abnormalities, especially in the posterior periphery where prostate cancer commonly starts. This proximity to the rectum makes it easier to detect any early signs of prostate cancer before symptoms may arise, leading to potentially better outcomes with early intervention.

Explanation

Digital rectal examination (DRE) is a good screening test for prostate cancer because it allows healthcare providers to physically feel the prostate gland and check for any abnormalities, especially in the posterior periphery where prostate cancer commonly starts. This proximity to the rectum makes it easier to detect any early signs of prostate cancer before symptoms may arise, leading to potentially better outcomes with early intervention.

22. A patient with FIXED back pain and urinary obstruction symptoms undergoes imaging studies which show OSTEOBLASTIC lesions in the Lumbar vertebra. What is most likely his Free fraction of PSA? What do you need for diagnosis? What are the risk factors?

The Free fraction of PSA would be significantly elevated due to the presence of prostate cancer.

The first screening modality should be a PSA test rather than DRE.

*patient has likely Prostatic adenocarcinoma which metastasized to lumbar vertebra, in prostate cancer TOTAL PSA is increased but fraction of FREE PSA is decreased because prostate cancer secretes Bound form of PSA).*Diet High in SATURATED FAT increases risk of BPH and it is most common in African Americans and is leads common in Asians.*It is MC cancer in Males and is SECOND most common cause of death related to cancer in males(Second after Lung cancer).*For diagnosis you need BIOPSY, PSA levels and DRE(digital rectal exam) are just screening methods(Screening methods should begin in males over 50 years of age),FIRST screening modality is still DRE(Lot of people choose PSA which is WRONG answer).*To confirm diagnosis Prostatic biopsy is MUST(You'd see small neoplastic glands that infiltrate normal prostatic stroma, HY finding is Nuclei with DARK nucleOLI), grading of prostate cancer is done by GLEASON grading system(evaluates ARCHITECTURE not nuclear atypia), you take multiple segments and score them and then you get final score(higher score>WORSE prognosis)

The risk factors include a diet low in SATURATED fat and Asian ethnicity.

23. Male presents with fever and dysuria now presents with LOWER BACK PAIN.DRE reveals WARM,BOGGY prostate..prostatic secretion shows WBC and Culture reveals bacteria...Which agent should you suspect in older vs younger men?

*WARM BOGGY PROSTATE with WBC and Bacteria in prostatic secretions is suggestive of ACUTE prostatitis.*E.coli is OVERALL MCC and you should pick it as answer choice for Older male with acute prostatitis while In younger men you should suspect CHLAMYDIA TRACHOMATIS,N.Gonorrhea.

Bacillus cereus, Chlamydia trachomatis in older men, Mycoplasma genitalium in younger men

Staphylococcus aureus

Escherichia coli (E. coli) in older men, Neisseria gonorrhoeae in younger men

The correct answer is E.coli for older men and Chlamydia trachomatis or Neisseria gonorrhoeae for younger men based on the typical pathogens associated with acute prostatitis in different age groups.

Explanation

The correct answer is E.coli for older men and Chlamydia trachomatis or Neisseria gonorrhoeae for younger men based on the typical pathogens associated with acute prostatitis in different age groups.

24. Chronic pelvic pain syndrome..how might it present on step 1?

Acute pelvic pain syndrome typically presents with severe pain localized to a specific area with positive urine cultures.

Chronic pelvic pain syndrome presents with abdominal bloating as the main symptom, and cultures often show positive results for bacterial infections.

Chronic pelvic pain syndrome is mainly caused by gastrointestinal issues and rarely involves nerve injuries or infections.

*Chronic pelvic pain syndrome is characterized by perineal/lower back pain,dysuria-very characteristically even though WBC are present,cultures are NEGATIVE.it can be caused by NERVE injuries,chemicals and infections.

25. What histological finding is characteristic of eczematous patches on the nipple that do not respond to corticosteroids? What underlying malignancy is likely associated with this finding?

*eczematous patches on nipples that don't go away with corticosteroids should make you think paget disease which is characterized by infiltration of the nipple by LARGE cells with CLEAR cytoplasm, those cells are PAS+ and diastase resistant(INTRAepithelial ADENOcarcinoma cells).*it is usually related to underlying invasive malignancy like DCIS.

Hyperplastic epidermal cells with thickened stratum corneum consistent with psoriasis

Fibrous tissue with lymphocytic infiltrate suggestive of autoimmune breast disease

Atypical melanocytes within the dermis pointing towards melanoma

26. What type of mole has fetal parts?

Benign mole has fetal PARTS.

Complete mole has fetal PARTS.

*PARTIAL mole has fetal PARTS.*partial mole is triploid(69 chromosomes) because it is result of combo of 2 sperms and 1 egg.

Invasive mole has fetal PARTS.

A partial mole is triploid (69 chromosomes) because it is a result of a combination of 2 sperms and 1 egg.

Explanation

A partial mole is triploid (69 chromosomes) because it is a result of a combination of 2 sperms and 1 egg.

27. Why might a patient at 18 weeks of gestation (

*She likely has PRE-eclampsia which is characteristic for MOLAR pregnancy, hydatidiform moles increase risk of CHORIOCARCINOMA(Especially complete mole)

D. The presence of hypertrophic decidual vasculopathy is unrelated to the risk of developing choriocarcinoma.

A. She may have a normal pregnancy without any complications.

C. The patient is likely to develop gestational diabetes rather than choriocarcinoma.

B. The symptoms are indicative of an ectopic pregnancy rather than choriocarcinoma.

The correct answer is based on the association between pregnancy-related conditions like pre-eclampsia and molar pregnancies with the increased risk of choriocarcinoma.

Explanation

The correct answer is based on the association between pregnancy-related conditions like pre-eclampsia and molar pregnancies with the increased risk of choriocarcinoma.