Urinary Tract & Male Reproductive System

What is the primary function of the urinary tract?

formation and excretion of urine

What comprises the urinary tract?

kidneys, ureters, urinary bladder, urethra

What is the most important developmental disorder of the urinary tract?

autosomal polycistic kidney disease

85% of all cases of autosomal polycystic kidney disease are related to what?

mutation of a gene

What is autosomal polycystic kidney disease?

both kidneys are enlarged and contain numerous cysts; weigh 20x more than the normal weight

What are the cysts in autosomal polycystic kidney disease derived from?

derived from obstructed tubules and contain fluid

What is crescentic glomerulonephritis?

chronic immune-mediated disease which causes severe glomerular inflammation and injury and often leads to irreversible kidney failure

What is the pathogenesis of crescentic glomerulonephtritis?

-fibrinoid necrosis of capillary loops leads to local rupture of basement membranes

-early crescent is formed of macrophages and some proliferated epithelial cells derived from the lining of Bowman's capsule

-later stage crescent consists of fibroblasts

What is the most prevalent metabolic disease affecting the kidneys?

diabetes mellitus

What is diabetic glomerulosclerosis?

changes to glomerular as a result of diabetes mellitus including thickening of basement membrane and increased amount of mesangial matrix

What are the types of urinary stones?

-calcium

-struvite

-uric acid

-cystine

What is the most common type of urinary stones?

calcium stones

What is the least common type of urinary stones?

cystine stones

What are calcium stones?

urinary stones of calcium phosphate or calcium oxalate

What results in the formation of struvite stones?

upper UTI from bacteria

What makes up uric acid urinary stones?

high uric acid; chronic acidic urine

What leads to cystine stones?

inherited defect leads to excretion of the amino acid cystine that can be deposited as stones

What is the clinical presentation of immune-mediated glomerular diseases? (5)

-acute renal failure

-nephritic syndrome

-nephrotic syndrome

-isolated hematuria/proteinuria

-chronic renal failure

What occurs in acute renal failure?

crescentic glomerulonephritis (GN)

What occurs in nephritic syndrome?

-hematuria

-acute GN

What occurs in nephrotic syndrome?

-proteinuria

-membranous neuropathy

-focal segmental glomerulosclerosis

What is Wilms' tumor?

mutation that causes kidney cells to develop into a tumor

What is the only neoplasm of the urinary tract found in children?

Wilms' tumor

Is a Wilms' tumor more often malignant or benign?

more often malignant

What do Wilms' tumors originate from?

epithelial cells of kidney or urothelium (transitional cell lining of pelvis, ureter, urinary bladder, posterior urethra)

What makes up the cells of Wilms' tumors?

-immature cells resembling renal blastema

-sometimes related to deletion or mutation of tumor suppressor gene

What is the prognosis of Wilms' tumors?

good prognosis with surgery and chemotherapy

What is cryptorchidism?

congenital malpositioning of the testes outside of their normal scrotal location

What happens to the inguinal canal normally in fetal development?

inguinal canal is obliterated, thus preventing the testes from retracting into the abdominal cavity and remain permanently fixed in the scrotum

What happens to the inguinal canal in cryptorchidism?

inguinal canal remains open allowing cremasteric muscle to pull the testes back into the inguinal canal or abdominal cavity (called retractile testes)

What population does cryptorhidism affect?

3-4% of newborn male infants

What are common reasons for genital infection in males?

-orchitis (inflammation of testes)

-epididymitis

-prostatitis

-urethritis

-balanitis (inflammation of glans penis)

What are the stages of syphilis?

primary, secondary, and tertiary

What occurs in the primary stage of syphilis?

painless sores (chancre) and inguinal swelling (lymphadenopathy)

What occurs in the secondary stage of syphyils?

systemic symptoms (ex. body rash)

When does the secondary stage of syphilis occur?

2 months to 2 years after primary stage

What occurs in the tertiary stage of syphilis?

CNS damage or cardiovascular lesions

When does the tertiary stage of syphilis occur?

20 years later

Is there a cure for syphilis?

there is a cure for primary and secondary stage but NO CURE for tertiary stage

Where do most tumors of the testis originate from?

germ cell origin

Are tumors of testis usually benign or malignant?

usually malignant

How can tumors of the testis be treated?

surgery and chemotherapy or radiation therapy

Are tumors of the testis common?

no

What is a seminoma?

germ cell tumor of the testis

What are the types of malignant nonseminomatous germ cell tumor (NSGCT)?

-embryonal carcinoma

-teratocarcinoma (all 3 germ layers)

-choriocarcinoma

When does a yok sac tumor of the testis occur?

infancy

What are examples of germ cell tumors of the testis? (5)

-seminoma

-NSGCT

-mixed germ cell tumor

-teratoma

-yolk sac tumor of infancy

Where does benign prostatic hyperplasia originate in the prostate?

central (periurethral) part of the gland and often involves the median lobe

Where does carcinoma of the prostate originate in the prostate?

in the peripheral portion of the gland and often in the posterior lobe

What is the most common cancer of internal organs in males?

prostate cancer

Is there effective treatment for carcinoma of the prostate?

no

What is the cause of prostate carcionma?

unknown; no major risk factors identified

What increases the risk of penile cancer?

HPV

What reduces the risk of penile cancer?

circumcision

What is the systemic disease that is the most common reason for kidney failure or kidney disease?

diabetic glomerulosclerosis

What are factors contributing to formation of urinary calcium stones?

-hyperparathyroidism

-low water intake

-UTI