Practice questions answers Male reproductive system I

Practice questions answers
Male reproductive system I
© Jun Wang, MD, PhD

1. E. Screening test for syphilis has been recommended for all sexually active patients with genital ulcers, especially painless hard ulcers. These screening tests including rapid plasma reagin and venereal disease research laboratory (VDRL). Fluorescent treponemal antibody absorption and treponema pallidum hemagglutination assay are confirmation tests, performed after the screening tests are positive. Culture and gram stain for ulcer debris may growth various bacteria, but not treponema pallidum, the microorganism causing syphilis. Human papilloma virus is associated with condyloma and many penile squamous neoplasia, but not syphilis.

2. B. See discussion in question 1.

3. E. Treponema pallidum causes syphilis. Chlamydia trachomatis is the most common sexually transmitted infection, and is associated with various conditions, including lymphogranuloma venereum and pelvic inflammatory disease. Human herpes virus causes herpes. Human papilloma virus is associated with condyloma and many penile squamous neoplasia. Klebsiella granulomatis causes granuloma inguinale.

4. C. Syphilitic chancre is characterized by diffuse plasma cell infiltrate and spirochetes identified by silver stain. Atypical squamous cells with malignant appearance is seen in squamous dysplasia, including penile squamous neoplasia and cervical intraepithelial neoplasia. Diffuse neutrophilic infiltration is seen in many acute inflammations, including herpes. Granulomatous changes may be seen in granuloma inguinale. Irregular nests and cords of markedly atypical squamous cells is characteristic for squamous cell carcinoma, regardless of the location.

5. A. Non-syphilitic ulcer of genital area with positive culture of Gram-negative rod in chains is most compatible with chancroid. Condyloma has papillary growth and koilocytic changes. Granuloma inguinale is caused by Klebsiella granulomatis and characterized by painless nodule and ulcer with Donovan bodies (large intracytoplasmic encapsulated bipolar bodies).  Herpes has multinucleated cells with margining of chromatin and nuclear molding. Lymphogranuloma venereum is caused by chlamydia trachomatis, and characterized by painless papule or ulcer at inoculation site appears and rapidly disappears; followed later by enlarged inguinal lymph nodes with suppurative granulomatous changes, with focal necrosis (stellate abscesses).

6. A. Chancroid is caused by Gram-negative rod haemophilus ducreyi. Human herpes virus causes herpes. Human papilloma virus is associated with condyloma and many penile squamous neoplasia. Klebsiella granulomatis causes granuloma inguinale. Treponema pallidum causes syphilis.

7. C. Clusters of small painful ulcer with multinucleated cells containing molding nuclei and margining chromatin are most likely herpes. Chancroid has painful non-syphilitic ulcer of genital area with positive culture of Gram-negative rod in chains. Granuloma inguinale is caused by Klebsiella granulomatis and characterized by painless nodule and ulcer with Donovan bodies (large intracytoplasmic encapsulated bipolar bodies). Lymphogranuloma venereum is caused by chlamydia trachomatis, and characterized by painless papule or ulcer at inoculation site appears and rapidly disappears; followed later by enlarged inguinal lymph nodes with suppurative granulomatous changes, with focal necrosis (stellate abscesses). Syphilitic chancre is characterized by diffuse plasma cell infiltrate and spirochetes identified by silver stain.

8. B. See discussion of question 6.

9. B. See discussion of question 7.

10. D. See discussion of question 6.

11. C. See discussion of question 7.

12. A. See discussion of question 7.

13. B. Papillary growth with koilocytic changes is characteristic for condyloma. Bowen’s disease is squamous cell carcinoma in situ. It has full thickness squamous dysplasia. Molluscum contagiosum is caused by molluscum contagiosum virus, and is characterized by pruritic red skin nodules. Microscopically it has invagination of epidermis containing eosinophilic viral inclusion. Phimosis is characterized by foreskin fibrosis and non specific inflammation. Squamous cell carcinoma has irregular nests and cords of markedly atypical cells with squamous differentiation, such as intercellular bridges and squamous pearls.

14. C. See discussion of questions 6 and 13.

15. B. Bowen’s disease is squamous cell carcinoma in situ. It has full thickness squamous dysplasia. Balanoposthitis is a nonspecific inflammation of glans and foreskin. Chancroid has painful non-syphilitic ulcer of genital area with positive culture of Gram-negative rod in chains. Condyloma has papillary growth and koilocytic changes. Syphilitic chancre is characterized by diffuse plasma cell infiltrate and spirochetes identified by silver stain.

16. C. See discussion of question 6. Candida is the most common cause of balanoposthitis.

17. E. Irregular nests and cords of markedly atypical squamous cells is characteristic for squamous cell carcinoma, regardless of the location. Bowen’s disease is squamous cell carcinoma in situ. It has full thickness squamous dysplasia but no invasion. Condyloma has papillary growth and koilocytic changes, but not markedly atypia nor invasion. Granuloma inguinale is caused by Klebsiella granulomatis and characterized by painless nodule and ulcer with Donovan bodies. Syphilitic chancre is characterized by diffuse plasma cell infiltrate and spirochetes identified by silver stain.

18. B. HPV associated carcinogenesis involves degradation of p53 and inactivation of Rb1. It usually has overexpression of p16. Over expression of Her2 and PTEN can be seen in certain malignancies, including breast cancer and endometroid adenocarcinoma of endometrium and ovary, but not squamous cell carcinoma.

19. D. Squamous dysplasia involving mid third of the epithelium is PeIN II. This is the same grading system used in cervical intraepithelial neoplasia. Bowen’s disease is squamous cell carcinoma in situ, or equivalent to PeIN III. Condyloma has papillary growth and koilocytic changes, but usually the dysplasia, if present, is limited to lower third, or equivalent to PeIN I. Squamous cell carcinoma has irregular nests and cords of markedly atypical cells with squamous differentiation, such as intercellular bridges and squamous pearls.

20. Bowenoid papulosis is a full thick dysplasia but the severity is less than Bowen’s disease. It is more common in young population, while the later is seen in older population. Condyloma has papillary growth and koilocytic changes, but usually the dysplasia, if present, is limited to lower third. Squamous cell carcinoma has irregular nests and cords of markedly atypical cells with squamous differentiation, such as intercellular bridges and squamous pearls. Verrucous carcinoma is an extremely well differentiated squamous cell carcinoma with pushing border of invasion. It is usually NOT associated with HPV.

21. E. See discussion of question 20.






Back to male reproductive system
Back to contents

Comments

Post a Comment

Popular posts from this blog

Contents

Pathology notes Jun Wang, MD, PhD 1. General information Frequently discussed syndromes Terms of dermatology Terms of hematology 2. Primary immunodeficiency disorders 3. Hemodynamic abnormalities Shock Thrombosis and embolism Bleeding disorders 4.  Benign blood cell disorders Anemia Benign white cell disorders 5. Hematopoietic neoplasms Lymphoid neoplasms Myeloid neoplasms Histiocytic neoplasms: Langerhans cell histiocytosis 6. Cardiovascular system Pulmonary hypertension Cardiovascular system tumors 7. Respiratory tract tumors 8. Gastrointestinal tract Congenital disorders Infectious gastroenteritis Oral cavity Esophagus Stomach Intestinal tumors Salivary glands Exocrine pancreas and gallbladder 9. Urinary system Kidney masses Lower urinary tract 10. Male reproductive system 11. Female genital tract 12. Breast 13. Endocrine organs Pituitary gland Adrenal gland Thyroid gland Parathyroid gland Endocrine pancreas...
Read more

Anemia

Anemia Updated: 07/13/2024 © Jun Wang, MD, PhD   General features Decrease in red cell mass Hemoglobin: Levels of hemoglobin in a specific volume of whole blood Hematocrit: Fraction of whole blood composed of red blood cells Red cell count: Quantity of red cell in a specific volume of whole blood Three major groups based on RBC sizes Microcytic Normocytic Macrocytic Three major causes Blood loss: acute or chronic Increased red cell destruction: hemolysis Reduced production: marrow failure due to genetic abnormality or nutritional deficiency Etiology Genetic abnormality Hemoglobinopathies RBC cytoskeletal abomorlities Enzyme abnormalities Fanconi anemia Nutritional deficiencies: iron, VB12, folate, general malnutrition Physical etiologies: trauma, burns, frostbite, prosthetic valves, etc Chronic diseases: chronic infections, neoplasia, autoimmune disorders, kidney or liver diseases, etc Infectious diseases: hepatitis, sepsis , malaria, e...
Read more

Lymphoid neoplasms

Lymphocytic neoplasms Updated: 05/17/2020 © Jun Wang, MD, PhD Terminology Lymphoma : Proliferations forming discrete tissue masses Leukemia : Widespread involvement of the bone marrow and usually the peripheral blood Any "lymphoma" can present with or evolve to a leukemic picture, and any "leukemia" can occasionally present with a mass lesion Other hematology terms Important risk factors Immunodeficiency (primary or secondary) Autoimmune disorders Viruses (HIV, KSHV/HHV8, HTLV-1) H. pylori infection Radiation Chemotherapy Diagnostic approaches Complete history, especially those with possible epidemic characters, such as Burkitt lymphoma CBC, Bone marrow Morphology/immunohistochemistry Immunofluorescence flow cytometry Cytogenetic studies Molecular studies Commonly used markers All lymphomas: CD45 B-cell neoplasms: CD5, CD10, CD19, CD20, CD79a, CD23, bcl2, bcl6, cyclin D1, light chai...
Read more