REPODUCTIVE

Cryptorchidism
Definition - a failure of testicular descent into the scrotum
Etiology: In the vast majority of cases, the cause is unknown
Epidemiology: affects 1% of the male population
Brief Pathophysiology: In addition to infertility, failure of testicular
descent is associated with a 3-to5-fold increased risk for testicular
cancer
Clinical Manifestation: Symptoms include testicle absence from
scrotum or swollen lymph nodes in the groin

Testicular Neoplasms
Definition- Cancer in the male organs that make male hormones and
sperm
Etiology: In post pubertal males, 95% of testicular tumors arise from
germ cells, and almost all are malignant
Epidemiology: occur in roughly 6 per 100,000 males. In the 15-to 34-
year-old age group
Brief Pathophysiology: In prepubertal males, teratomas are benign,
whereas the majority of teratomas in post pubertal males are
malignant, being capable of metastasis regardless of whether they are
composed of mature or immature elements
Clinical Manifestation: Symptoms present most frequently with a
painless testicular mass that is non translucent

Prostatitis
Definition- Swelling of the small walnut-sized gland (prostate) that
produces seminal fluid
Etiology: Caused by a bacterial infection in the prostate
Epidemiology: In the United States, the most common cause of
granulomatous prostatitis is instillation of Bacille Calmette Guérin
Brief Pathophysiology: Prostatitis is divided into three categories: (1)
acute bacterial prostatitis (2%–5% of cases), caused by the same
organisms associated with other acute urinary tract infections; (2)
chronic bacterial prostatitis (2%–5% of cases), also caused by
common uropathogens; and (3) chronic pelvic pain syndrome (90%–
95% of cases)
Clinical Manifestation: Symptoms include sudden onset of fever, chills,
dysuria, perineal pain, and bladder outlet obstruction

Benign Prostatic Hyperplasia

Definition- an extremely common cause of prostatic enlargement
resulting from proliferation of stromal and glandular elements
Etiology: Resulting from proliferation of stromal and glandular
elements
Epidemiology: BPH does not occur in males who are castrated before
the onset of puberty or in males with genetic diseases that block
androgen activity
Brief Pathophysiology: BPH virtually always occurs in the inner
transition zone of the prostate. The affected prostate is enlarged,
typically weighing between 60 and 100 g, and contains many well
circumscribed nodules that bulge from the cut surface, the nodules
may appear solid or contain cystic spaces, the latter corresponding to
dilated glands, the urethra is usually compressed, often to a narrow
slit, by the hyperplastic nodule
Clinical Manifestation: The most common manifestations are related to
lower urinary tract obstruction

Carcinoma of the Prostate

Definition- A cancer in a man's prostate, a small walnut-sized gland
that produces seminal fluid

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Etiology: Clinical and experimental observations suggest that
androgens, heredity, environmental factors, and acquired somatic
mutations have roles in the pathogenesis and progression of prostate
cancer
Epidemiology: Is the most common form of cancer in men
Brief Pathophysiology: Prostate carcinomas range from indolent
lesions that will never cause harm to aggressive fatal tumors
Clinical Manifestation: Symptoms include difficulty with urination, but
sometimes there are no symptoms at all

Malakoplakia
Definition- a rare granulomatous disease of infectious etiology that
involves the skin and other organs
Etiology: results from defects in the phagocytic or degradative function
of macrophages
Epidemiology: an uncommon inflammatory disease
Brief Pathophysiology: As a result of this defect, undigested bacterial
products accumulate within distended phagosomes
Clinical Manifestation: symptoms include fever, back side (flank) or
groin pain, abdominal pain, frequent urination, pus or blood in the
urine, and a burning sensation with urination

Syphilis
Definition- a chronic venereal infection caused by the spirochete
Treponema pallidum
Etiology: Caused by the spirochete Treponema pallidum
Epidemiology: The increase for the most part can be attributed to the
increased incidence in men who have sex with men
Brief Pathophysiology: a chancre, appears at the point of spirochete
entry. Systemic dissemination of organisms occurs during this period,
while the host mounts an immune response. Two types of antibodies
are formed: antibodies that cross-react with host constituents and

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antibodies to specific treponemal antigens, this humoral response,
however, fails to eradicate the organisms
Clinical Manifestation: symptoms you may have can include fever,
swollen lymph glands, sore throat, patchy hair loss, headaches,
weight loss, muscle aches, and fatigue

Gonorrhea
Definition- a sexually transmitted infection caused by Neisseria
gonorrhoeae
Etiology: Caused by Neisseria gonorrhoeae
Epidemiology: is second only to chlamydial infection among reportable
communicable diseases in the United States. With an estimated
350,000 cases reported in 2014
Brief Pathophysiology: transmitted through unprotected
vaginal/oral/anal sex and can also be vertically transmitted from
mother to child
Clinical Manifestation: manifested by the presence of dysuria, urinary
frequency, and a mucopurulent urethral exudate

Lymphogranuloma Venereum
Definition- a chronic, ulcerative disease caused by certain strains of C.
trachomatis that are distinct from those causing the more common
nongonococcal urethritis or cervicitis
Etiology: Caused by certain strains of C. trachomatis
Epidemiology: An increased incidence has been noted in the US in the
past 15 years, due in large part of infections in men having sex with
men, who are often co infected with HIV
Brief Pathophysiology: primary infection appears at the site of
inoculation in the form of a genital ulcer or a mucosal inflammatory
reaction
Clinical Manifestation: may progress to proctocolitis, associated with
pain, constipation, fever, and bleeding, features that mimic
inflammatory bowel disease

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Chancroid (Soft Chancre)
Definition- an acute, ulcerative infection caused by Haemophilus
ducreyi, a small, gram-negative coccobacillus
Etiology: Caused by Haemophilus ducreyi
Epidemiology: The disease is most common in tropical and subtropical
areas and is more prevalent in lower socioeconomic groups,
particularly among men who have regular contact with prostitutes
Brief Pathophysiology: The primary lesion of chancroid appears first
as a papule that rapidly breaks down to produce an ulcer
Clinical Manifestation: In untreated cases, the inflamed and enlarged
nodes may erode the overlying skin to produce chronic, draining
ulcers

Granuloma Inguinale
Definition- a chronic inflammatory disease caused by
Calymmatobacterium granulomatis
Etiology: Caused by Calymmatobacterium granulomatis
Epidemiology: This disease is uncommon in the United States and
Western Europe, but it is endemic in the rural parts of certain tropical
and subtropical regions
Brief Pathophysiology: Untreated cases are characterized by
extensive scarring, often associated with lymphatic obstruction and
lymphedema of the external genitalia
Clinical Manifestation: Disfiguring scars may develop in untreated
cases, sometimes associated with formation of urethral, vulvar, or anal
stricture

Genital Herpes Simplex

Definition- a very common STD, painful, erythematous vesicles on the
mucosa or skin of the lower genitalia and adjacent extragenital sites

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Etiology: most cases of anogenital herpes are caused by HSV-2.
However, recent years have seen a rise in the number of genital
infections caused by HSV-1
Epidemiology: According to CDC, approximately 800,000 people get
new infections every year in the United States. One in six persons
between the ages of 14 and 49 has HSV-2 infection in the US
Brief Pathophysiology: painful, erythematous vesicles on the mucosa
or skin of the lower genitalia and adjacent extragenital sites
Clinical Manifestation: Some symptoms dysuria, urethral discharge,
local lymph node enlargement and tenderness

Human Papillomavirus Infection

Definition- a number of squamous proliferations in the genital tract,
including condyloma acuminatum, as well as several precancerous
lesions that commonly undergo transformation to carcinomas
Etiology: Transmitted sexually
Epidemiology: Genital HPV infection may be transmitted to neonates
during vaginal delivery
Brief Pathophysiology: a number of squamous proliferations in the
genital tract, including condyloma acuminatum, as well as several
precancerous lesions that commonly undergo transformation to
carcinoma
Clinical Manifestation: infection may be asymptomatic or cause
painful, erythematous, intraepithelial vesicles on the mucosa and skin
of external genitalia, along with painful regional lymph node
enlargement

Carcinoma of the Vulva

Definition- A type of cancer that occurs on the outer surface area of
female genitals
Etiology: Can be caused by age or HPV
Epidemiology: represents about 3% of all female genital tract cancers,
occurring mostly in women older than age 60

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Brief Pathophysiology: preceded by a subtle lesion, differentiated
vulvar intraepithelial neoplasia (dVIN), characterized by cytologic
atypia confined to the basal layer and abnormal keratinization
Clinical Manifestation: Symptoms include pain and tenderness,
bleeding that isn't from menstruation, skin changes, such as color
changes or thickening

Extramammary Paget Disease

Definition- an intraepidermal proliferation of epithelial cells that can
occur in the skin of the vulva or nipple of the breast
Etiology: The cause of extramammary Paget disease (EMPD) remains
unknown. Approximately 25% of cases are associated with an
underlying tumor
Epidemiology: unlike in the breast, where Paget disease is virtually
always associated with an underlying carcinoma, only a minority of
cases of vulvar Paget disease have an underlying tumor
Brief Pathophysiology: an intraepidermal proliferation of epithelial cells
Clinical Manifestation: red, scaly plaque caused by proliferation of
epithelial cells within the epidermis

Squamous Intraepithelial Lesion

Definition- abnormal growth of squamous cells on the surface of the
cervix
Etiology: High-risk HPV infection is the most important risk factor for
the development of SIL
Epidemiology: LSIL is 10 times more common than HSIL
Brief Pathophysiology: begins with the precancerous epithelial change
termed SIL, which usually precedes the development of an overt
cancer by many years, sometimes decades
Clinical Manifestation: Abnormal pap smear result

Invasive Carcinoma of the Cervix

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Definition- A malignant tumor of the cervix, the lowermost part of the
uterus
Etiology: Risk factors for progression include cigarette smoking and
human immunodeficiency virus (HIV) infection
Epidemiology: Invasive cervical cancer most often is seen in women
who have never had a Pap smear or who have not been screened for
many years
Brief Pathophysiology: progression of SIL to invasive carcinoma is
variable and unpredictable and requires HPV infection as well as
mutations in tumor suppressor genes and oncogenes
Clinical Manifestation: Symptoms include vaginal bleeding after
intercourse, between periods or after menopause, watery, bloody
vaginal discharge, pelvic pain or pain during intercourse

Breast carcinoma
Definition- A cancer that forms in the cells of the breasts
Etiology: occurs when some breast cells begin to grow abnormally
Epidemiology: most common malignancy of women globally and
causes the majority of cancer deaths in women
Brief Pathophysiology: The three major subtypes of breast cancer
defined by differential expression of hormone receptors and HER2
arise through more-or-less distinct pathways that involve the stepwise
acquisition of driver mutations in the epithelial cells of the duct/lobular
system
Clinical Manifestation: Symptoms include a lump in the breast, bloody
discharge from the nipple, and changes in the shape or texture of the
nipple or breast

Endocrine

Hypopituitarism

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Definition- a rare disorder in which your pituitary gland fails to produce
one or more hormones, or doesn't produce enough hormones
Etiology: is caused by a tumor of the pituitary gland
Epidemiology: It may be congenital (exceedingly rare) or result from a
wide range of acquired intrinsic abnormalities of the pituitary
Brief Pathophysiology: Hypopituitarism accompanied by evidence of
posterior pituitary dysfunction in the form of diabetes insipidus
Clinical Manifestation: The clinical manifestations of anterior pituitary
hypofunction depend on the specific hormones that are lacking. In
children, growth failure may occur as a result of growth hormone
deficiency, gonadotropin or gonadotropin-releasing hormone
deficiency leads to amenorrhea and infertility in women and to
decreased libido, impotence, and loss of pubic and axillary hair in men

Hyperthyroidism
Definition- The overproduction of a hormone by the butterfly-shaped
gland in the neck
Etiology: a hypermetabolic state caused by elevated circulating levels
of free T3 and T4
Epidemiology: Nearly 50% develop proximal muscle weakness
Brief Pathophysiology: the oversupply either is related to excessive
release of preformed thyroid hormone or comes from an extrathyroidal
source, rather than a hyperfunctioning gland
Clinical Manifestation: the skin of thyrotoxic individuals tends to be
soft, warm, and flushed because of increased blood flow and
peripheral vasodilation to increase heat loss; heat intolerance and
excessive sweating are common. Increased sympathetic activity and
hypermetabolism result in weight loss despite increased appetite

Chronic Lymphocytic Thyroiditis

Definition- an autoimmune disease caused by an immune response to
thyroid autoantigens
Etiology: Caused by an immune response to thyroid autoantigens

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Epidemiology: It is most prevalent between 45 and 65 years of age
and is more common in women with a female to male ratio of 10: 1 to
20:1
Brief Pathophysiology: the most common cause of hypothyroidism in
areas of the world where iodine levels are sufficient, characterized by
gradual thyroid failure secondary to autoimmune destruction of the
thyroid gland
Clinical Manifestation: Symptoms include fatigue and unexplained
weight gain

Graves' Disease
Definition- an immune system disorder that results in the
overproduction of thyroid hormones
Etiology: associated with enlargement of the thyroid gland
Epidemiology: has a peak incidence between 20 and 40 years of age,
with women being affected up to seven times more commonly than
men
Brief Pathophysiology: the most common cause of endogenous
hyperthyroidism
Clinical Manifestation: Symptoms include anxiety, hand tremor, heat
sensitivity, weight loss, puffy eyes and enlarged thyroid

Thyroid Carcinoma
Definition- A cancer of the thyroid, the butterfly-shaped gland at the
base of the neck
Etiology: cause of thyroid cancer is unknown, but certain risk factors
have been identified and include a family history of goiter, exposure to
high levels of radiation, and certain hereditary syndromes
Epidemiology: A female predominance has been noted among
patients who develop thyroid carcinoma in the early and middle adult
years, by contrast, cases seen in childhood and late adult life are
distributed equally between males and females

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Brief Pathophysiology: Genetic alterations in the three follicular cell–
derived malignancies are clustered along two oncogenic pathways
that lie downstream of growth factor receptors and RAS—the mitogen-
activated protein kinase pathway and the phosphatidylinositol-3-
kinase (PI-3K)/AKT pathway
Clinical Manifestation: Some people have no symptoms; others may
notice a lump in the neck

Type 1 Diabetes
Definition- A chronic condition in which the pancreas produces little or
no insulin
Etiology: islet destruction is caused primarily by immune effector cells
reacting against endogenous beta cell antigens
Epidemiology: According to the American Diabetes Association,
diabetes affects over 29 million children and adults, or 9.3% of the
population, in the United States
Brief Pathophysiology: culmination of lymphocytic infiltration and
destruction of insulin-secreting beta cells of the islets of Langerhans in
the pancreas, as beta-cell mass declines, insulin secretion decreases
until the available insulin no longer is adequate to maintain normal
blood glucose levels
Clinical Manifestation: Symptoms include excessive thirst, fatigue,
hunger, or sweating

Type 2 Diabetes
Definition- A chronic condition that affects the way the body processes
blood sugar
Etiology: involves interactions of genetics, environmental risk factors,
and inflammation
Epidemiology: association of obesity with type 2 diabetes has been
recognized for decades, with visceral obesity being common in a
majority of affected patients

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Brief Pathophysiology: a decreased ability of peripheral tissues to
respond to insulin (insulin resistance) and beta cell dysfunction that is
manifested as inadequate insulin secretion in the face of insulin
resistance and hyperglycemia
Clinical Manifestation: Symptoms include increased thirst, frequent
urination, hunger, fatigue, and blurred vision

Addison Disease
Definition- A disorder in which the adrenal glands don't produce
enough hormones
Etiology: are attributable to one of four disorders: autoimmune
adrenalitis, tuberculosis, the acquired immune deficiency syndrome
(AIDS), or metastatic cancer
Epidemiology: Autoimmune adrenalitis accounts for 60% to 70% of
cases and is by far the most common cause of primary adrenal
insufficiency
Brief Pathophysiology: progressive destruction of the adrenal cortex
Clinical Manifestation: Symptoms tend to be non-specific and include
fatigue, nausea, darkening of the skin, and dizziness upon standing

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