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All the things continued > 14.4 Prostate > Flashcards

14.4 Prostate Flashcards

1
Q

What is the function of the secretions of the prostate? What maintains the glands?

A
  • Milky fluid that nourishes the sperms

- Androgens maintain it

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2
Q

Acute prostatitis in young adults is usually what? Older adults?

A

Young = Chlamydia or Gonorrhea

Old = Pseudomonas or E. coli

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3
Q

What are the classic s/sx of acute prostatitis?

A

Tender/boggy prostate with dysuria, fever, and chills

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4
Q

What do prostatic secretions show on culturing?

A

WBCs and bacteria

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5
Q

What are the s/sx of chronic prostatitis? What do prostatic secretion cultures show?

A
  • Dysuria with pelvic or LBP

- WBCs on culture, but no bacteria

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6
Q

What is BPH?

A

Hyperplasia of the prostatic stroma and glands

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7
Q

Is there an increased risk of CA with BPH?

A

Nah dawg

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8
Q

What is the hormone that is drives to BPH? What cells produce this?

A
  • DHT

- Stromal cells

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9
Q

Where does in the prostate does BPH occur?

A

Periurethral zone of the prostate

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10
Q

What are the s/sx of BPH?

A
  • Noctura
  • Urine dribbling
  • Trouble starting and stopping
  • Stream is weak

(NUTS)

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11
Q

What are the UA findings of BPH?

A

Microscopic hematuria

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12
Q

Why is there a slight increase in PSA with BPH?

A

Increase in prostatic glands

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13
Q

What are the kidney sequelae of BPH?

A

Hydronephrosis 2/2 backed up urine

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14
Q

What is the MOA of terazosin in the treatment of BPH? Does this have an effect on systemic HTN?

A
  • Alpha-1 antagonist to relax smooth muscle

- Reduces systemic HTN

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15
Q

What is the MOA of Tamsulosin in the treatment of BPH? Does this have an effect on systemic HTN?

A
  • Selective alpha-1A antagonist

- No effects on systemic HTN

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16
Q

What is the MOA of Leuprolide in the treatment of BPH?

A

continuous GnRH analog that reduces testosterone

17
Q

What is prostatic adenocarcinoma?

A

Malignant proliferation of prostatic glands

18
Q

What is the most common cancer in men?

A

Prostatic adenocarcinoma

19
Q

What are the risk factors for prostatic adenocarcinoma? (Age, race, diet)

A

-Old
African American ethnicity
-Diet high in sat fat

20
Q

What is the most common location for prostatic adenocarcinoma in the prostate? What does this mean in terms of s/sx?

A

-Posterior periphery

Since this is far away from the urethra, s/sx do not present until late in the disease course

21
Q

When does prostate screening begin? What is done?

A
  • age 50

- DRE and PSA

22
Q

PSA greater than what level is worrisome at any age?

A

10 ng/dL

23
Q

Is an increase or decrease in the free PSA in the serum is worrisome for CA? Why?

A

Decrease in free PSA, since cancer produces bound PSA

24
Q

What is absolutely required to diagnose prostatic cancer?

A

Bx

25
Q

What are the histological characteristics of prostatic cancer?

A

Glands that invade the tubules, and contain dark nucleoli

26
Q

What is the Gleason grading system of prostatic cancer based on?

A

Based on architecture, NOT nuclear atypia

27
Q

Where does prostate cancer like to spread? What type of lesion is produced here?

A

Lumbar spine, with osteoblastic mets, thus you get sclerotic lesions

28
Q

How does prostatic cancer often present?

A

LBP with increased alk phos, PSA, and Prostatic acid phos (PAP)

29
Q

What is the difference between osteoblastic and osteolytic lesions?

A

Osteoblastic produce sclerotic lesions

Osteolytic produces punched out lesions

30
Q

What is the treatment for local prostate cancer?

A

Cut it out

31
Q

What is the MOA of flutamide?

A

Androgen receptor inhibitor

32
Q

What is the MOA of leuprolide?

A

GnRH analog, that is given continuously to inhibit testosterone

All the things continued (28 decks)

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