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Pathoma Ch 14- Male Genital System > 14.4 Prostate > Flashcards

14.4 Prostate Flashcards

1
Q

glands and stroma of prostate are maintained by what homo

A

androgens

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2
Q

how does prostate present on digital rectal exam in acute prostatitis (2) (HY)

A

tender and boggy

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3
Q

what bacteria cause acute prostatitis in: (2 each)
young
older

A

young: Neisseria gonorrhea, Chlamydia trachomatis
old: E. coli, pseudomonas

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4
Q

CP in acute prostatitis (3)? chronic? (2)

A

acute: fever, chills, dysuria
chronic: dysuria, pelvic or low back pain

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5
Q

What do prostate secretions show in acute prostatitis? chronic?

A

Acute: WBCs, bacteria
Chronic: only WBCs

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6
Q

what is hypertorphic in BPH (stroma or glands)

A

both

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7
Q

is BPH normal? increase risk for cancer?

A

yes normal age-related change

no increased risk for cancer

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8
Q

what homo is acting to cause BPH

A

DHT

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9
Q

What is DHT derived from and enzyme that converts

A

5@-reductase converts testosterone to BPH

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10
Q

On what receptor does DHT act in prostate

A

androgen receptor

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11
Q

what zone of prostate does BPH affect (HY)

A

central periurethral zone

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12
Q

what kidney issues are assc/czed by BPH (2)

A

can lead to impaired bladder emptying–> infx, hydronephrosis

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13
Q

what 2 things happen to bladder wall in BPH

A

hypertrophy of smooth muscle

diverticuli

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14
Q

What is found in urine in BPH

A

microscopic hematuria

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15
Q

Why is PSA elevated in BPH

A

proliferation of glands

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16
Q

What is normal function of PSA

A

to liquify semen

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17
Q

3 drugs used to treat BPH (one is a drug class)

A

terazosin = alpha-1 antagonist (relaxes sm)
tamsulosin = selective alpha-1 antagonist
5@-reductase inhibitors

18
Q

which drug would be used to treat BPH in normotensive individuals and why? What receptor?

A

tamsulosin- doesn’t affect bvs via alpha-1b receptor

19
Q

whaqt is problem of using 5@-reductase inhibitors (3)

A

takes months to achieve results

ADEs: gynecomastia, sexual dysfunction

20
Q

5@-reductase inhibitors are also used to treat what

A

male pattern baldness

21
Q

what is MC cancer in men

A

Prostatic adenocarcinoma

22
Q

what rank is Prostatic adenocarcinoma in causing cancer-deaths in men

A

2nd MC

23
Q

risk factors for Prostatic adenocarcinoma (3)

A

age, race, diet high in sat fat

24
Q

rank 3 races in incidence of Prostatic adenocarcinoma

A

AA > whites > asians

25
Q

how does Prostatic adenocarcinoma present

A

it is clinically silent-

26
Q

why is Prostatic adenocarcinoma clinically silent (HY)

A

the tumor arises in the peripheral, posterior region of the prostate and doesn’t affect the urethra

27
Q

what level of PSA is alarming at any age

A

> 10 ng/ml

28
Q

Prostatic adenocarcinoma produces what type of PSA and why is this relevant

A

Prostatic adenocarcinoma produces bound-PSA. Decreased free-PSA % in serum –> suggestive of cancer

29
Q

What is required to confrim dx of Prostatic adenocarcinoma

A

bx

30
Q

What is seen in histo oif prostate in Prostatic adenocarcinoma (HY)

A

small, invasive glands with PROMINENT NUCLEOLI

31
Q

what is the Gleason grading system of Prostatic adenocarcinoma based on? what is it NOT based on (HY)

A

based on architecture alone

NOT based on uclear atypia

32
Q

lower or higher score in gleason grading system of Prostatic adenocarcinoma = worse px?

A

higher score

33
Q

where does Prostatic adenocarcinoma like to spread (2)

A

lumbar spine or pelvis

34
Q

osteoblastc metastases in Prostatic adenocarcinoma present in what 4 ways

A 
low back pain
elevated:
serum alkaline phosphatase
PSA
PAP- prostatic acid phosphatase
35
Q

what is serum alkaline phosphatase a sign of? both generally and in Prostatic adenocarcinoma

A

osteoblastic activity- indicating bone growth generally in Prostatic adenocarcinoma: metastasis

36
Q

tx for localized in Prostatic adenocarcinoma

A

prostatectomy

37
Q

advacned in Prostatic adenocarcinoma is treated with what? for what goal?

A

hormone suppression to reduce Testosterone and DHT

38
Q

What 2 drugs treat in Prostatic adenocarcinoma

A

leuprolide, FLutamide

39
Q

MOA of lutamide in in Prostatic adenocarcinoma tx

A

it is a GnRH analog–> shuts down anterior pituitary gland–> decreased LH, FSH –> decreased androgen production

40
Q

MOA of flutamide in in Prostatic adenocarcinoma tx

A

competitive inhibitor of androgen receptors

Pathoma Ch 14- Male Genital System (4 decks)

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