237/239 prostate

Question 1

What findings on digital rectal examination are concerning for prostate malignancy?

Answer 1

irregular, nodular prostate

Question 2

What value of PSA is suspicious for cancer?

Answer 2

> 4 (but could also be a number of benign prostate conditions)

Question 3

When are each of the major screening and diagnostic tests for prostate cancer indicated? How do they compare?

Answer 3

digital rectal exam: screening test, low sensitivity and good specificity
PSA levels: indicated for suspected cancer, non-specific
Prostate biopsy: diagnostic test

Question 4

What is the basic architecture of prostate cancer?

Answer 4

small glands, infiltrating patterns, prominent nucleoli

Question 5

Where is prostate cancer usually located?

Answer 5

peripheral zone, posterior lobe

Question 6

What are the symptoms of prostate cancer?

Answer 6

usually none (it would need to be super large to cause obstructive symptoms because of its location); can cause bone pain in metastasis

Question 7

How are Gleason grades converted to scores?

Answer 7

group 1 < 6
Group 2 = 7 (3 + 4)
Group 3 = 7 (4+3)
Group 4 = 8
Group 5 = 9-10
the scores come from Gleason grades of the first and second most prevalent differentiation patterns

Question 8

What is the half life of PSA?

Answer 8

2-3 days

Question 9

What cells make PSA?

Answer 9

adluminal (secretory) cells?

Question 10

What cells does pancreatic adenocarcinoma arise from?

Answer 10

adluminal/secretory cells

Question 11

What are the key histologic features of prostate cancer?

Answer 11

small glands
infiltrating patterns
prominent nucleoli
presence of extracellular material
perineural invasion

Question 12

What is used to determine the score of prostate cancer?

Answer 12

architectural patterns

Question 13

What factors determine the staging of prostate cancer?

Answer 13

spread/local invasion