B8-042 Prostate Pathology

Question 1

prostate cancer arises from the […] zone

Answer 1

peripheral

Question 2

BPH arises from the […] zome

Answer 2

transition

Question 3

what zone of the prostate surrounds the prostatic urethra?

Answer 3

transition

Question 4

what zone of the prostate surrounds the ejaculatory duct?

Answer 4

central

Question 5

what zone of the prostate is palpable on digital rectal exam?

Answer 5

peripheral

Question 6

what zone of the prostate is composed of non-glandular tissue and fibromuscular stroma?

Answer 6

anterior

Question 7

tenderness on DRE may indicate

Answer 7

prostatitis

Question 8

enlargement on DRE may indicate

Answer 8

BPH

Question 9

hard nodule on DRE may indicate

Answer 9

prostatic cancer

Question 10

2 types of BPH

Answer 10

epithelial predominant
stromal predominant

Question 11

type of BPH that is nodules composed of tightly clustered expanded ductal acinar elements

Answer 11

epithelial predominant

Question 12

type of BPH that is bland spindle cells with small cytoplasm and large nuclei

Answer 12

stromal predominant

Question 13

the secretory cells of the prostate secrete

Answer 13

PSA

Question 14

only secretory epithelium
loss of basal cells

Answer 14

prostatic adenocarcinoma

Question 15

how does excess estrogen cause BPH?

Answer 15

disrupts balance between epithelial cell proliferation and cell death

more proliferation

Question 16

how does excess DHT cause BPH?

Answer 16

stimulates growth factor receptors on both stromal and epithelial cells –> hyperplasia

Question 17

if the specimen does not take up HMW-CK stain, what is likely?

Answer 17

prostatic adenocarcinoma (no basal layer)

HMW-CK stains basal layer

Question 18

prostatic adenocarcinoma is graded using the […] grade

Answer 18

Gleason grade

(based on glandular architecture and correlates with metastatic potential)

Question 19

metastasis of prostatic adenocarcinoma to the spine occurs via

Answer 19

vertebral (Batson) venous plexus

Question 20

increased total PSA
increased fraction of free PSA

Answer 20

BPH

Question 21

increased total PSA
decreased fraction of free PSA

Answer 21

prostatic adenocarcinoma

Question 22

hot, boggy, tender prostate

Answer 22

acute bacterial prostatitis

Question 23

fever, chills, malaise with
irritative and obstructive symptoms

Answer 23

acute bacterial prostatitis

Question 24

what do you need to see on histology to diagnose acute bacterial prostatitis?

Answer 24

neutrophils

Question 25

[…] treatment is a common cause of granulomatous chronic bacterial prostatitis

Answer 25

BCG

Question 26

what do you need to see on histology to diagnose chronic bacterial prostatitis?

Answer 26

lymphocytes

Question 27

granulomas on histology and chronic bacterial prostatitis in a patient with hx of bladder cancer

Answer 27

post-BCG granulomatous inflammation

Question 28

prostate cancer causes […] lesions of the bone

Answer 28

osteoblastic

Question 29

standard of care for diagnosis of prostatic adenocarcinoma

Answer 29

MRI

Question 30

patients under […] years of age do not need prostate screening

Answer 30

40

Question 31

patients over […] years of age do not need prostate screening

Answer 31

70

Question 32

rising PSA in a perviously treated patient signifies

Answer 32

biochemical recurrence

Question 33

treatment recommendation for Gleason grade 3+3 = Score 6

Answer 33

yearly biopsies (active surveillance)

Question 34

treatment recommendation for Gleason grade 3+4 = Score 7 and above

Answer 34

radical prostatectomy

Question 35

alpha blockers inhibit smooth muscle tone by inhibiting […] receptors

Answer 35

a1 adrenergic

Question 36

genetic changes associated with prostatic adenocarcinoma [5]

Answer 36

Loss of p53
PTEN Deletion
MYC Amplification
BRCA2
ERG-TMPRSS2 fusion

Question 37

most common pathogen causing acute bacterial prostatitis

Answer 37

E coli