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Clin Med GU > Benign prostate disease > Flashcards

Benign prostate disease Flashcards

1
Q

What is benign prostatic hyperplasia

A

Proliferation of epithelial and smooth muscle cells in the transition zone which surrounds the urethra.

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2
Q

What are the symptoms of BPH

A

Bladder outlet obstruction
weak strea
hesitancy
urgency, nocturne
incomplete emptying
terminal dribbling

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3
Q

How do you treat BPH

A

5 alpha-reductase inhibitors
alpha blockers
tadalafil
surgery

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4
Q

How do you diagnose BPH

A

DRE & symptoms**
cystoscopy
transrectal US
urodynamics

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5
Q

What causes urinary outflow obstruction with BPH

A

lumen of the prostatic urethra narrowing and lengthening

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6
Q

What does increased bladder emptying lead to

A

stasis
*predisposing them to stone formation/infection

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7
Q

What can prolonged urinary tract obstruction lead to

A

hydronephrosis
compromised renal function

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8
Q

What lower urinary tract symptoms generally progress with BPH

A

urinary frequency
urgency
nocturia
hesitancy
intermittency

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9
Q

What causes an increase in frequency, urgency, and nocturia with BPH

A

incomplete emptying and subsequent rapid refilling of bladder

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10
Q

What is urinary retention

A

sudden, complete retention with marked abdominal discomfort and bladder distention

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11
Q

What causes urinary retention

A

prolonged attempts to postpone voiding

immobilization

exposure to cold

use of anesthetics, anticholinergics, sympathomimetics, opioids, or alcohol.

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12
Q

What urology symptom score is associated with mild symptoms

A

1-7

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13
Q

What urologic score is indicative of severe symptoms

A

20-35

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14
Q

What will the prostate feel like on DRE with BPH

A

enlarged, contender, rubbery, lost median furrow

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15
Q

What may firm or hard areas in a prostate indicate

A

prostate cancer

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16
Q

What PSA level requires further workup and evaluation

A

a 3x jump from normal
*even if within normal range

17
Q

What is a normal PSA level

A

0-4

18
Q

What is the first step in testing if PSA levels indicate it

A

multi parametric MRI

19
Q

What is the first attempt at relieving someones urinary retention

A

standard urinary catheter placement

*second step is coude tip

20
Q

What are the BPH treatments

A

behavior modification: decrease caffeine

alpha blockers

5 alpha reductase inhibitors

PDE5i

21
Q

What is the first line medical management for BPH

A

Alpha blockers

22
Q

What are surgical options for BPH

A

TURP
prostatectomy
PVP
PVEP

23
Q

What is the standard surgery to treat BPH

A

transurethral resection of prostate (TURP)

24
Q

What is urethritis and what is the most common organism

A

Infection of the urethra
Gonorrhea / trachomatis

25
Q

What is the clinical presentation of urethritis

A

purulent urethral discharge
dysuria
pain at meatus

26
Q

What complications can makes have with urethritis

A

epididymitis
disseminated gonococcal inf
Reiters syndrome

27
Q

What is the treatment for urethritis

A

IM dose of ceftriaxone
+ Azythro or doxy x7days

28
Q

What are the different types of prostatitis

A

bacterial
nonbacterial

29
Q

What causes bacterial prostatitis

A

urinary pathogens (klebsiella/E.Coli)

30
Q

What causes nonbacterial prostatitis

A

inflammation

31
Q

How is prostatitis diagnosed

A

2 urine samples
*first sample is midstream

digital prostate massage with immediate void (this is the 2nd sample)

32
Q

What is the clinical presentation of prostatitis

A

perineum pain
painful ejaculation

33
Q

How will acute bacterial prostatitis present

A

flu like symptoms
urinary symptoms
sensation of sitting on a ball

34
Q

Why is a DRE NOT completed with acute bacterial prostatitis

A

risk of sepsis

35
Q

How do you treat acute bacterial prostatitis

A

abx (Fluoroquinalones), analgesics, stool softener, hydration

abx x30 days

36
Q

If a patient has septic prostatitis, how do you treat them

A

broad spectrum abx
*ampicillin + gentamicin

Clin Med GU (11 decks)

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