Benign Prostate Hyperplasia Flashcards

1
Q

BPH is hyperplasia of what kind of tissue

A

glandular tissue

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2
Q

and hypertrophy of what

A

smooth muscle and glands

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3
Q

What is BPH

A

gradual periurethral enlargement around the urethra

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4
Q

what is the most prevalent risk factor

A

age

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5
Q

why is age the most prevalent risk factor

A

there is a change in the T:E ratio

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6
Q

what kind of change is occurring in the T:E ratio

A

there is a quantitive decrease in T and a relative increase with E

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7
Q

what are other Etiology of BPH

A

unclear, with a tie to diet, ethnicity, and genetic predisposition

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8
Q

the patho of BPH is related to what

A

to changed in testosterone, dihydrotestosterone, and estrogen

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9
Q

What converts T to DHT

A

5a reductase

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10
Q

what does E do

A

sensitizes the prostate to DHT

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11
Q

what does DHT do

A

promotes prostate growth and function

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12
Q

hyperplasia of the periurethral tissue causes what

A

compression against the urethra

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13
Q

hypertrophy of the smooth muscle cells causes what

A

impeded urine flow, and increase urine in the bladder

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14
Q

What are the histologic changes that are occurring

A

the bladder wall thickens and trebeculations and diverticula are forming to create more room for the urine

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15
Q

what is a complication that arises from this compensatory changes

A

urine stasis occurs = renal calculi and infections

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16
Q

Consequences of BPH

A

Urine reflux

  • urine is backed up in the ureters, ureters distend (hydroureter)
  • ureter then fish hooks and loops down
  • backs up into the kidney (hydronephrosis) which is distention of the renal pelvis and calices
17
Q

Manifestations of BPH

A
frequency
hesitancy 
poste urine dribble
week urine stream 
complete obstruction = renal failure
18
Q

Diagnosis of BPH- what is the golden standard

A

DRE

Prostate specific antigen (increases with the size)

19
Q

what are other diagnosis of BPH

A
PSAv, PSAd
US
BUN
Creatinine
Urinalysis
20
Q

Treatment for BPH

A

often no treatment
alpha adrenergic antagonists (relax smooth muscle)
5a reductase inhibitors

21
Q

Severe treatment

A

TURP (transurethral resection of the prostate)

laser prostatectomy