Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Patho Final > Benign Prostatic Hyperplasia (BPH) > Flashcards

Benign Prostatic Hyperplasia (BPH) Flashcards

1
Q

Benign Prostatic Hyperplasia (BPH)?

A

Gradual periurethral enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common reproductive disorder in men?

A

Benign Prostatic Hyperplasia (BPH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When do symptoms typically appear with BPH?

A

quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who does BPH mainly occur in?

A

Very common in older males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

BPH is age-related. List the age groups and prevalence of this disorder.

A
  • 40-60 yrs ~20% have BPH
  • 60-80 yrs ~50% have BPH
  • 80 yrs + ~ 90% have BPH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain hyperplasia in terms of BPH.

A

increase in the number of glandular cells (accounts for most of the enlargement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain hypertrophy in terms of BPH.

A

Increase in the size of smooth muscles (less significant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What primarily occurs in BPH, hyperplasia or hypertrophy?

A

Hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Primary risk factor of BPH?

A

Aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which ethnicity does BPH occur in more? And which ethnicity does BPH occur in less? Why is this the cause?

A

More common in African American, least common in Japanese men. Unclear why but could be d/t lifestyle, genetics and diet.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Etiology of BPH?

A
  • unclear
  • aging
  • genetics
  • race
  • diet
  • hormonal influence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In a pt with BPH, which 3 horTmone levels change as men age?

A
  • testosterone
  • dihydrotestosterone (DHT)
  • Estrogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does DHT stand for?

A

Dihydrotestosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dihydrotestosterone?

A

A metabolite of testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Do men have the same amount of estrogen as women?

A

No, they require a decreased amount compared to women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is testosterone normally converted to and how?

A

Testosterone is converted into dihydrotestosterone (DHT) with 5-alpha reductase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does DHT support?

A

It supports the growth and function of the prostate gland (it allows the prostate to continue to produce secretions)

18
Q

What does estrogen normally do?

A

It sensitizes prostatic cells to DHT

19
Q

What occurs if there is no estrogen?

A

Cells in the prostate will not respond to DHT

20
Q

What are 2 mechanisms that cause BPH?

A

Decreased testosterone and prostatic IGF-1

21
Q

Explain how decreased tester one plays a role with BPH?

A

You continue to produce testosterone but there is a decline as men age) -> this results in decreased DHT which is a normal part of aging. Testosterone:Estrogen ratio changes. This ratio decreases as testosterone production decreases and estrogen production remains the same. “Relative increase” in estrogen; “absolute decline” in testosterone. With the decreased ratio, estrogens effects are more pronounced, -> meaning that estrogen will make prostatic cells more sensitized to DHT. Increased responsiveness to DHT = Increased growth and secretion = enlargement.

22
Q

What is prostatic IGF-1?

A

Prostatic Insulin Growth Factor-1

23
Q

Explain how prostatic IGF-1 plays a role with BPH?

A

Mechanism is unclear (stimulates the proliferation of prostate cells -> enlargement)

24
Q

What will a DRE reveal?

A

It will reveal peripheral nodules on the prostate if cancer is present

25
Q

What is the histology of the bladder wall?

A

Transitional

26
Q

What occurs to the bladder wall in BPH?

A

The bladder wall thickens to compensate for the retention of urine d/t the inability to release urine through the obstructed prostatic urethra.

27
Q

Why does the bladder wall thicken in BPH?

A

this is compensatory to prevent the bladder from bursting d/t increased volume of urine

28
Q

What structural changes occur in BPH and why?

A

Trabeculations and diverticula to increase storage in the bladder and prevent rupture

29
Q

Why do trabeculations occur in BPH?

A

D/t the thickened muscle wall and loss of elasticity and muscle tone

30
Q

What is a complication that can occur in BPH?

A

urine stasis can form calculi (kidney stones)

31
Q

What occurs with urine when a pt has BPH?

A

Urine may flow into the urethra, but with compression from the prostate gland is squeezed back into bladder. (It brings normal flora from the urethra into the bladder)

32
Q

What occurs with the ureters in BPH?

A

Urine backs up in the kidneys causing hydroureter

33
Q

Hydroureter?

A

Kink in the bottom of the ureter leading into the bladder d/t the build up of urine in the vertical portion of the ureter and resulting weight causing a bend in the ureter (ureters loops)

34
Q

What can urine backing up in kidneys cause?

A

Hydronephrosis

35
Q

Hydronephosis?

A

Distention of renal pelvis and calyces

36
Q

Manifestations of BPH?

A
  • problems with voiding (r/t the fact that the urethra is compressed)
  • Hesitancy
  • Weak urine stream (the bladder will not empty fully)
  • Frequency
  • Terminal dribbling
  • complete obstruction of the urethra would result in NO urine flow (usually this does not result because the individual would seek help sooner)
37
Q

What complications can occur with a complete obstruction of the urethra?

A

Urine retention and renal failure

38
Q

Diagnostics of BPH?

A
  • based off manifestations
  • usually part of standard physical (if the pt is over 50, part of the GU assessments should be asking them if they have issues with voiding)
  • Digital rectal exam
  • Dx tests done only on individuals whose manifestations indicate BPH:
  • Prostate Specific Antigen (PSA)
  • BUN, Creatinine (kidney function tests),
  • Urinalysis
39
Q

Treatment for BPH?

A
  • based on the severity and complications
  • often no tx is required (if S+S are not severe)
  • Behavioural approach (bc of frequency and hesitancy the pt may have to get up 5-6 x in a night, so you address this problem by instructing the pt to: Avoid fluids a few hrs before bedtime so the bladder does not fill; avoid alcohol and caffiene)
  • Pharmacological (5 alpha reductase inhibitor; alpha adrenergic antagonist; combining the two gives the greatest benefit)
  • Transurethral Resection of the prostate
  • Laser Prostatectomy
40
Q

Why are 5-alpha-reductase inhibitors taken for treatment?

A

Reduces the production of DHT (which is the hormone that natures prostatic growth) so decreased DHT will inhibit the growth of the prostate (must be used long-term for benefit)

41
Q

What are alpha adrenergic antagonists taken for treatment?

A

Acts on muscles (causes relaxation of the muscles in the urethra, resulting in decreased obstruction and improved urination.

Patho Final (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions