Benign Prostatic Hypertrophy Flashcards

1
Q

Benign prostatic hyperplasia (BPH) is a hyperplastic process, meaning what?

A

there is an increased number of cells

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2
Q

BPH is the most common benign tumor in men and its incidence is age related.
(a) At age 55 years, approximately ___ % of men report obstructive voiding symptoms
(b) At age 75, ___% of men report decrease in the force and caliber of the urinary stream.

A

a) 25%
b) 50%

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3
Q

Symptoms for BPH can be related either what two responses?

A

the obstructive component of the prostate
OR
the secondary response of the bladder to the outlet resistance (irritative).

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4
Q

These S/S are attributed to what component or response to BPH?
(a) Hesitancy
(b) Decreased force and caliber of stream
(c) Sensation of incomplete bladder emptying
(d) Double voiding (urinating a second time within 2 hours)
(e) Straining to urinate
(f) Postvoid dribbling(a) Urgency
(b) Frequency
(c) Nocturia

A

Obstructive

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5
Q

These S/S are attributed to what component or response to BPH?
(a) Urgency
(b) Frequency
(c) Nocturia

A

Irritative symptoms

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6
Q

What is the most important tool used in the evaluation of patients with BPH.
— Should be calculated for all patients before starting therapy.

A

American Urological Association (AUA) symptom index

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7
Q

American Urological Association (AUA) symptom index
Answers to seven questions quantitate the severity of obstructive or irritative complaints on a scale of ____-____.

A

0-5

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8
Q

What physical examp components should you do for suspected BPH?

A

(a) Digital rectal exam
–Smooth firm elastic enlargement of the prostate
–Induration should alert you to the possibility of cancer
(b) Neurologic exam
(c) Abdominal exam -Assess for a distended bladder

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9
Q

Induration of the prostate durring a DRE should alert you to the possibility of what?

A

cancer

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10
Q

DDx for BPH

A

(1) Urethral stricture
(2) Bladder neck contracture
(3) Bladder stones
(4) Prostate cancer
(5) Urinary tract infection
(6) Bladder carcinoma
(7) Neurogenic bladder

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11
Q

Laboratory considerations for BPH

A

-Urinalysis
(a) To exclude infection or hematuria
-Prostate specific antigen test (PSA)

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12
Q

When is upper tract imaging recommended for suspected BPH?

A

only in the presence of concomitant urinary tract disease or
complications of BPH
(hematuria, UTI, Chronic kidney disease, history of stone
disease)

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13
Q

Treatment of BPH
–Patients with mild symptoms (AUA scores 0-7)

A

Watchful waiting waiting only.
-Men with symptomatic disease, progression is not inevitable some men undergo spontaneous improvement or resolution of their symptoms.

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14
Q

Medical Therapy for BPH

A

–Alpha-blockers
–5-alpha-reductase inhibitors
–Phosphdiesterase-5 inhibitors

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15
Q

What medication
Used in patients with erectile dysfunction with mild or moderate symptoms
– Improve lower urinary tract symptoms

A

Phosphdiesterase-5 inhibitors

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16
Q

What medication
Act by reducing the size of the prostate gland and in turn improves symptoms

A

5-alpha-reductase inhibitors

17
Q

What medication
Act against bladder outlet obstruction by relaxing smooth muscle in the bladder neck, prostate capsule, and prostatic urethra

A

Alpha-blockers