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D2 Fall > Gen Path Exam 4 - Male Reproductive Pathology > Flashcards

Gen Path Exam 4 - Male Reproductive Pathology Flashcards

1
Q

Located at base of bladder, encircling urethra, anterior to rectum

A

Prostate

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2
Q

Posterior aspect is palpable by digital rectal exam

A

Prostate

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3
Q

___________ maintain the glands and stroma, which make a milky fluid added to sperm and fluid from seminal vesicle to make semen

A

Androgens

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4
Q

Histologically consists of central zone, peripheral zone, and transitional zone

A

Prostate

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5
Q

Which disease?

Very common after age 40; only 10% with histologic evidence have symptoms

A

Benign prostate hyperplasia (BPH)

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6
Q

Which disease?

Arises from inner transitional or central zones; produces urinary obstruction

A

Benign prostatic hyperplasia (BPH)

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7
Q

Which disease has the following symptoms?

Difficulty/hesitancy starting urinary stream and intermittent interruption of urinary stream

A

Benign prostatic hyperplasia (BPH)

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8
Q

Which disease has the following symptoms?

With obstruction - urgency, frequency, nocturia (irritated bladder)

A

Benign prostatic hyperplasia (BPH)

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9
Q

Which disease?

Caused by an increase in androgens

A

Prostatic hyperplasia

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10
Q

Which disease?

5-alpha reductase -> Testosterone -> dihydrotestosterone (DHT) -> nodular hyperplasia

A

Prostatic hyperplasia

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11
Q

Which disease?

Increased estrogen may also increase expression of DHT receptors in prostate

A

Prostatic hyperplasia

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12
Q

Which disease has the following methods of treatment?

5-alpha reductase inhibitors: finasteride (Proscar, Propecia)
alpha-1-adrenergic blockers: relax prostate SM (Terazosin, Tamsulosin)

A

Prostatic hyperplasia

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13
Q

Which disease?

Well-defined nodules compressing the urethra

A

Prostatic hyperplasia

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14
Q

Which disease?

Variable amount of normal appearing but hyperplastic glandular and stromal components

A

Prostatic hyperplasia

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15
Q

Most common cancer in men

A

Prostatic carcinoma

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16
Q

Which disease?

Lifetime risk is ~11%; affects men aged 65-75

A

Prostatic carcinoma

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17
Q

Which disease?

Highly variable disease course; can’t reliably predict which tumors will be aggressive

A

Prostatic carcinoma

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18
Q

Which disease?

Androgens promote, but don’t initiate cancer growth

A

Prostatic carcinoma

19
Q

Which disease?

Increased risk in 1st degree relatives

A

Prostatic carcinoma

20
Q

Which disease?

Geographic variations and diet may play a role

A

Prostatic carcinoma

21
Q

Which disease?

Acquired genetic aberrations; most often seen androgen-regulated fusion genes

A

Prostatic carcinoma

22
Q

Which disease?

Inherited BRCA1 and BRCA2 mutations can increase risk

A

Prostatic carcinoma

23
Q

Which disease?

Often clinically silent

A

Prostatic carcinoma

24
Q

Which disease?

Arise from peripheral zone, which can be palpated on digital rectal exam

A

Prostatic carcinoma

25
Q

Which disease?

First sign is metastasis, bone involvement is common (osteolytic or osteoblastic)

A

Prostatic carcinoma

26
Q

What is the normal product of prostatic epithelium that is secreted in semen?

A

Prostate specific antigen (PSA)

27
Q

What level of Prostate specific antigen (PSA) suggests cancer? What is normal?

A

Cancer: > 10 ng/mL
Normal: < 4 ng/mL

28
Q

Is Prostate specific antigen (PSA) highly sensitive and specific?

A

NO

29
Q

What is Prostate specific antigen (PSA) helpful for?

A

Monitoring pts for progression/recurrence

30
Q

What age range of men have a small net benefit for doing PSA screening?

A

55-69

31
Q

What age range of men have benefits that do NOT outweigh the expected harms for doing PSA screening?

A

70+

32
Q

What are the benefits of PSA screening in men aged 55-69?

A

May prevent 3/1000 cases of metastasis and 1.3 death over 13 yrs

(small reduction in risk of death)

33
Q

What are the risks of PSA screening in men aged 55-69?

A

False + leading to biopsy and potential overtreatment

34
Q

What are the complications of overtreatment, specifically after prostatectomy and radiation?

A

Prostatectomy = incontinence and ED
Radiation = ED, bowel urgency, fecal incontinence

35
Q

How is prostate cancer pathologically graded?

A

Gleason score

36
Q

Describe the Gleason score

A

1 = well differentiated
5 = no differentiation

Add the 2 most common patterns together

Ex: most differentiated: 1+1 = 2; least differentiated: 5+5 = 10

37
Q

What does the Gleason score correlate with?

A

Prognosis

38
Q

Gleason score = 6 or less

A

Low risk

39
Q

Gleason score = 7

A

Intermediate risk

40
Q

Gleason score = 8, 9 ,10

A

High risk

41
Q

Which disease?

Clinical spread and histologic grade (Gleason score) correlate with prognosis

A

Prostatic carcinoma

42
Q

Which disease has the following treatment?

Active surveillance (watching/waiting)
Surgery (robotic prostatectomy)
Radiation
Androgen deprivation (only for advanced metastasis)

A

Prostatic carcinoma

43
Q

Which disease?

Stage T1 or T2 = good prognosis

A

Prostatic carcinoma

44
Q

Which disease?

Disseminated disease = poor prognosis

A

Prostatic carcinoma

D2 Fall (45 decks)

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