ILOs Flashcards
Where is the prostate located?
Between the bladder and the peniss, just infront of the rectum
What is the main role of the prostate?
To produce fluid that nourishes and transport the sperm
What runs through the prostate?
The urethra
As you get older how does the size of your prostate naturally change?
It gets bigger
How many lobes does the prostate have?
2
How many parts make up the bladder, and what are they?
4 parts….
- The dome
- The base
- The body
- The neck
How many layers make up the 4 parts of the bladder?
3 layers….
- Urothelium
- Lamina propria
- Muscularis propria
What is PSA?
Prostate - specific antigen
Are PSA levels increased or decreased is many prostate cancer cases?
They are increased
What releases PSA into the blood stream?
The prostate
What is the normal range of PSA levels?
0-4 ng/mL
Does the upper limit of a PSA ever change?
Yes. Depending on the patients age
When may you see a false positive PSA result?
If the patient has recently done any of the following things:
- Ride a bike
- Strenuous exercise
- Enlarged prostate
- Recent ejaculation
- Anal sex
- Has a UTI
What percentage of patients that have a prostate biopsy go on to have prostate cancer?
25%
What are some of the real red flags for prostate cancer?
Weight loss, asymmetrical prostate, fatigue, bone pain, visible haematuria
What is the biggest risk when someone under goes a prostate biopsy?
Infection, due to you having to go through the rectum
If a patient does not want any intervention in terms of treatment, what are the two options we can give them?
- Active surveillance
- Watchful waiting
Is active surveillance or watchful waiting more intense?
Active surveillance
What are the 4 main treatment options for prostate cancer?
- Removal of the prostate (prostatectomy)
- External beam radiotherapy
- Seed Brachytherapy (Internal beam radiotherapy)
- Hormone therapy
Who do NICE say are entitled to a PSA screen?
Any man over the age of 50 that asks for one
What is Micturition?
Eliminating water and electrolytes from the urinary system aka urinating
What are the two phases of micturition?
Storage/continence phase and the voiding phase
What happens during the storage/continence phase of micturition?
The urine is stored in the bladder
What happens during the voiding phase of micturition?
The urine is released through the urethra
What two muscles keep the neck of the bladder closed?
Internal and external sphincter
What muscles are relaxed when you are storing urine?
Detrusor muscles
What muscles need to be contracted when you are storing urine?
Internal urethral sphincter and the external urethral sphincter
What controls the internal urethral sphincter?
Autonomic nervous system
Is the internal urethral sphincter voluntary or involuntary controlled?
Involuntary controlled
What controls the external urethral sphincter?
The somatic nervous system
Is the external urethral sphincter voluntary or involuntary controlled?
Voluntary controlled
At what volume do the stretch receptors become stimulated and send a signal to the brain?
250 mls
How much urine remains in the bladder after urinating?
Around 10 mls
How much urine do you have to have in your bladder after urinating to classify you are being in urinary retention?
Around 200-250 mls
What part of the brain are signals sent to to tell you that you need to urinate?
Thalamus and cerebral cortex
What is Benign Prostatic Hyperplasia (BPH)?
It is a condition that is only seen in men, where the prostate is enlarged but NOT cancerous
When are the 2 main growth periods of the prostate?
- Early on in puberty
- Around age 25 which will then continue for life
What are the two main drugs used to treat BPH?
Tamsulosin and Finasteride
If patients are not eligible for surgery and their symptoms are very severe how can we treat them?
Giving them a catheter
What is the main symptom of someone being in urinary retention?
Lower abdominal pain
What residual volume of urine classes a patient to be in urinary retention?
200-300 mls
Who are at the higher risk of going into urinary retention?
Older men with prostate problems
How can you assess whether a patients in urinary retention or not?
By carrying out a bladder scan
Whats the biggest complications of urinary retention?
- UTIs
- AKIs
- Renal scarring
- CKD
Who are at risk of suffering from a urinary tract obstruction?
Infants and the elderly. Men more than women
What is the most common cause of a urinary obstruction?
BPH
When theres a urinary restriction where does the pressure back up?
Into the collecting system of the kidneys
What does an increase in pressure in the collecting system do to the kidneys?
Dilation occurs and the kidney filtration system can then become damaged
Name a tumour suppressor gene?
p53
What are oncogenes?
Genes that can cause cancer
What bacteria is responsible for causing UTIs generally?
E.coli
What is the first line drug used to treat a UTI?
Nitrofurantoin
What is the second line drug to treat UTIs?
Trimethoprim
What are the 3 things that cause resistance to antibiotics?
- Inherent resistance
- Mutations
- Gene transfer
What part of the prostate is usually enlarged causing BPH?
Transitional zone
What part of the prostate can cancer grow in?
Any part of the prostate