Midterm 2 Flashcards

1
Q

List the 3 major prostate problems

A
  1. prosatate cancer
  2. BPH
  3. Prostatitis
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2
Q

list the signs of Benign Prostatic Hyperplasia

A
  • Bladder palpable on abdominal exam
  • symmetric prostate enlargement
  • Prostate palpates smooth, rubbery
  • Hematuria if straining at micnutrition
  • Palpates boggy, firm but elastic
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3
Q

what are the normal placatory findings when performing

A
  • symmetrical
  • consistency of a pencil eraser
  • 1 cm protrusion into the rectum
  • median sulcus is palpable
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4
Q

What are placatory findings for BPH during a DRE

A
  • boggy
  • smooth, rubbery
  • enlarged - more than 1cm protrusion
  • symmetrical
  • median sulcus may or may not be obliterated
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5
Q

what are the placatory findings of prostate cancer during a DRE

A
  • Stony hard irregular nodule
  • Asymmetrical
  • 1 cm protrusion into the rectum
  • median sulcus obliterated
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6
Q

________ causes nocturia, hematuria , weak stream , hestinancy, pain or burning on urination , continuous pain in lower back, pelvis and thighs … also contains a malignant neoplasm with multiple nodules

A

Carcinoma

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7
Q

____ causes fever, chills, malaise, urinary frequency and urgency, dysuria, urethral discharge, dull, aching pain in perineal and rectal area… an exquisitely tender enlargement is acute inflammation of the prostate gland

A
  • prostatitis
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8
Q

________ causes urinary frequency, urgency, hesitancy, straining to urinate, weak stream, intermittent stream, sensation of incomplete emptying, nocturne.. a symmetric nontemder enlargment. the prostate surface feels smooth, rubbery or firm with the median sulcus obliterated

A

Benign Prostatic Hypertrophy

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9
Q

Benign prostatic Hyperplasia often begins in the ______

A

transition zone

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10
Q

Prostate cancer often begins in the ______ zone and grows ___ this is less noticeable to the patient

A
  • peripheral zone

- outwards

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11
Q

name the four areas of the prostate

A
  1. anterior fibromuscular area
  2. peripheral zone
  3. transition zone
  4. central zone
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12
Q

List the prostate cancer locations from most common to least common

A
  • Peripheral zone 70%
  • 15-20% central zone
  • 10-15% transition zone
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13
Q

_____ is prostate cancer cells that do not depend on androgen for growth

A

Androgen independent prostate cancer (AIPC)

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14
Q

_______ is prostate cancer cells that depend on androgens for continued cell growth and vitality

A

Androgen dependent prostate cancer (ADPC)

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15
Q

Describe the 5 Gleson grading system for prostate cancer

A
  1. cancer is well differentiated composed of uniform circular acini
  2. cancer is still well differentiated, but acini are arranged more loosely and irregular shaped
  3. most common grade … cancer is moderately differentiated, with acini varying in size
  4. Cancer is poorly differentiated, unable to form separate acinar units… highly irregular, distorted shapes, progressive invasion of neighboring tissue
  5. Cancer is undifferentiated and bears no resemblance to normal prostate cells .. cells are unable to form acinar units
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16
Q

PSA density = ______ divided by _____

A

serum PSA level divided by prostate volume

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17
Q

prostate volume is determined by _____

A

transrectal ultrasonograpghy

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18
Q

_____ and ____ are better tests than just PSA alone

A

Free and Bound PSA

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19
Q

_______ increases more in benign prostatic hypertrophy

A

Free PSA

20
Q

________ increases more in prostate cancer

A

protein bound psa

21
Q

list some natural health approaches to prostate problems

A
  • avoid exnoesstrogens
  • increase number of ejaculations
  • colon cleansing
  • take amino acids
  • increase veggie intake
  • omega -3 oils
  • vitamin E
  • use progesterone
22
Q

Testosterone is covered to DHT by the enzyme 5 alpha- reductase

A

True

23
Q

T/ F prostate cancer is most common in the transitional zone

A

false
peripheral zone
the transitional zone is common in BPH

24
Q

Which Grade is most common for prostate cancer

A

Grade 3- cells are moderately differentiated with the acini varying in size and may affect neighboring tissue

25
Q

PSA greater than 10ng/cu.mm, then ___ % reveal ____

A
  • 66%

- prostate biopsies reveal prostate cancer

26
Q

PSA between __ and___ then 22% of prostate biopsies reveal prostate cancer

A

4 and 10

27
Q

Metastatic prostate cancer in an asymptomatic patient with PSA serum concentration of_______

A

21, 380 ng/ml

28
Q

greater than ____ ng/ml per year increase is considered clinically significant

A

.75

29
Q

__________ is another possible test for prostate cancer

A

prostate acid phosphatase

30
Q

_____ technique of freezing prostate sections as a therapy

A

Cryoablation

31
Q

_________ a radiotherapy treatment with ionizing radiation whose source is applied to the surface of the body or is located a short distance from the body area being treated

A

Brachytherapy

32
Q

what can the pathophysiology or prostatitis be

A
  1. ascending infection from infected urethra
  2. direct or lymphatic spread from rectum
  3. hematogenous spread
33
Q

List the characteristics of Prostatitis

A
  1. usually seen in younger men
  2. risk factors : catheters, infected sexual contacts, bladder outlet obstruction, suppressed immune system, diabetes mellitus
  3. prostate palpates (DRE) as warm, boggy tender on palpation
  4. there are several types of prostatitits
34
Q

High fever, chills, nausea, vomiting and general feeling of being unwell is describing which type of acute bacterial prostatitis

A

Acute bacterial prostatitis

35
Q

_____ is an ascending infection pup the vas defers from the prostatic urethra

A

Epididymitis

36
Q

List the symptoms of epididymitis

A
  • scrotal pain, fever, urethral discharge, urinary symptoms, epipdymis is sensitive to palpation and enlarged
37
Q

Predisposing factors for epididymitis

A
  • severe physical strain
  • heightened sexual activity
  • STD
  • recent urethral instrumentation
38
Q

________ is the foreskin of the penis of an uncircumcised male cannot be fully retracted

A

Phimosis

39
Q

________ the forskin becomes trapped behind the ridge of the glans penis and cannot fully be pulled back to its normal position

A

Paraphimosis

40
Q

_______ is 5x more potent than testosterone and is a major factor in BPH and prostate cancer

A

DHT

41
Q

what are the mainstream prostate cancer treatment agents

A
  • 5 alpha reductase inhibitors 9finasteride)

- Antiandrogens (flutamide)

42
Q

most common cancer in males

A

testicular cancer

43
Q

What tumor markers for testicular cancer

A
  1. AFP alpha fetoproein
  2. HCG
  3. LDH
44
Q

Patients with testicular cancer

A
  1. painless unilateral testicular
  2. dull ache in scrotum
  3. scrotal heaviness
45
Q

Testicular cancer is 40x more common is _____

A

misolaced testes