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Reproductive-Week 1/2 > Pathology of Prostate > Flashcards

Pathology of Prostate Flashcards

1
Q

gland distal to the bladder; surrounds the urethra; provides ~30% of seminal secretions and has testosterone receptors

A

Prostate

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2
Q

Two types of epithelial cells of prostate and their chemical markers

A
  1. Luminal (secretory cells) –> PSA+ and PAP+

2. Basal cells –> HMCK+

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3
Q

Zones of the prostate

A

Peripheral zone
Transitional zone
Central zone

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4
Q

Zone of prostate 75% of total prostate volume and where most carcinomas arise

A

Peripheral zone

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5
Q

Zone of prostate most prone to hyperplasias

A

Transitional

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6
Q

Zone of prostate that is most RESISTANT to pathology

A

Central zone

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7
Q

Normal prostatic growth depends on _________; blocking these can help with hyperplasia and malignancies

A

androgens

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8
Q

testosterone is required for prostatic hyperplasia and carcinoma (True or False)

A

False: testosterone is converted to di-hydrotestosterone (DHT) by prostatic cells, and that contributes to hyperplasia and carcinoma

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9
Q

Receptors in the prostate

A

a-receptors (in stromal tissue)

Testosterone receptors

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10
Q

increased amount of prostate stromal and epithelial tissue; increased prevalence with age; more glands with dilated lumens; associated with increased a-1 receptors (increased smooth muscle resulting in restricted urine flow)

A

Benign Prostatic Hyperplasia

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11
Q

In the setting of BPH, the degree of obstruction doesn’t correlate with severity of symptoms, and vice versa (True or False)

A

True

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12
Q

Common symptoms of BPH

A

Hesitancy
Slow stream
Straining to void
Frequency/nocturia/urgency

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13
Q 
Symptoms and Severity
Prostate exam
Urinarlysis
PSA
Flow and residual volume
Frequency and volume charts...

can be used to

A

Diagnose for BPH

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14
Q

Treatment for BPH

A

a1-blockers (help relax urethra)

5a-reductase inhibitors (Finasteride)

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15
Q

Side effects for a-receptor blockers

A 
Postural hypotension/dizziness
Retrograde ejaculation (relaxed sphincter)
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16
Q

Side effects for 5a reductase inhibitors

A

Decrease PSA by 50% after 6 months

post-finasteride syndrome

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17
Q

Procedural treatments for BPH

A

TURP (trim away)
Urolift (dilation of urethra)
Simple Prostatectomy (remove)

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18
Q

inflammation of prostate; ranges from acute bacterial infection of the prostate to chronic aching in pelvic region; almost always NOT caused by infection; very common and can present before age 50

A

Prostatitis

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19
Q

Most common type of Prostatitis

A

Type III (chronic non-bacterial) (95%)

20
Q

type of prostatitis; caused by gram negative rods; NEUTROPHILS are seen on microscopy; believed to be caused by refluxed urine, contamination via intercourse or compromised immunity; presents with fever/chills, boggy prostate

A

Acute Bacterial Prostatitis

21
Q

Diagnostic test for Acute Bacterial Prostatitis

A

Voided Urine
CT scan for abscesses

DON’T due prostate massage (risk of bacteremia/sepsis)

22
Q

Treatment for Acute Bacterial Prostatitis

A

Antibiotics (especially quinolones)

23
Q

Why are quinolones preferred for treating bacterial prostatitis

A

can penetrate the prostate tissue well

24
Q

type of prostatitis; prostate serves as a long-term reservoir for bacteria with recurrent symptoms; urinary difficulties WITHOUT fever; LYMPHOCYTES seen on microscopy

A

Chronic Bacterial Prostatitis

25
Q

Diagnostic tests for Chronic Bacterial Prostatitis

A

Post massage urine culture

26
Q

Treatment for Chronic Bacterial Prostatitis

A

Quinolones or Sulfa antibiotics for 4-6 weeks (long course!)

27
Q

type of prostatitis; most common form; relapsing problem with significant impact on quality of life; unknown etiology; pain in pelvis, voiding and sexual dysfunction

A

Non-Bacterial Prostatitis

28
Q

Diagnostic tests for Non-Bacterial Prostatitis

A

4 glass test

Residual volume

29
Q

Treatment for Non-Bacterial Prostatitis

A

NO antibiotics!

Lifestyle changes
Treat symptoms

30
Q

How can you tell between chronic bacterial prostatitis and non-bacterial prostatitis

A

4 glass test

31
Q

Explain the 4 glass test for determining the type of prostatitis (chronic bacterial or non-bacterial)

A

VB1: initial urine
VB2: midstream urine
EPS: prostatic massage fluid
VB3: post massage urine

all negative= non-bacterial prostatitis

32
Q

Risk factors for prostate cancer

A

Age
Family history
Race (African American)

33
Q

95% of prostate cancers occur between the ages of ____ and ____

A

45-90

34
Q

What are some examples of Prostate Cancer Screening

A

Digital Rectal Examination (finger test)

Serum Tumor Markers (PSA blood test)

35
Q

When would a TRUS (ultrasound) and prostate biopsy be indicated

A

When you have a positive screening

36
Q

What findings on digital examination of the prostate are worrisome

A

Nodules
Loss of distinct borders
Fixed to pelvic wall

(asymmetry, enlargement or loss of sulcus NOT worrisome)

37
Q

antigen specific for the prostate; glycoprotein present in ejaculate; most useful for longitudinal marker for prostatic abnormalities (NOT cancer specific!)

A

Prostate Specific Antigen (PSA)

38
Q

What level of PSA density (PSA/prostate volume) indicates for biopsy?

A

> 1.5

39
Q

What age range is it now recommended to start screening for prostate cancer

A

55-69 years old

40
Q

What testings are used to after prostate cancer screening is positive?

A

TRUS (prostate U/S)

Prostate Needle Biopsy

41
Q

Transrectal Ultrasound (TRUS) are NOT diagnostic (True or False)

A

True

42
Q

vast majority of prostate cancers (98%); firm, yellow nodule grossly; numerous small glands and lack of basal cell layer and prominent nucleoli; PSA+ and PAP+; most arise in PERIPHERAL ZONE

A

Prostate adenocarcinoma

43
Q

histologic grading for Prostate Adenocarcinoma; higher scores correlate to worsening differentiation

A

Gleason score

44
Q

Treatment for Prostate Cancer

A

Hormone Therapy/Medication
Radiation
Surgery (Prostatectomy)

45
Q

Common sites of metastases by prostate CARCINOMA

A

regional lymph nodes

BONE!

46
Q

What serum marker is helpful for tracking prostate cancer metastases

A

PSA

47
Q

Treatment for Metastatic Prostate Cancer

A

Androgen Ablation (block testosterone action)
Chemo
Palliative therapy

Reproductive-Week 1/2 (14 decks)

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