Prostate

Question 1

Where is the tunica vaginalis?

Answer 1

Exterior to the testes

Question 2

There are 4 common lesions of the tunica vaginalis. What are they?

Answer 2

Hematocele
Chylocele
Spermatocele
Varicocele

Question 3

Hematocele

Answer 3

Collection of blood usually from trauma

Question 4

Chylocele and what is its association?

Answer 4

Collection of lymph

– associated with elephantiasis (lymph obstruction)

Question 5

Spermatocele

Answer 5

Collection of semen in ducts

Question 6

Varicocele

Answer 6

Dilated vein in the spermatic cord that looks like a bag of worms

Question 7

What are the 4 zones of the Prostate?

Answer 7

Peripheral
Central
Transition
Periurethral

Question 8

The prostate consists of ___ separated by fibromuscular stroma. What cell types are the ____ lined by?

Answer 8

GLANDS

- lined by cuboidal and overlying columnar secreting cells

Question 9

What controls the growth and survival of the prostatic cells?

Answer 9

Testicular androgens

– thus castration causes atrophy of the prostate gland

Question 10

Acute and Chronic Bacterial Prostatitis (inflammation) causing bacteria are similar to the common ones that cause?

Answer 10

UTI’s

Question 11

What are the symptoms of Acute Bacterial Prostatitis?

Answer 11

Fever
Chills
Dysuria
Tender and boggy prostate

Question 12

What are the symptoms of Acute Bacterial Prostatitis?

Answer 12

Fever/chills
Dysuria
Tender and boggy prostate

Question 13

With Chronic Bacterial Prostatitis, what will the patient have a history of?

Answer 13

Recurrent UTI’s

Question 14

What are the symptoms (if they have any) of Chronic Bacterial Prostatitis?

Answer 14

Lower back pain
Perineal/suprapubic pain
Dysuria

Question 15

What are the symptoms (if they have any) of Chronic Bacterial Prostatitis?

Answer 15

Lower back pain
Perineal/suprapubic pain
Dysuria

Question 16

With Chronic Bacterial Prostatitis, what will be present in the prostatic secretions and what will be result of the culture?

Answer 16

Leukocytosis in the secretions

(+) culture

Question 17

What are the symptoms of Chronic Abacterial Prostatitis?

Answer 17

Same as Chronic Bacterial

= Lower back pain, perineal/suprapubic pain, dysuria

Question 18

With Chronic Abacterial Prostatitis, is there a history of recurrent UTI’s?

Answer 18

NO

Question 19

With Chronic Abacterial Prostatitis, what will be present in the prostatic secretions and what is the result of the culture?

Answer 19

Leukocytosis in the secretions

(-) culture

Question 20

Granulomatous Prostatitis has many causes. What are the 3 most common?

Answer 20

1. Instillation of BCG for bladder cancer treatment
2. Reaction from secretions from ruptured prostatic ducts/acini
3. Fungal

Question 21

Granulomatous Prostatitis has many causes. What are the 3 most common?

Answer 21

1. Instillation of BCG for bladder cancer treatment
2. Reaction from secretions from ruptured prostatic ducts/acini
3. Fungal

Question 22

What zone does BPH affect?

Answer 22

Transition zone

= Compresses urethra

Question 23

What zone does BPH affect?

Answer 23

Transition zone

= Compresses urethra

Question 24

What is the main culprit that incites the events that lead to BPH?

Answer 24

Dihydrotestosterone (DHT)

Question 25

With BPH, what cells does DHT activate?

Answer 25

Stromal cells

Question 26

With BPH, DHT activates stromal cells. What molecules do stromal cells activate and what does that result in?

Answer 26

TGF-beta = epithelial cell death | IGFs, EGF, KGF = epithelial cell proliferation

Question 27

When stromal cells (+) TGF-beta that results in epithelial cell death. What can (-) that in order to cause BPH?

Answer 27

Estrogen

Question 28

When stromal cells (+) IGFs, EGF, KGF that results in epithelial cell proliferation. What does that result in and what can help further that along?

Answer 28

BPH | -- estrogen (+) as well

Question 29

BPH is due to what cell proliferating?

Answer 29

Epithelial cells

Question 30

How does Estrogen progress BPH?

Answer 30

(+) epithelial cell proliferation | (-) epithelial cell death

Question 31

What type of malignancy commonly affects the Prostate?

Answer 31

Adenocarcinoma

Question 32

What type of malignancy commonly affects the prostate?

Answer 32

Adenocarcinoma

Question 33

What type of diet is a risk factor for Prostatic Adenocarcinoma?

Answer 33

Western diet of red meats and animal fats

Question 34

What mutations can also increase the risk for Prostatic Adenocarcinoma?

Answer 34

MYC MMR HOXB13

Question 35

What fusion gene is responsible for Prostatic Adenocarcinoma?

Answer 35

TMPRSS - ETS fusion gene

Question 36

What fusion gene is responsible for Prostatic Adenocarcinoma?

Answer 36

TMPRSS - ETS fusion gene

Question 37

The ETS gene is involved with the fusion gene that causes prostatic adenocarcinoma. What are its 2 most common forms?

Answer 37

ERG | ETV1

Question 38

After the TMPRSS - ETS fusion gene arises, what is lost in order for prostatic adenocarcinoma to arise?

Answer 38

P27 loss

Question 39

What zone does Prostatic Adenocarcinomas affect?

Answer 39

Peripheral zone

Question 40

What zone does Prostatic Adenocarcinomas affect?

Answer 40

Peripheral zone

Question 41

Prostatic Adenocarcinomas usually arise in the peripheral zone. Why is that significant?

Answer 41

That zone is posteriorly which allows for the cancer to be palpable on a DRE

Question 42

What 3 morphologic changes are present wit Prostatic Adenocarcinoma?

Answer 42

1. Perineural invasion 2. Absence of basal cells 3. Upregulation of AMACR

Question 43

What 3 morphologic changes are present with Prostatic Adenocarcinomas?

Answer 43

1. Perineural invasion 2. Absence of basal cells 3. Upregulation of AMACR

Question 44

What may be elevated in the serum with prostatic adenocarcinoma that is NOT cancer specific?

Answer 44

PSA

Question 45

What is PSA good for with Prostatic Adenocarcinomas?

Answer 45

Monitoring treatment