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FINALS RENAL + UROLOGY > prostate > Flashcards

prostate Flashcards

1
Q

common causes LUTS in men

A

PBH or prostate cancer

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2
Q

voiding symptoms LUTS

A

hesitance, poor stream, straning, incomplete emptying, dribbling

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3
Q

storage symptoms LUTS

A

urgency, frequence, nocturia , incontinence

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4
Q

post-micturation LUTS symptoms

A

dribbling eg in pants, feeling incomplete

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5
Q

invx LUTS

A

urinalysis // PR // PSA

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6
Q

what scoring system affects LUTS affect on daily life

A

IPSS

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7
Q

mx voiding LUTS symptoms

A

physio // alpha blocker eg doxasocin,tamulosin // 5a reductase eg finasteride // anticholinergic eg Oxybutynin

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8
Q

mx overactive bladder (urge)

A

reduce fluid // bladder retraining // oxybutiin, tolterodine // mirebegron

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9
Q

mx nocturia LUTS

A

furosomide 40mg // desmopressin

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10
Q

symptoms BPH

A

LUTS (weak flow, straining, dribbling, hesitancy, urgency, frequency, nocturia, post-mic dribbling)

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11
Q

complications BPH

A

UTI, retention, obstrictive

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12
Q

invs BPH

A

urinalysis // U+Es // PSA // urinary frequency // IPPS

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13
Q

medical mx PBH

A

1 = alpha antagonist eg tamulosin // 2 = 5alpha eg

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14
Q

medical mx PBH

A

1 = alpha antagonist eg tamulosin // 2 = 5alpha eg finasteride // 3 = combination of alpha 5a if voiding symptoms // 3 = alpha + anticholinergic if storage and voiding

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15
Q

mechanism + SE alpha antagonists

A

decrease smooth muscle tone of bladder and prostate // dizzy, postural hypotension, dry mouth, depression

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16
Q

mechanism + SE 5a reductase inhibitors

A

block testosterone –> DHT (causes BPH) // ED, reduced libido, ejaculation problems, gynaecomastia

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17
Q

when are 5a reducatase inhibitors indicated in BPH

A

significantly large + progressing prostate // symptoms can take 6 months to resolve

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18
Q

surgery for BPH

A

transurethral resection (TURP)

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19
Q

complications TURP

A

haemorrhage, retrograde ejaculation, TURP syndrome

20
Q

what causes TURP syndrome

A

glycine irrigation in TURP –> hyponatraemia, hyperammonia

21
Q

symptoms TURP syndrome

A

CNS, respiratory, systemic symptoms, visual disturbance

22
Q

RF TURP syndrome

A

surgery >1hr // large resection // large blood loss // perforation // poorly controlled CHS

23
Q

RF prostate cancer

A

age, obese, black, FH

24
Q

possible symptoms prostate cancer

A

bladder outflow obstruction (hesitancy, retention) // haematuria, haematospermia // pain (back, balls, perineal)

25
Q

what causes PSA to rise

A

Cancer // prostatitis, UTI, BPH, retention // recent ejaculation // exercise // catheter

26
Q

what PSA warrants referall

A

aged 50-69 >3 OR abnormal PR

27
Q

invx prostate cancer

A

MRI

28
Q

what scale is used for reporting prostate cancer

A

5‑point Likert scale

29
Q

when is trans rectal USS + biopsy offered in prostate cancer

A

after MRI if score >3

30
Q

most common prostate cancer

A

adenocarcinoma (95%)

31
Q

what scoring is used for prognosis in prostate cancer

A

gleason (2 = good –> 10 = bad)

32
Q

which zone do prostate cancers usually arise

A

peripheral

33
Q

which nodes are often first affected prostate cancer

A

obturator (+ pelvic nodes)

34
Q

common mets prostate

A

bone!! spinal back pain can be first symptoms

35
Q

mx local prostate cancer (T1-2)

A

active monitoring // radical prostatectomy // radio

36
Q

mx local advanced prostate cancer (T3-4)

A

hormone therapy // radical prostatectomy // radiotherapy

37
Q

complication radical prostaectomy

A

erectile dysfunction

38
Q

complication prostate radiotherapy

A

increased risk: bladder, colon, rectal

39
Q

mechanism GnRH agonists + example

A

Goserelin // lower LH levels by overstimulating receptors

40
Q

what happens in the initial few weeks of GnRH analogue therapy

A

rise in testosterone –> can cause tumour flare

41
Q

what needs to be given during the first few weeks of GnRH agonists in prostate cancer

A

anti-androgen therapy

42
Q

mechanism bicalutamide prostate cancer

A

non-steroids anti-androgen // blocks androgen receptors

43
Q

mechanism cyproterone acetate
prostate cancer

A

steroidal anti-androgen // prevents DHT from binding

44
Q

mechanism abiraterone
prostate cancer

A

androgen sythesis inhibitor

45
Q

surgical hormone option protestatic cancer

A

bilateral orchidectomy

FINALS RENAL + UROLOGY (16 decks)

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