Prostate

Question 1

Grade 3 prostate cancer

grade 4

Grade 5

Answer 1

Grade 3 prostate cancer: small glands, infiltration, loss of double cell layer

grade 4: prominent nucleoli, non basement cells, fusion of glands

Grade 5: single cells

Question 2

clinical findings in acute/chronic prostatitis

serum findings

Answer 2

Fever

lower back / perineal / suprapubic pain

painful, swollen gland on rectal

dysuria, hematuria

elevated sserum PSA (>4.0)

Question 2

Cancer prostate staging (“T”0

Answer 2

T1, T1a - incidental tumor in
T1b > tumor >5%

T2, T2a tumor in
T2b tumor in moree than half of one lobe, but not both
T2c tumor in left AND right lobe

T3, T3a: extraprostatic extension into fat
T3b invasion to one or both seminal veiscles

T4 invasion to near by structures

Question 2

prostatic carcinoma spread

Answer 2

seminal veiscles

external iliac nodes

boney metastasis due to BAtson venous plexus (elevated prostatic alk phas, PSA increased)

possible compression of spinal cord

Question 3

Chronic non bacterial prostatitis (chronic pelvic pain syndrome)

presentation and etiology

Answer 3

prostatitis without UTI or positiive cultures

Chlamydia trachomatis

Ureaplasma urealyticum

trihcomonas vaginalis

Question 3

histology granlulomatous prostatitis

chronic

Answer 3

aggregate of histiocytes (macrophages)

chronic - inflammatory cells, glands

Question 4

BPH is ____ dependent process

Answer 4

androgen (primarily DHT)

Question 6

normal prostate cellualr morphology

Answer 6

double cell layer:

secretory cells and basal cells

Question 7

causes of acute prostatitis

granulomatous

Answer 7

acute - intraprostate reflux, Rod bactera (E coli, aeruginosa, K pneumoniae)

granulomatous - instrumentation, bacille Calmette Guerin therapy for bladder cancer, others

Question 9

area of BPH

Answer 9

transitional

Question 10

indications for PSA screening

Answer 10

men over 50

Family Hx of Prostate CA

African AMericans

(increased risk screening begins at 40)

Question 12

Dx chronic bacterial prostatitis

Answer 12

10-12wbc/field in secretions/urine

AND

positive bacterial cultures

Question 12

causes granulomatous prostatitis

Answer 12

Infectious - Tuberculosis (hematogenous)

Fungal/mycotic (AIDS)

non infectious: Post surgical (biopsy rxn)

Post Bacille calmette guerin

non specific

Question 14

possible serum marker for BPH

Answer 14

elevated PSA

Question 15

role of PSA

Answer 15

increases sperm motility

maintains semilar secretions in liquid state

protease formed by epithelial cells of prostate

Question 16

prostatic precursor to invasive Cancer

does not raise PSA alone

Answer 16

High grade prostatic intraepithelial neoplasm HGPIN

Question 17

zone of most cancer incidence

Answer 17

Peripheral