Prostate Flashcards
What is the most common cancer in men? What are three risk factos?
Prostate adenocarcinoma which is a malignant proliferation of prostatic glands. Risk factors include age, race (Blacks >Whites>Asians) and diet high in saturated fats.
How does prostatic carcinoma present clinically? Where does it arise?
Clincially silent. Usually arises in the peripheral, posterior region of the prostate and hence does not produce urinary symptoms early on.
When does screening begin for prostate cancer? What markers are used and what trend issuggestive of cancer?
Screening begins at age 50 with DRE and PSA. Decreased %free PSA is suggestive of cancer.
What are the normal levels of normal serum PSA in ages 40 - 49? 70- 79? What level of PSA is worrisome at any age?
2.5 ng/mL for ages 40-49 years vs. 7.5 ng/mL for ages 70- 79 years. PSA > 10 ng/mL is highly worrisome.
How is prostate carcinoma diagnosed? What is observed? What is Gleason grading system based on? What do the scores mean?
Prostatic biopsy which shows small, invasive glands with prominent nucleoli. Based on ARCHITECTURE alone. Higher score suggests worse prognosis.
Where does prostate carcinoma spread to? How does it present? What two values are elevated?
Spreads to lumbar spine or pelvis. Results in osteoblastic metastases that presents as low back pain and increased serum alkaline phosphatase, PSA and prostatic acid phosphatase (PAP)
How is localized prostate cancer treated? Advanced disease?
Prostatectomy is perfomred for localized disease. Advnaced disease is treated with hormone suppression to reduce testosterone and DHT.
How is localized prostate cancer treated? Advanced disease?
Prostatectomy is perfomred for localized disease. Advnaced disease is treated with hormone suppression to reduce testosterone and DHT.
What two drugs are used to treat advanced prostate cancer?
- Leuprolide (continuous GnRH analog) to shut down the anterior pituitary gonadotrophs (LH and FSH are reduced)
- Flutamide to competitively inhibit at the androgen receptor
Which part of the prostate is palpable by digital rectal exam? Which organ does it lie under?
Posterior aspect. Bladder.
What cells are the inner layers of the prostate gland composed of? Outer layers? What do they secrete and what is it used for? How are the glands and stroma maintained?
Luminal cells (inner) and basal cells (outer part). Secrete alkaline, milky fluid that is added to sperm and seminal vesicle fluid to make semen. By androgens.
A 23 year old student presents with dysuria with fever and chills. His prostate is tender and boggy on digital rectal exam. What is causing this presentation? What organisms are implicated? What would a culture show? What would prostatic secretions show?
Acute prostatits. Chlamidya trachomatis and Neisseria gonorrhea in young adults. Prostatic secretions show WBCs, culture shows bacteria.
A 53 year old student presents with dysuria with fever and chills. His prostate is tender and boggy on digital rectal exam. What is causing this presentation? What organisms are implicated? What would a culture show? What would prostatic secretions show?
Acute prostatits. E. coli and Pseudomonas in older adults. Prostatic secretions show WBCs, culture shows bacteria.
A 53 year old student presents with dysuria with fever and chills. His prostate is tender and boggy on digital rectal exam. What is causing this presentation? What organisms are implicated? What would a culture show? What would prostatic secretions show?
Acute prostatits. E. coli and Pseudomonas in older adults. Prostatic secretions show WBCs, culture shows bacteria.
A 43 year old man comes in with dysuria and pelic pain. He sometimes complained of low back pain. What could be causing it? What would a culture show? What would prostatic secretions show?
Chronic prostatitis. Prostatic secretions show WBCs, culture is negative.
