prostate Flashcards
Describe the zones of the prostate and the diseases that may be associated with each of them Describe the presentation and types of prostatic inflammation and how they may mimic malignancy Describe benign prostatic hyperplasia including its presentation and underlying pathologic process Describe the clinicopathologic features of prostate cancer and its precursor lesion (PIN) Be able to interpret PSA levels in regards to possible prostatic causes Describe the Gleason grading system for prost
zone of prostate with most hyperplastic lesions
inner transition
zone of prostate with most carcinomas
peripheral zones
urinary obstructing benign lesions most likely orginates in
inner transition zone
most common type of prostatitis
chronic non bacterial/chronic pelvic pain syndrome
tender and boggy prostate on DRE with fever, chills and disuria
acute bacterial prostatitis
low back pain, dysuria, perineal/suprapubic discomfort
chronic bacterial/nonbacterial prostatitis
really is a pain in the ass to diagnose
chronic nonbacterial prostatsis
cause of BPH
androgen-dependant growth of stromal and glandular elements
chemical produced by prostate
dihydrotestosterone
drug type that can exacerbate BPH
alpha 1 adrenergic agonists
zone where BPH occurs
inner transitional zone
gross apperance of BPH
enlarged prostate with well-circumscribed solid or cystic nodules
secretory material in the glandular lumina produced by BPH
corpora amylacea
most common clinical manifestation of BPH
hesitancy and inturruption of the stream while voiding, urinary urgency, nocturia, incerased urinary frequency
ddx of BPH
urethral stricture or impaired bladder detrusor muscle
prostate cancer is what kind of tumor
adenocarcinoma
prostate cancer is dependant on what for survival
androgens
mutation common in prostate cancer as it progrosses
permits androgen receptors to activate the expression of the target genes even in the absence of the hormones
common genes in prostate cancer
TMPRSS2-ETS
signaling pathway activated in prostate cancer
Pi3K/AKT inactivating PTEN
gene that may lead to more prostate caner in blacks
MYC on 8q24
gross morphology of prostate cancer
more solid whitish mass than the spongy normal stroma
prostatic cancer grading system
gleason
how to use gleason grading system
addisn the primary and secondary patterns 1-5 value and add (1 for well-differentated, 5 for no glandular differentiaion)
DRE exam finding with prostate cancer
irregular hard nodule
pattern of spread of prostate cancer
seminal vesciles, wall of urinary bladder, to rectum, advacing to axial skeleton
level of PSA considered abnormal
generally 4
PSA finding more indicitive of cancer
ratio of free PSA to total PSA
may to assess prostate cancer therapy response
change in PSA
