Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal and Urology > prostate and bladder cancer > Flashcards

prostate and bladder cancer Flashcards

1
Q

prostate gland is located at

A

the neck of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the apex of the prostate gland is

A

counter-intuitively the inferior portion of the prostate gland and is continuous with the striated sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

the base of the prostate gland is

A

superior portion of the prostate gland and is continuous with the bladder neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

prostatic urethra is covered by

A

transtitiola epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is distal to the urethral angulation

A

verumonanum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ejaculatory ducts are the

A

union of seminal vesicles and each vas deferens and drain to either side of the prostatic urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

zonal anatomy of the prostate gland

A
  • transitional zone
  • central zone
  • peripheral zone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

transitional zone

A

surrounds the prostatic urethra proximal to the veromontanum only 20% of prostate cancers arise here and it mostly gives rise to BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

central zone

A

cone shaped region which surround the ejacultatory ducts, only 5% of prostate cancers arise in this region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

peripheral zone

A

posteriolateral prostate where the majority of prostate cancers arise from, origin of 70% of prostatic adenocarcinoams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

prostate cancer is rare in

A

under 50s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

increased risk of prostate cancer if

A

you are black rather than white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

presentation of prostate cancer

A

vast majority are asymptomatic and picked up by increased PSA levels and abnormal PR exam findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what can prostate cancer sometimes cause

A

lower urinary tract symptoms such as haamaturia hamatospermia anorexia and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

majority of prostate cancers arise from the

A

peripheral zone so can be felt on a PR exam from asymmetry, nodule or a fixed craggy mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

30% of patients with normal prostate specific antigen and abnormal PR exam

A

have prostate cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

prostate specific antigen is a

A

glycoprotein enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

prostate specific antigen is produced by

A

the secretory epithelial cells of the prostate gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

PSA is involved in

A

the liquefaction of semen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

sensitivity of PSA

A

in detecting prostate cancer is high 90% but specificity is low only 40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

other conditions which elevate PSA

A

BPH, PROSTATITIS, UTIS, URINARY RETENTION, CATHETERISATION, DIGITAL RECTAL EXAMINATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

indications for carrying out PSA levels

A
  • all symptomatic patients
  • in asymptomatic patients counselling for PSA testing should be given prior to carrying out PSA testing (i.e. you must explain that increased levels does not automatically mean prostate cancer)
23
Q

if PSA level is elevated then it requires a

A

trans-rectal ultrasound guided biopsy

24
Q

in those with elevated levels of PSA prostate cancer is present in only

A

ionly 5% of patients

25
indications for trans-rectal ultrasound
- abnormal DRE and increased PSA - Previous biopsies which show prostatic intra-epithelial neoplasia (PIEN) OR ASAP (atypical small acinar proliferation) - previous normal biopsies but rising PSA trends
26
during a trans rectal ultrasound
an ultrasound is passed into the rectum and 10 biopsies are taken
27
complications of a transrectla ultrasound
0.5% risk of sepsis, risk of recta bleeding haematospermia and haematuria occur for 2-3 weeks after the procedure
28
the vast majority of prostate cancers are
multi-focal adenocarcinomas
29
pattern of tumour growth in prostate cancer
extension through the prostatic capsule to the urethra and the bladder base to the seminal vesicles and with perineurial invasion along autonomic nerves
30
most common sites for metastatic deposits
pelvic lymph nodes and the bones where it causes sclerotic lesions rather than lytic lesions
31
what scoring system is used for prostate cancer
the gleason score
32
the leasing scoring system is used to determine
the aggressiveness of the prostate cancer
33
gleason score ranges from
1-5 and describes how much the tissue from the biopsy looks like healthy tissue (score of 1 is the lowest score) score of 5 is the highest and most abnormal score
34
prostate tumours are often made up of
cancerous cells that have different grades therefore, 2 grades are assigned per tumour
35
primary grade is given to the
cells that make up the larget part of the tumour
36
secondary grade is given to the
cells that make up the second largest part of the tumour
37
the primary grade and secondary grade are then added together to give
a total gleason score
38
gleason scores can range from between
2-10 (10 being the worse)
39
staging using TNM criteria
``` T1= tumour is not palpable T2= tumour is palpable but confined to the prostate T3= tumour extends through the prostate capsule T4= tumour has invaded adjacent structure other than the seminal vesicles N0= no regional lymph node metastases N1= regional lymph node metastases M0= no distant metastases M1= distant metastases ```
40
modalities for staging prostate cancer
Bone scan, CT, MRI
41
broad classification of prostate cancer
- organ confined disease= T1-2, NO,MO - locally advanced disease= T3-4, NO, MO - metastatic disease= N1 AND M1
42
management of organ confined disease
option 1= active surveillance i.e. the decision not to treat the patient immediately and to follow with close surveillance and treat at pre-defined thresholds that classify progression when treatment is initiated it will be curative option 2 = radical prostectomy OPTION 3 = radical radiotherapy (but has complications) option 4= conservative management of prostate cancer until it gets to a point where management is palliative appropriate in very elderly people with many co-morbidities
43
complications of a radical prostectomy
ERECTILE DYSFUNCITON, INCONTINENCE, BLADDER NECK STNEOSIS
44
complications of radical radiotherapy
irritatitive lower urinary tract symptoms, haeamturia, GI symptoms, erectile dysfunction, incontinence
45
management of locally advanced disease
option 1- radiotherapy with neo-adjucvant hormonal therapy (prostate cancer depends on testoreone to grow so by blocking testosterone you can slow its growth) option 2- watchful waiting in asymptomatic patients with well and modernly differentiated tumours who have a life expectancy of less than 10 years or using hormonal therapy in symptomatic patients but are unfit for curative treatment
46
anti-hormonal therapy used
- anti-androgens- bicalutamide or flutamide - GNRH blockers= degarelix - LHRH agonsits= leuprorelin
47
management of metastatic disease
- androgen deprivation therapy ( anti-androgens, GNRH blockers, LHRH agonists) - bilateral sub capsular orchidectomy - steroids - cytotoxic chemotherapy
48
how do LHRH agonists work
chronic exposure to LHRH Agonists eventually results in down regulation of lHRH receptors which subsequently surpasses the release of LH AND FSH FROM THE PITUITARY RESULTING IN REDUCED PRODUCTION OF TESTOSTERONE
49
Side effects of LHRH agonists
loss of libido, erectile dysfunction, hot flushes, gynaecomastia, osteoporosis
50
how do anti-androgens work
they compete with testosterone for the and DHT for the binding site on their receptors in the prostate cells using apoptosis of the prostate cells
51
types of anti-androgens
- steroidal (cyproterone acetate) | - non-steroidal (nilutanide and flutanide)
52
side affects of acproterone acetate
loss of libido, erectile dysfunction, hepatotoxic
53
side effects of nilutamide and flutamide
gynaecomastia and hepatotoxic

Renal and Urology (51 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions