Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GU > Prostate Conditions > Flashcards

Prostate Conditions Flashcards

1
Q

What causes acute bacterial prostatitis?

A

MC gram negative: E.coli and pseudomonas

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

What is the presentation for acute bacterial prostatis?

A

Abrupt:
PERINEAL, SACRAL, suprapubic pan

High FEVER

Initiative voiding
+//- urinary retention

Exquisitely tender prostate
(GENTLE DRE) NO PROSTATIC MASSAGE could have bacteria leak out and cause septicemia

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

What are the labs for acute bacterial prostatis?

A

UA: pyuria, bacteriuria, hematuria
CBC: leukocytosis
Urine culture: + offending pathogen

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

What is the treatment for acute bacterial prostatitis?

A

You have to base your abx off of you cultures

IV: fluoroqunolone + aminoglycoside
(Ciprofloxacin/levofloxacin + gentamicin or tobramycin)

P.O.: fluoroquinolone: TMP-SMX after afebrile for 24 hours

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

When would you admit for acute bacterial prostatitis?

A

Septicemia, comorbidities, unlikely to f/u

Initiate parenteral broad spectrum: ampicillin + aminoglycoside

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

How long is treatment for acute bacterial prostatitis?

A

4-6 weeks

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

What happens if urinary retention develops as a result of acute bacterial prostatitis?

A

Percutaneous suprapubic tube indicated

URETHRAL CATH CI DUE TO RISK OF SEPTICEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the f/u for acute bacterial prostatitis?

A

Urine and prostatic secretion culture to ensure eradication

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

Patient presents w/ irritating voiding symptoms, low back pain, perineal pain, HX OF UTIs w/ a prostatic calculi?

A

Chronic bacterial prostatis?

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

How do the labs for chronic and acute bacterial prostatitis differ?

A

In chronic the UA and culture are likely unremarkable and you WANT TO DO A POSTPROSTATIC MASSAGE W/ EXPRESSED PRSTATIC SECRECTIONS: indicates inflammation not necessarily infection

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

What is the treatment for chronic bacterial prostatitis?

A

TMP-sulfamethoxazole 6-12 weeks

Symptomatic relief
NSAIDS or sitz baths

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

What are your options for if treatment for chronic bacterial prostatitis fails?

A

Try again w/ longer course of abx

Consider possibility of infected prostate stone

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

What is the MC prostatitis?

A

Chronic non bacterial prostatitis

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

What is the difference between the clinical presentation of chronic bacterial and non bacterial prostatitis?

A

Nonbacterial prostatitis does not have a hx of UTIs

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

How are the labs for bacterial and non bacterial chronic prostatitis different?

A

They will both show increased leukocytes on prostatic secretions becuase that indicated inflammation not infection, but all cultures are negative

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

What is thee treatment for chronic nonbacterial prostatitis?

A

Trial of abx against atypical organisms

ERYTHROMYCIN: 14 DAYS

NSAIDs
Sitz baths

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

What is prostatodynia?

A

Voiding dysfunction or pelvic floor musculature dysfunction

Leads to similar symptoms as chronic prostatis, but everything is normal.

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

What is the treatment for prostatodynia?

A

Alpha-blockers: bladder neck and urethral spasms

Diazepam: pelvic floor dysfunction

Sitz baths

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

What 2 factors are essential for BPH development?

A

DHT, aging

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

What does 5-alpha-reductase do?

A

Converts testosterone to DHT

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

What does DHT do?

A

Promotes prostate cell proliferation, leading to BPH

22
Q

What is the pathology of BPH?

A

Hyperplastic process increasing cell numbers leads to nodular growth pattern.

Growth occurs in the transition zone and includes stroma and epithelium

23
Q

How do the treatments for BPH affect the different tissue types?

A

Alpha blockers decrease the tone of the prostatic stroma

5 alpha reductase inhibitor: works on the increased prostate epithelium

24
Q

What are the two ways that symptoms can show for BPH?

A

Obstructive and irritating

25
Q

What is the single most important tool for the evaluation of BPH?

A

American urological association symptom index (questionnaire)

26
Q

How does the prostate feel in BPH?

A

Smooth, firm, elastic enlargement,

If there is induration further work up needed to rule out cancer (Transrectal U/S and biopsy)

27
Q

If the AUA score is >=8 what are other studies you can consider for BPH?

A

Urodynamic studies or Post void residual

28
Q

When should you get imaging for BPH?

A

Only if there are complications: hematuria, UTI, CKD, urinary stone disease

29
Q

What lab do you need to get for BPH?

A

UA to rule out infection and PSA to r/o cancer

30
Q

What is the treatment for mild BPH (AUA score 0-7)?

A

Watchful waiting , some men will undergo spontaneous resolution

31
Q

What is the treament for moderate to severe symptoms of BPH?

A

Watchful waiting, surgery, medical therapy

32
Q

What are absolute surgical indications for BPH?

+/-

A

Refractor urinary retention (failing at least 1 attempt at catheter removal)

Large bladder diverticula

BPH sequelae:

  1. Recurrent UTI
  2. Recurrent or persistent hematuria
  3. Bladder stones
  4. CKD (renal insufficiency/failure)
33
Q

what does the 5-alpha-reducatase inhibitor do finasteride do?

A

reduces serum PSA by 50%

34
Q

what if you have BPH and erectile dysfunction?

A

tadalafil

35
Q

what are the essentials for diagnosis of prostate cancer?

A

PROSTATIC INDURATION on DRE or PSA elevation

36
Q

what is the MC non cutaneous cancer in men in US?

A

prostate

37
Q

what is the 2nd leading cause of cancer-related death

A

prostate cancer

38
Q

if you have symptoms w/ prostate cancer what does that mean?

A

locally advanced or metastatic disease, think bone pain or lumbar spine pain, obstructive or irritative

39
Q

what labs are important for indicating prostate cancer and what level means confined to the prostate and what level indicates advanced disease?

A

PSA
retention or obstruction: inc. BUN or creatinine
skeletal metastases: inc. alk phos or hypercalcemia

confined: <10ng/mL
advanced: PSA >40 ng/mL

40
Q

what is important to remember about PSA and prostate cancer?

A

even if it’s negative you can still have cancer

41
Q

what do you do if someone has an elevated PSA?

A

ultrasound and biopsy

42
Q

what do you do if someone has an abnomral DRE, but a normal PSA>

A

refer for u/s and biopsy

43
Q

if a patient is older and has a low cancer risk what is an option for prostate cancer treatment?

A

active surveilance

44
Q

who is a poor candidate for radical prostectomy?

A

T4 advanced disease or lymph node mets (not good candidates)

45
Q

what is a good treatment for cancer that has metastasized?

A

androgen suppression via hormonal therapy

46
Q

what is used for prognosis of prostate cancer and what does a high score mean?

A

CAPRA nomogram

higher is worse

47
Q

what’s prevention of prostate cancer?

A 
antioxidants
cruciferous veggies
vit. D
omega 3
lose weight
dont smoke
high fiber/low fat
green tea (polyphenols)
decreased ETOH intake
48
Q

what is the screening criteria for prostate cancer according to american cancer society?

A 
begin at 50 for average age white
45 at w/ high risk
-black
-BRCA-1
-FAm HX

stop when life expectancy <10years

49
Q

what does the USPSTF recommend for prostate cancer screening?

A

against it

50
Q

what rate for PSA change indicates cancer?

A

> .75 ng/mL/ year

51
Q

what does free PSA indicate?

A

> 25% cancer unlikely

<10% = 50% chance of cancer

GU (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions