Prostate Pathologies

Question 1

What is acute prostatitis typically a complication of?

Answer 1

UTIs

Question 2

What are the four parts of the urethra from internal to external?

Answer 2

Prostatic
Membranous
Spongy
Penile

Question 3

Where is sperm made?

Answer 3

Seminiferous tubules

Question 4

What two structures form the ejaculatory duct?

Answer 4

Seminiferous tubules and ductus deferens

Question 5

What is prostatitis?

Answer 5

Inflammation of the prostate typically from a UTI or reflux of infected urine into the prostate

Question 6

Prostatitis is treated with ________________?

Answer 6

Antibiotics

Question 7

35 year old male patient presents to your office complaining of painful urination. The patient also reports low back pain and pain in the area around the groin. The patient has a fever of 101.1 and is cold and clammy. CBC shows 14000 WBC and 80% neutrophils. A biopsy of the prostate is performed and inflammatory infiltrate of neutrophils and macrophages is seen in prostatic acini and stroma. What is the likely diagnosis?

Answer 7

Acute prostatitis

Question 8

What is the normal epithelium of the prostate?

Answer 8

Simple cuboidal

Question 9

49 year old male patient presents to your office complaining of painful urination around the opening of the penis. He reports that this problem has been going on for months and that he is frequently experiencing low back pain and frequent urination at night. PSA tests show a PSA of 2.5. Urinalysis is positive for escheria coli. Biopsy of the prostate shows high amounts of lymphocytes and plasma cells. What is the likely diagnosis?

Answer 9

Chronic bacterial prostatitis

Question 10

What is non-bacterial prostatitis?

Answer 10

A diagnosis of exclusion in men over 50 with no identifiable cause

Question 11

What is the most common form of inflammation in prostatic biopsies?

Answer 11

Non-bacterial prostatitis

Question 12

What is benign prostatic hyperplasia also called?

Answer 12

Nodular prostatic hyperplasia

Question 13

What enzyme converts testosterone to dihydrotestosterone (DHT)?

Answer 13

5 alpha reductase

Question 14

What hormone is primarily responsible for growing the prostate?

Answer 14

Dihydrotestosterone (DHT)

Question 15

What part of the prostate is most affected by DHT?

Answer 15

Periurethral zone

Question 16

What is the normal age range for a patient with BPH or prostate carcinoma?

Answer 16

70+

Question 17

71 year old male patient presents to your office complaining of frequent urination that has him getting up in the middle of the night as well as some non-specific low back pain that has progressed for the past few months. A digital rectal exam reveals a firm, enlarged, nodular prostate. PSA Test demonstrates a PSA level of 5.2. What is the likely diagnosis and what can this lead to if untreated?

Answer 17

Benign prostatic hyperplasia that can lead to hydroureter, hydronephrosis, renal failure, and prostate carcinoma

Question 18

Where is the uvula vesicae located?

Answer 18

Prostate gland

Question 19

How can benign prostatic hypertrophy lead to heart failure?

Answer 19

BPH can cause decreased kidney function due to compression of the urethra leading to backflow and hydronephrosis. This causes an increase in kidney blood pressure and the heart works harder leading to left sided heart failure

Question 20

BPH can cause (Right/Left) sided heart failure?

Answer 20

Left

Question 21

What is the most common cancer in men?

Answer 21

Prostate adenocarcinoma

Question 22

How will a prostate feel on digital rectal exam if a patient has BPH?

Answer 22

Enlarged, firm, nodular

Question 23

How will a prostate feel on digital rectal exam if a patient has prostate adenocarcinoma?

Answer 23

Stony, hard, craggy, “coral-like” prostate

Question 24

72 year old male patient presents to your office complaining of low back pain and frequent urination throughout the day and at night. Also, he decided to come in because he started seeing some blood in his stool. A PSA test is performed and demonstrates a value of 16. A digital rectal exam is performed and the prostate feels craggy and stony. A biopsy of the prostate is performed and Gleason grades of 5 and 4 are given for a Gleason score of 9. What is the likely diagnosis and what is the chief concern after diagnosis?

Answer 24

Prostate adenocarcinoma with a chief concern of metastatic spread to the lumbosacral spine

Question 25

Where does prostate cancer commonly Mets to?

Answer 25

Bone (LS JXN)