Prostate Pathology: Norton

Question 1

what are the 4 zones of the prostate

Answer 1

1. peripheral
2. central
3. transitional
4. anterior fibromuscular stroma

Question 2

what zone of the prostate is the most common site for carciomas? hyperplasia?

Answer 2

carcinoma: peripheral
hyperplasia: transitional

Question 3

What are the 2 layers that line the prostate gland

Answer 3

1. basal layer of cuboidal epithelium

2. inner layer of columnar secretory epithelium

Question 4

What separates the prostate glands

Answer 4

fibromuscular stroma

Question 5

What role does prostatic fluid play

Answer 5

protects and increases motility of sperm

Question 6

what control growth and survival of prostate cells

Answer 6

testicular androgens

Question 7

what are 3 pathological processes that occur in prostate

Answer 7

1. inflammation
2. Benign prostatic hyperplasia (BPH)
3. protsatic hyperplasia

Question 8

What are 4 types of prostate inflammation

Answer 8

acute bacterial prostatitis
chronic bacterial prostatitis
chronic abacterial prostatitis
granulomatous prostatitis

Question 9

what are common bacteria that cause acute bacterial prostatitis

Answer 9

same as UTI

• E.coli
• other gram -
• enterococci
• staph

Question 10

clinical features of acute bacterial prostatitis

Answer 10

fever
chills
dysuria
prostate TENDER

Question 11

what is the urinalysis for acute bacterial prostatitis

Answer 11

positive leucocytes

positive bacteria

Question 12

clinical features of chronic bacterial prostatitis

Answer 12

mild symptoms 
back pain
dysuria 
pernieal and suprapubic discomfort
asymptomatic

Question 13

a male with chronic bacterial prostatitis may have a history of what

Answer 13

recurrent UTI

Question 14

urinalysis for chronic bacterial prostatitis

Answer 14

positive leucocytes

positive bacterial

Question 15

What is the most common form of prostatitis

Answer 15

chronic abacterial prostatitis

Question 16

urinalysis of chronic abacterial prostatitis

Answer 16

positive leucocytes

negative bacterial culture

Question 17

clinical symptoms for chronic abacterial prostatitis

Answer 17

similar to chronic bacterial prostatitis

Question 18

How can a male get Granulomatous prostatitis

Answer 18

from Bacillus Calmette-Guerin (BCG) instilled into bladder to treat superficial bladder cancer

Question 19

what is the main prostate hormone

Answer 19

DHT dihydrotestosterone

Question 20

What converts testosterone to DHT

Answer 20

type 2

5 alpha reductase

Question 21

What does DHT bind to in prostate

Answer 21

androgen receptors on nuclei of stormal and epithelial cells

Question 22

What is the etiology of BPH ( benign prostatic hyperplasia)

Answer 22

increased number of epithelial cells and stromal components influenced by DHT

Question 23

Benign prostatic hyperplasia originates in what part of the prostate

Answer 23

transition zone (periurethral)

Question 24

What are late and early nodules of prostate in BPH composed of

Answer 24

early: stromal cells
late: epithelial cells/glands

Question 25

What is a clinical feature for benign prostatic hyperplasia

Answer 25

urethral obstruction causes - bladder hypertophy and distension - urine retention - sudden acute urinary retention

Question 26

what are some conservative treatment options for benign prostatic hyperplasia

Answer 26

decrease fluids before bedtime | decrease caffeine and alcohol

Question 27

what are 2 medication options for moderate to severe symptoms of BPH

Answer 27

1. alpha blockers | 2. 5-alpha reductase inhibitors

Question 28

How do alpha-blockers help with BPH

Answer 28

decrease smooth muscle tone

Question 29

how do alpha blockers help with BPH

Answer 29

decrease smooth muscle tone

Question 30

what is a surgical option for BPH

Answer 30

transurethral resection of prostate

Question 31

What type of diet can give you a greater risk for prostate adenocarcinoma

Answer 31

high fat diet

Question 32

What are 3 things that can cause prostate adenocarcinoma

Answer 32

diet androgens genetics

Question 33

What is a precursor lesion to prostate adenocarcinoma

Answer 33

porstate intraepithelial neoplasia (PIN)

Question 34

prostate intraepithelial neoplasia is seen in what zone

Answer 34

peripheral zone

Question 35

how do PIN glands differ from prostate adenocarcinoma

Answer 35

- larger than cancer glands with branching/folding | - surrounded by patchy layer of basal cells and intact basement membrane

Question 36

what is histo for prostate adenocarcinoma

Answer 36

- glands small - croweded - no branching/folding - no stroma - "back-to-back" glands

Question 37

What lines the glands in prostate adenocarcinoma

Answer 37

single layer of cuboidal or columnar cells | OUTER BASAL CELL LAYER IS ABSENT

Question 38

where does prostate adenocarcinoma spread to

Answer 38

periprostatic tissues seminal vesicles base of bladder

Question 39

what are 2 routs of mestastasis for prostate adenocarcinoma

Answer 39

lymphatics | blood

Question 40

if prostate adenocarcinoma mets via lymph , where does it go

Answer 40

obtruator nodes then to paraaortic nodes

Question 41

if prostate adenocarcinoma mets via blood, where does it go? what is formed?

Answer 41

bones - lumbar spine - proximal femur - thoracic spine - ribs forms osteoblastic lesions

Question 42

how is prostate adnenocarcinoma scored

Answer 42

``` adding 1. prominent pattern 2. second most prominent pattern OR 1. prominent pattern 2. highest grade pattern ```

Question 43

what is the lowest grade for prostate adnenocarcinoma

Answer 43

gleason 1

Question 44

what is the highest grade for prostate adnenocarcinoma

Answer 44

Gleason 5

Question 45

What are 2 methods that detect what is the lowest grade for prostate adnenocarcinoma

Answer 45

1. digital rectal exam (DRE) | 2. tranrectal ultrasonography

Question 46

what confirms diagnosis of prostate adenocarcinoma

Answer 46

transrectal needle biopsy

Question 47

what is clinical feature of local prostate cancer

Answer 47

asymptomatic - later urinary symptoms - back pain

Question 48

for prostate adnenocarcinoma what is most important test for screening

Answer 48

PSA | prostate specific antigen

Question 49

what is most common treatment for localized prostate adnenocarcinoma

Answer 49

surgery: radical prostatectomy

Question 50

what are treatment options for prostate adnenocarcinoma

Answer 50

radiation hormone manipulation acute surveillance of PSA