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D&T 4 exam 1 > Prostate Pathology: Norton > Flashcards

Prostate Pathology: Norton Flashcards

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1
Q

what are the 4 zones of the prostate

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

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

A

carcinoma: peripheral
hyperplasia: transitional

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3
Q

What are the 2 layers that line the prostate gland

A
  1. basal layer of cuboidal epithelium

2. inner layer of columnar secretory epithelium

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4
Q

What separates the prostate glands

A

fibromuscular stroma

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5
Q

What role does prostatic fluid play

A

protects and increases motility of sperm

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6
Q

what control growth and survival of prostate cells

A

testicular androgens

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7
Q

what are 3 pathological processes that occur in prostate

A
  1. inflammation
  2. Benign prostatic hyperplasia (BPH)
  3. protsatic hyperplasia
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8
Q

What are 4 types of prostate inflammation

A

acute bacterial prostatitis
chronic bacterial prostatitis
chronic abacterial prostatitis
granulomatous prostatitis

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9
Q

what are common bacteria that cause acute bacterial prostatitis

A

same as UTI

  • E.coli
  • other gram -
  • enterococci
  • staph
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10
Q

clinical features of acute bacterial prostatitis

A

fever
chills
dysuria
prostate TENDER

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11
Q

what is the urinalysis for acute bacterial prostatitis

A

positive leucocytes

positive bacteria

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12
Q

clinical features of chronic bacterial prostatitis

A 
mild symptoms 
back pain
dysuria 
pernieal and suprapubic discomfort
asymptomatic
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13
Q

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

A

recurrent UTI

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14
Q

urinalysis for chronic bacterial prostatitis

A

positive leucocytes

positive bacterial

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15
Q

What is the most common form of prostatitis

A

chronic abacterial prostatitis

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16
Q

urinalysis of chronic abacterial prostatitis

A

positive leucocytes

negative bacterial culture

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17
Q

clinical symptoms for chronic abacterial prostatitis

A

similar to chronic bacterial prostatitis

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18
Q

How can a male get Granulomatous prostatitis

A

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

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19
Q

what is the main prostate hormone

A

DHT dihydrotestosterone

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20
Q

What converts testosterone to DHT

A

type 2

5 alpha reductase

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21
Q

What does DHT bind to in prostate

A

androgen receptors on nuclei of stormal and epithelial cells

22
Q

What is the etiology of BPH ( benign prostatic hyperplasia)

A

increased number of epithelial cells and stromal components influenced by DHT

23
Q

Benign prostatic hyperplasia originates in what part of the prostate

A

transition zone (periurethral)

24
Q

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

A

early: stromal cells
late: epithelial cells/glands

25
Q

What is a clinical feature for benign prostatic hyperplasia

A

urethral obstruction causes

  • bladder hypertophy and distension
  • urine retention
  • sudden acute urinary retention
26
Q

what are some conservative treatment options for benign prostatic hyperplasia

A

decrease fluids before bedtime

decrease caffeine and alcohol

27
Q

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

A
  1. alpha blockers

2. 5-alpha reductase inhibitors

28
Q

How do alpha-blockers help with BPH

A

decrease smooth muscle tone

29
Q

how do alpha blockers help with BPH

A

decrease smooth muscle tone

30
Q

what is a surgical option for BPH

A

transurethral resection of prostate

31
Q

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

A

high fat diet

32
Q

What are 3 things that can cause prostate adenocarcinoma

A

diet
androgens
genetics

33
Q

What is a precursor lesion to prostate adenocarcinoma

A

porstate intraepithelial neoplasia (PIN)

34
Q

prostate intraepithelial neoplasia is seen in what zone

A

peripheral zone

35
Q

how do PIN glands differ from prostate adenocarcinoma

A
  • larger than cancer glands with branching/folding

- surrounded by patchy layer of basal cells and intact basement membrane

36
Q

what is histo for prostate adenocarcinoma

A
  • glands small
  • croweded
  • no branching/folding
  • no stroma
  • “back-to-back” glands
37
Q

What lines the glands in prostate adenocarcinoma

A

single layer of cuboidal or columnar cells

OUTER BASAL CELL LAYER IS ABSENT

38
Q

where does prostate adenocarcinoma spread to

A

periprostatic tissues
seminal vesicles
base of bladder

39
Q

what are 2 routs of mestastasis for prostate adenocarcinoma

A

lymphatics

blood

40
Q

if prostate adenocarcinoma mets via lymph , where does it go

A

obtruator nodes then to paraaortic nodes

41
Q

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

A

bones

  • lumbar spine
  • proximal femur
  • thoracic spine
  • ribs

forms osteoblastic lesions

42
Q

how is prostate adnenocarcinoma scored

A 
adding 
1. prominent pattern 
2. second most prominent pattern 
OR
1. prominent pattern
2. highest grade pattern
43
Q

what is the lowest grade for prostate adnenocarcinoma

A

gleason 1

44
Q

what is the highest grade for prostate adnenocarcinoma

A

Gleason 5

45
Q

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

A
  1. digital rectal exam (DRE)

2. tranrectal ultrasonography

46
Q

what confirms diagnosis of prostate adenocarcinoma

A

transrectal needle biopsy

47
Q

what is clinical feature of local prostate cancer

A

asymptomatic

  • later urinary symptoms
  • back pain
48
Q

for prostate adnenocarcinoma what is most important test for screening

A

PSA

prostate specific antigen

49
Q

what is most common treatment for localized prostate adnenocarcinoma

A

surgery: radical prostatectomy

50
Q

what are treatment options for prostate adnenocarcinoma

A

radiation
hormone manipulation
acute surveillance of PSA

D&T 4 exam 1 (17 decks)

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