Prostate + UTI Flashcards

1
Q

RF for prostate cancer

A

Urban african americans
Family history
High dietary fat
Smoking

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2
Q

Sx of prostate cancer

A

Asymptomatic
LUTS - storage, voiding, incontinence
LBP (mets)

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3
Q

Rx of prostate cancer (low, intermediate + high risk)

A

Low risk = active surveillance (PSA q6mo, DRE annually)
Intermediate risk = radical prostatectomy, brachytherapy, RT, PSA q6mo for 5 yrs
High risk = RT, androgen deprivation therapy, radical prostatectomy, radical RT, PSA q6mo

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4
Q

Complications of radical prostatectomy, radiation + mets

A

Radical prostatectomy: urinary incontinence
Radiation: bowel dysfunction, erectile dysfunction
Mets: adrenal gland, bone, liver, lung

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5
Q

Ix for prostate cancer

A

Order PSA if abnormal DRE, LUTS, FU of man w/ prostate cancer
Free PSA <10% suggestive of cancer
Don’t order if life expectancy <10 yrs

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6
Q

RF for BPH

A

Age
Obesity
Fam hx

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7
Q

Sx of BPH

A

LUTS - storage, frequency, incontinence, nocturia, hesitancy, weak stream, intermittance, straining, dribbling, incomplete void, retention
Erectile dysfunction

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8
Q

Ix for BPH

A

UA
PSA if life expectancy >10 yrs

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9
Q

Lifestyle management of BPH

A

Fluid restrict at bedtime
Avoid alcohol, caffeine, spicy food
Avoid irritating meds (TCAs, diuretics, antihistamines)
Bladder training
Pelvic floor exercises
Urethral milking

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10
Q

Medications for BPH

A

Alpha blocker (Tamsulosin)
5-alpha reductase inhibitors (Finasteride)
Combo best if symptomatic LUTS + enlarged prostate
DC alpha blocker after 6mo
Desmopressin

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11
Q

Alpha blocker (Tamsulosin) monitoring, effectiveness + SE

A

Monitor BP
Reduces LUTS but not dz progression
SE: HA, dizziness, somnolence, postural hypotension

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12
Q

5-alpha reductase inhibitors (Finasteride) uses, SE

A

Only if enlarged prostate on DRE
Shrinks prostate, reduces retention
Used best in conjunction with alpha blocker
SE: ED, reduced libido

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13
Q

Use of desmopressin

A

Good for nocturnal polyuria

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14
Q

Surgical options for BPH

A

Mono or bipolar transurethral resection of prostate
Bipolar plasma kinetic vaporization
Prostatectomy

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15
Q

Irritative vs obstructive sx of BPH

A

Irritative: frequency, urgency
Obstructive: weak stream, hesitancy, incomplete voiding

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16
Q

Pathogens causing prostatitis

A

E coli, pseudomonas, proteus, enterobacter, enterococcus

17
Q

RF prostatitis

A

indwelling catheter, DM, immunosuppression, perineal trauma

18
Q

Sx prostatitis

A

UTI sx, irritative + obstructive voiding sx, fever, pain in lower back, exquisitely tender prostate

19
Q

Acute + chronic rx of prostatitis

A

Acute = Septra 2 tabs BID
Chronic = levofloxacin 500mg

20
Q

RF for UTI

A

Sexually active
Diaphragm use
Not voiding after sex
New sexual partner
Vesicoureteral reflux
Posterior urethral valves

21
Q

Causes of UTI

A

Causes:
Klebsiella
E coli
Enterobacter
Proteus
Staph

22
Q

What makes a UTI complicated?

A

Complicated UTI:
Male
Pregnancy
Catheterisation
Anatomical abnormalities
Chronic renal dz
T2DM
Immunosuppressed

23
Q

Ix for UTI (adults + kids under 2)

A

UA: nitrites, leuks, blood
UC if complicated, peds, recurrent or pyelo
RBUS for <2y/o
Voiding Cystourethrogram if abnormal RBUS or <2y/o + 2nd UTI

24
Q

Rx for UTI

A

Management:
Nitrofurantoin 100mg BID 5/5
1-2w if nursing home
Trimethoprim for kids 1-2w
Ciprofloxacin 500mg BID x1-2w for pyelonephritis or complicated UTI

25
Q

Other causes of dysuria

A

STI
Vaginitis
Stones
Interstitial cystitis
Prostatitis