Brainscape's Knowledge GenomeTM

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


See full index

Urology > Prostatic enlargement > Flashcards

Prostatic enlargement Flashcards

1
Q

What are the clinical features of benign prostate enlargement?

A 
Nocturia (common early symptom)
Difficulty starting
Difficulty stopping/post void dribbling
Poor flow
Incomplete voiding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why might the risk of micturition syncope be increased in BPH?

A

Increased need to push/strain

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

Diagnoses which should be considered and that the history should take account of?

A 
Prostatic carcinoma
Bladder carcinoma
Urinary tract stones
Neurogenic bladder
UTI
Detrusor instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What scale can be used to rate the severity of LUTS?

A

International prostate symptom score (I-PSS)

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

Examination in suspected BPH? (3)

A

Abdominal exam for bladder enlargement
DRE (benign usually smooth)
Dipstick

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

Investigations for suspected prostatic enlargement? (5)

A 
Urine culture
Serum PSA
Routine bloods inc kidney function
Ultrasound imaging and biopsy (TRUS)
Bladder flow studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Drugs which lower muscle tone in the neck of the bladder?

A

Alpha blockers e.g. tamsulosin

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

Tamsulosin is most specific for which receptors?

A

Alpha 1a

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

How do finasteride and dutasteride work?

A

5-alpha reductase inhibitors, block synthesis of dihydrotestosterone

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

Why should finasteride be persisted with even if patients feel it is not helping?

A

Often takes several months to work

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

Contraindications to alpha blockers?

A

Postural hypotension

Micturition syncope

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

Opthalmic complication of tamsulosin?

A

Floppy iris syndrome during surgery e.g. cataract

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

What adverse effects do 5-ARIs have?

A

Adverse effects on sexual performance

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

What is the standard surgical approach for BPH?

A

Transurethral resection of the prostate (TURP)

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

Complications of bladder outlet obstruction?

A 
Urinary retention 
Recurrent UTI
Impaired kidney function
Bladder stones
Haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which class of drugs can precipitate urinary retention in BPH?

A

Antimuscarinic drugs;

drugs with antimuscarinic activity (e.g. TCAs, opiates, diuretics)

17
Q

What is prostate specific antigen?

A

Protein which makes semen more liquid, produced by prostatic cells, found in the serum

18
Q

What is serum PSA used for and what is the drawback?

A

Detection of prostate carcinoma and monitoring response to treatment;

Low specificity

19
Q

Conditions with elevated PSA?

A 
Acute urinary retention
BPH
Prostatitis
Prostate cancer
Catheterized patients
Increases with age
20
Q

All patients with a significantly raised PSA should have what test?

A

Prostate biopsy

21
Q

Histologically, what type of cancer is prostatic cancer?

A

Adenocarcinoma

22
Q

Presentation of local prostatic cancer?

A

LUTS
Acute retention
Incidental finding of hard, irregular mass on DRE

23
Q

Presentation of metastatic prostatic cancer?

A

Back and skeletal pain/sciatica
Weight loss
Anaemia
Lymphadenopathy

24
Q

Commonest site for growth of prostatic adenocarcinoma?

A

Peripheral zone of the prostate

25
Q

Risk factors for prostatic cancer? (3)

A

Increasing age
Black Afro-Caribbean family origin
Family history

26
Q

Features of local invasion e.g. bladder?

A

Haematuria, dysuria, incontinence
Ureteric obstruction
Perineal/suprapubic pain

27
Q

“Classical” picture on ultrasound of prostate cancer?

A

Hypoechoic region in the peripheral zone (not always seen)

28
Q

Grading system for histology in prostatic cancer?

A

Gleason score

29
Q

Surgical management of prostate cancer?

A

Radical prostatectomy +/- pelvic lymph node dissection

30
Q

Other management options for prostate cancer? (4)

A

Hormonal therapy
Radiotherapy (external beam, brachytherapy)
Cryotherapy
High-intensity focused ultrasound

31
Q

Examples of hormonal therapy for prostatic carcinoma? (3)

A

LHRH agonists e.g. goserelin
Bilateral orchidectomy (gold standard; unacceptable to many patients)
Androgen receptor antagonists

32
Q

Complications of hormonal treatment? (2)

A

Hot flushes

Gynaecomastia

33
Q

Indications for surgery in BPH?

A

Failure to respond to an adequate trial of medical therapy
Acute urinary retention
Renal insufficiency due to obstruction

34
Q

Complications for TURP? (4)

A

Bleeding can be hard to control

Absorption of irrigating fluid leading to hyponatraemia (TURP syndrome)

Later- retrograde ejaculation, erectile dysfunction

35
Q

When is the catheter usually removed after TURP?

A

Second day

36
Q

How are Gleason scores expressed?

A

Cells graded 1-5 depending on level of differentiation (1 = most differentiated), for the two most common malignant cell types. Expressed as an equation e.g. 4+3 =7, 10 being most advanced

37
Q

What may happen during the first stages of treatment with goserelin? How can this be avoided?

A

Transient increase in symptoms of prostatic carcinoma, known as the “flare effect”

Flutamide, a synthetic antiandrogen can be used pre-emptively to prevent this

Urology (10 decks)

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