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Fdnts 3 Exam 1 > Prostatitis > Flashcards

Prostatitis Flashcards

1
Q

What is prostatitis?

A

prostatic pain is the hallmark

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2
Q

What are the 4 types of prostatitis?

A

Acute Bacterial Prostatitis

Chronic Bacterial Prostatitis

Inflammatory Chronic Pelvic Pain Syndrome (Non-bacterial Prostatitis)

Non-inflammatory Chronic Pelvic Pain (Prostatodynia)

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3
Q

Presentation of acute bacterial prostatitis?

A

Fever, irritative, poss obstructive voiding sxs, warm boggy tender prostate

usually seen in young men

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4
Q

Typical pathogen of acute bacterial prostatitis?

A

E. coli

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5
Q

How do we eval for acute bacterial prostatitis?

A

H &P: no vigorous prostate exam

urine culture: not post prostate massage

CBC

blood cultures

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6
Q

Tx for acute bacterial prostatitis?

A

If significant fever, highly elevated WBC, sepsis, admit for IV abx

If in urinary retention: suprapubic tube might be preferable to urethral catheter

when no longer acutely toxic > switch to PO abx

on DC tx for a 4-6 wk course of abx

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7
Q

When might you check a CT in a pt with acute bacterial prostatitis? why?

A

if persistently febrile

r/o prostatic abscess

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8
Q

Presentation of chronic bacterial prostatitis?

A

Recurrent prostatic infections

Pain in genitals, urinary tract, perineum, low back

Irritative urinary symptoms (dysuria, urgency, frequency) and pain w/ejaculation

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9
Q

Who usually gets chronic bacterial prostatitis? typical pathogen?

A

older men

E. coli

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10
Q

What other organisms can cause chronic bacterial prostatitis?

A

Klebsiella, Pseudomonas, Proteus, Enterococcus, Staphylococcus saprophyticus, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis

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11
Q

Physical exam finding in chronic bacterial prostatitis?

A

tender boggy prostate

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12
Q

What labs would you check for chronic bacterial prostatitis?

A

Expressed prostatic secretion (EPS)

Post prostate massage urine culture

Meares Stamey 4 glass test -not really done

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13
Q

Tx for chronic bacterial prostatitis?

A

Abx: Bactrim, Fluroquinolones

  • adjust based on culture
  • prolonged therapy 8-16wks, may need longer

NSAIDS

Alpha Blockers

Anticholinergics

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14
Q

Other tx options for chronic bacterial prostatitis?

A

Phytotherapy- plant based therapy

Zinc

Diet

Stress management

Prostate massage, ejaculation

Sitz baths

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15
Q

Inflammatory Chronic Pelvic Pain Syndrome is also called…

A

nonbacterial prostatitis

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16
Q

Presentation of Inflammatory Chronic Pelvic Pain Syndrome

A

similar to chronic bacterial prostatitis

17
Q

How do you evaluate for Inflammatory Chronic Pelvic Pain Syndrome?

A

similar to chronic bacterial prostatitis

-hx of UTIs with negative cultures

18
Q

PE findings of Inflammatory Chronic Pelvic Pain Syndrome ?

A

prostatic tenderness

19
Q

Labs consistent with Inflammatory Chronic Pelvic Pain Syndrome?

A

Prostatic fluid with leukocytes; but cultures do not grow out bacterial pathogen

20
Q

Tx for Inflammatory Chronic Pelvic Pain Syndrome?

A

emperic abx: SMX-TMP x 6-8

If not responsive, doxycycline 4-6 wk (Ureaplasma, Chlamydia, Mycoplasma)

21
Q

Other tx options for Inflammatory Chronic Pelvic Pain Syndrome?

A

NSAIDs
Anticholinergics/antimuscarinic for urinary urgency
Alpha blockers
Sitz baths
Stress reduction, biofeedback, counselling
Can try zinc, nickel, saw palmetto, quercitin
Prostate massage
Dietary (caffeine, alcohol, spicy acidic food)
Benzodiazepine
Tricyclic antidepressant
Analgesics, Pain specialist consult

22
Q

Noninflammatory Chronic Pelvic Pain Syndrome is also called…

A

prostadynia

23
Q

Presentation of Noninflammatory Chronic Pelvic Pain Syndrome?

A

Like Chronic bacterial prostatitis and Inflammatory chronic pelvic pain syndrome

24
Q

Labs of Noninflammatory Chronic Pelvic Pain Syndrome?

A

no bacteria on culture, and no leukocytes in prostatic fluid

25
Q

Tx for Noninflammatory Chronic Pelvic Pain Syndrome?

A

NSAIDs
Anticholinergics for urinary
Alpha blockers
Sitz baths
Stress reduction, biofeedback, counselling
Can try zinc, nickel, saw palmetto, quercitin
Prostate massage
Dietary (caffeine, alcohol, spicy acidic food)
Benzodiazepine
Tricyclic antidepressant
Analgesics, Pain specialist consult

Fdnts 3 Exam 1 (17 decks)

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