Brainscape's Knowledge GenomeTM

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


See full index

Repro / GU > SM_242: BPH > Flashcards

SM_242: BPH Flashcards

1
Q

____ zone of prostate is where BPH arises

A

Transitional zone of prostate is where BPH arises

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

This is a ____

A

This is a normal prostate acinus and surrounding stroma

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

Describe the 3 anatomic / physiologic zones of the lower urinary tract

A

3 anatomic / physiologic zones of the lower urinary tract

  • Zone 1: supra-trigonal bladder
  • Zone 2: bladder neck, prostate, and prostatic urethra
  • Zone 3: membranous urethra surrounded by UGC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Prostate growth and differentiation is ___

A

Prostate growth and differentiation is a complex interaction between the epithelial / stromal components, hormones, and growth factors

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

___ may promote prostate cell proliferation

A

Estrogens may promote prostate cell proliferation

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

BPH has ___ with ___ and ___ on histology

A

BPH has nodular cell proliferation with glandular epithelial cells and stromal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BPH can compress the ____

A

BPH can compress the prostatic urethra

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

BPH results in ____

A

BPH results in bladder wall thickening / trabeculation reflecting increased detrusor collagen deposition

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

BPH usually begins at ___ histologically and increases with ___

A

BPH begins at age 30 histologically and increases with age

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

Describe phases of BPH

A

BPH phases

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

PSA is a surrogate marker of ___

A

PSA is a surrogate marker of prostate volume

  • Specifically [-2]proPSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe presentation of BPH

A

BPH presentation

  • Obstructive: decreased force of stream, hesitancy, intermittency, straining, feeling of incomplete bladder emptying
  • Irritative: frequency of urination, urgency
  • Nocturia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BPH is a ___ diagnosis

A

BPH is a clinical diagnosis

  • No biopsy required
  • Diagnosed by a combination of subjective and objective paramters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prostate volume ____ with age and ____ with PSA

A

Prostate volume increases with age and increases with PSA

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

Urinary flow rate ____ with age

A

Urinary flow rate decreases with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Post void residual urine is ___

A

Post void residual urine is amount of urine not emptied during voiding

  • Increases in elderly men due to blockage and weakening of the bladder muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

BPH involves detrusor ____

A

BPH involves detrusor areflexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
A
19
Q

Describe behavioral therapy for BPH

A

BPH behavioral therapy

  • Double voiding
  • Timed voiding
  • Avoidance of caffeine, alcohol, and other diuretics
  • Night-time fluid restriction
  • Increasing level of physical activity: leads to decreased body size, decreased sympathetic nervous system, decreased levels of systemic inflammation, and improved sleep quality
20
Q

There is ____ evidence for use of herbal therapies in BPH

A

There is NO objective evidence for use of herbal therapies in BPH

21
Q

Describe medical treatment of BPH

A

Medical treatment of BPH

  • Alpha antagonists
  • 5-alpha reductase inhibitors
  • Combination therapy
  • Antimuscarinics
  • Beta-3 adrenergic agonist
  • Phosphodiesterase-5 inhibitors
22
Q

____ is a potential complication associated with use of a1 blockers for BPH

A

Intraoperative Floppy Iris Syndrome is a potential complication associated with use of a1 blockers for BPH

23
Q

5a-reductase inhibitors ___ in treatment of BPH

A

5a-reductase inhibitors decrease likelihood of surgery and acute urinary retention in treatment of BPH

24
Q

Combination therapy with a1 blocker and 5-alpha reductase inhibitor is used for treatment of BPH in patients with ____, ____, ____, and ____

A

Combination therapy with a1 blocker and 5-alpha reductase inhibitor is used for treatment of BPH in patients with moderate-severe symptoms, prostates above 40 mL, higher PSA, and advanced age

25
Q

Anticholinergics block ACh signal at ____, leading to ____

A

Anticholinergics block ACh signal at NMJ of detrusor muscle, leading to inhibition of detrusor contractions

  • Target detrusor overactivity
26
Q

Anticholingergic side effects are ____, ____, and ____

A

Anticholingergic side effects are dry mouth, constipation, and blurry vision

  • Dementia
27
Q

Mirabegron (B3 agonist) is used to treat BPH due to ____

A

Mirabegron (B3 agonist) is used to treat BPH due to B3 activation and possible a1 blockade leading to relaxation of urethral smooth muscle

  • Same rate of adverse events as placebo
28
Q

PDE-5 inhibitors function by ____, leading to ____

A

PDE-5 inhibitors function by blocking the breakdown of cGMP to GMP by phosphodiesterase, leading to vasodilation

  • Sildenafil, tadalafil, vardenafil
  • Useful for treating lower urinary tract symptoms and ED
29
Q

____, ____, and ____ are adverse effects of PDE-5 inhibitors

A

Headache, dyspepsia, and flushing are adverse effects of PDE-5 inhibitors

30
Q

Describe indications for surgery for BPH

A

BPH surgery indications

  • Acute urinary retention
  • Bladder calculi
  • Azotemia
  • Recurrent UTI
  • Recurrent hematuria
  • Worsening lower urinary tract symptoms refractory to medical therapy
31
Q

Describe surgical options for BPH

A

BPH for surgical options

  • Minimally invasive technologies
  • Transurethral resection of the prostate
  • Transurethral incision of the prostate
  • Laser therapies
  • Open simple prostatectomy
  • Robotic-assisted laparoscopic simple prostatectomy
32
Q

____ is better for larger prostates in BPH

A

Bipolar transurethral resection of prostate (bTURP) is better for larger prostates in BPH

33
Q

Transurethral incision of the prostate is most suitable for ____ in BPH and ____ retrograde ejaculation

A

Transurethral incision of the prostate is most suitable for small prostates with an obstructing bladder neck in BPH and decreases retrograde ejaculation

34
Q

HoLEP (Holmium laser for BPH) requires ____

A

HoLEP (Holmium laser) for BPH requires morcellation of the specimen

  • Adds to complexity and length of operative time
35
Q

Simple prostatectomy for BPH involves ___

A

Simple prostatectomy for BPH involves enucleation of the transitional zone within the capsule

  • Generally reserved for prostates larger than 80 mL and/or in patients with large bladder diverticula or bladder stones requiring concomitant procedures
36
Q

Robotic assisted simple prostatectomy is ___, ___, and ___

A

Robotic assisted simple prostatectomy is good for large glands, minimizes blood volume and hospital time, and leads to quicker recovery

37
Q

BPH originates from ____ of prostate

A

BPH originates from transition zone of prostate

38
Q

___ cells are primarily responsible for production of type 2 5a-reductase in the prostate

A

Stromal cells cells are primarily responsible for production of type 2 5a-reductase in the prostate

39
Q

Describe stages of BPH

A

BPH stages

  • Stage 1: abnormal transition zone histology, normal DRE, no LUTS
    • Stage 2: abnormal transition zone, enlarged prostate, no LUTS
    • Stage 3: abnormal transition zone, enlarged prostate, increased LUTS
40
Q

____ of men ages 60-69 are affected by symptoms of BPH

A

70% of men ages 60-69 are affected by symptoms of BPH

41
Q

Components of initial evaluation of a patient with presumed BPH are ___, ___, ___, and ___

A

Components of initial evaluation of a patient with presumed BPH are history, DRE and focused physical exam, urinalysis, and PSA in selected patients

42
Q

____ adrenergic receptors are linked to smooth muscle contraction in the prostate

A

a-1A adrenergic receptors are linked to smooth muscle contraction in the prostate

43
Q

Recurrent episodes of gross hematuria with clot retention in BPH are an absolute indication for ___

A

Recurrent episodes of gross hematuria with clot retention in BPH are an absolute indication for surgical management

Repro / GU (46 decks)

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