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Unit 13 Flashcards

1
Q

at what age does bph begin to dev

A

> 55

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2
Q

main risk factor for bph

A

aging

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3
Q

characteristic of prostatic growth with age

A

slow, gradual growth

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4
Q

how is growth of prostate characterized in bph

A

periurethral growth, originating in center of gland

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5
Q

what type of growth is bph and what cells areinvolved

A

hyperplasia and hypertrophy

m. and exocrine epith tissue

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6
Q

number one risk of bph

A

aging

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7
Q

what change does age cause in bph

A

change in androgen levels

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8
Q

et of bph

A

aging
genetic predisposition
race (inc in blacks, dec in asian)
diet (directly linked to genes and race)

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9
Q

what are the 2 male androgens

A

T

DHT

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10
Q

what percent of t is converted to dht

A

95

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11
Q

how is t converted to dht

A

via ez 5 alpha reductase

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12
Q

what is dht responsible for

A

str, fx, growth of prostate

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13
Q

what is the physiologic fx of E in men

A

facilitates action of DHT on cells by sensitizing them -> inc effect of DHT

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14
Q

what happens to the T:E ratio as men age

A

qualatative dec in T while E remains the same

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15
Q

what happens to E when T decreases

A

it makes E relatively more significant

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16
Q

what does the inc significance of E do to prostatic cells

A

makes them more sensitive, so DHT has more effect

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17
Q

why does urethral compression occur in BPH

A

inc in tissue size is space occupying -> urethral compression

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18
Q

when does urine accum occur

A

with inc urethral compression

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19
Q

what happens when urine accums

A

inc urge to urinate, inability to enter bladder,, residual badder volume

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20
Q

what 2 compensatory changes occur to prevent ballder rupture

A
  1. bladder wall thickens

2. diverticula/trabeculae in bladder expand to inc bladder size

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21
Q

why is thickening of the bladder wall worsening the problem

A

we can now retain urine longeer

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22
Q

why is increassing bladder size worsening the problem

A

promotes urine stasis

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23
Q

2 complications of urine stasis

A

UTI/infc

renal calculi

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24
Q

why may renal calculi occur with urine stasis

A

rt percipitable components in urine

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25
what happens when the bladder is full of urine
backs up into urine and kidney
26
hydrouretur
distention of uretur to accomodate inc urine vol
27
fish hook uretur
occurs at point where uretur attatches to bladder. inc P on this points pulls uretur downwards making hook apperance
28
2 consequences of hydroeuretur
urine begins to accum in kidney | hydronephrosis
29
what happens when urine accums in kidney
inc p pushing out on glomerulus, inc P in capsule > P of filtrate entering capsule -> no filtration
30
what leads to hydronephrosis
no filtration rt to no P gradient to faciliate filtration
31
hydronephrosis
distention of renal pelvis/calculi
32
mfnts of bph
``` frequency with nocturia hesistancy weak stream rt compression terminal dribbling urine retention of obstr is complete ```
33
dx of bph
``` hx, mnfts, px digital rectal exam PSA kidney fx tests urinalysis ```
34
PSA
prostate spec androgen
35
how is psa measured
in blood or in prostatic fluid
36
what is total psa porprortional too
total size of prostate
37
PSAv and PSAd
psa velocity | psa dencity
38
how is psav and psad calculated
using total psa
39
what are issues with psa
may have false positives or negatives | mixed up in prostate ca
40
what is tx of bph dependent on
s and s, sev, complicatiosn
41
tx for bph
``` no tx often lifestyle mod alpha andregenic antagonist 5 a reductase inhibit sx ```
42
what lifestyle mod might be done in bph
no fluids 2-3 h prior HS | no caffiene or alcohol
43
fx of aplha andregent antagonist
relax m. in gland to improve voiding by acting on obstr to improve urination
44
when is an alpha adregenic antagonist used
short term
45
fx of 5 alpha reductase inhibitor
dec DHT by inhibiting conversion of t to Dht
46
when is 5 alpha reductase inhibitor used
long term
47
what drugs do we use if cases of bph are sev
both
48
what 2 sx are used as a last resort for bph tx
transurethral resec of prostate | laser prostectomy
49
which population has in inc risk for prostate ca
men >65 yo
50
risks for prostate ca
``` age diet ethinicity family hx androgens ```
51
what type of carcinoma is in prostate ca
adenocarcinoma
52
what is adenocarcinoma rt to in prostate ca
glandular epith
53
characteristics of prostate ca
subcapsular, peripheral, multisite
54
why is prostate ca have a delayed dx
no early mnfts dt peripheral origin of ca
55
normal prostate size
2-3cm
56
prostate size in ca
4cm
57
prostate size in bph
5-6cm
58
when do mnfts appear in prostate ca
if it is well established
59
where do mets occur in prostate ca
bone liver lung
60
where do bone mets in prostate ca usually mnfts
back, hip, spine
61
where does prostate ca extend regionally
seminal vesicles, | bladder
62
mnfts of prostate ca
prostatisis | late back/hip pain rt to mets
63
dx prostate ca
hx, px DKE (inc in men >50yo) PSA biopsy sample
64
what is tx of prostate ca based on
stage, age, grade
65
tx for beningn prostate ca
inc in men with inc age, no tx, activley monitor
66
tx for prostate ca
prevent cell griwth via DHT radical prostectomy/remove seminal vesicles combo tx (radiation)
67
how do we prevent cell growth via dht in prostate ca
admin estrogen/antiandrogenic drugs

PAtho (31 decks)

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