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Surgery > Urology (prostate) > Flashcards

Urology (prostate) Flashcards

1
Q

Which Zone is most commonly affected in BPH

A

Transitional zone

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2
Q

Which zone is most commonly affected by cancer ?

A

Peripheral zone

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3
Q

Most common compositions of prostatic calculi ?

A

CaPO4 (calcium phosphate)

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4
Q

What is corpora amylacea?

A

They are lamellated bodies found in prostatic tissue and to thought to be precursor for prostatic stones

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5
Q

Most common organism responsible for acute bacterial prostatitis

A

E.Coli

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6
Q

PSA VALUES are not affected by……

A

DRE

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7
Q

What is removed in TURP

A

Central, Transitional and majority of the peripheral zone is removed leaving behind a portion of peripheral zone hence patient can still develop prostate cancer even after TURP from the remaining peripheral zone.

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8
Q

Nerve bundles, which are responsible for erection lies

A

Posterolateral to the capsule

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9
Q

Most common complication following TURP

A

Retrograde ejaculation

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10
Q

How does retrograde ejaculation patient presents with

A

No semen during intercourse however, semen comes out later in  urine

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11
Q

To prevent the incontinence during TURP, what should we do?

A

Veru montanum (bulge in prostatic urethra) is taken, as the distal limit of TURP

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12
Q

Why should prostatic massage is avoided in patient with prostatitis?

A

As it can lead to septicemia

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13
Q

Prostatodynia (dull perineal of pelvic pain) is a symptom of

A

Chronic prostatitis

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14
Q

Diagnosis of chronic prostatitis is made by

A

Three tube test (standard Meares and Stamey test)

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15
Q

If chronic prostatitis is because of chlamydia, which drug is used

A

Doxycycline

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16
Q

If chronic prostatitis is because of trichomonas , which drug is used

A

Metronidazole

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17
Q

What is urge incontinence?

A

Pass urine before reaching toilet

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18
Q

What is a enuresis

A

Nocturnal incontinence

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19
Q

Chronic retention of urine is said when ____ of residual uterine is present

A

250 CC

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20
Q

What is the first step in Management of Chronic retention of urine

A

Urgent catheterization

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21
Q

If PSA value is >3-4 ng/ml what should we do to differentiate BPH and Cancer

A

TRUS guided Trucut biopsy

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22
Q

Transperineal biopsy is done from which zone of the prostate

A

Anterior zone

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23
Q

Transrectal biopsy is done from which zone of the prostate

A

Posterior lobe (IOC)

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24
Q

Uroflometry and bladder pressure is used to differentiate between

A

Bladder obstruction and Neurogenic bladder

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25
Q

In BOO/BPH bladder pressure and urine flow rate are

A

Increased bladder pressure
Decreased flow rate

26
Q

Urine flow rate and bladder pressure in neurogenic bladder are

A

Very low bladder pressure and
decrease flow rate

27
Q

What is Marion’s disease / Prostatism sans prostate

A

It is due to hypertrophy of internal sphincter seen in young patients with clinical features of LUTS but prostate is Normal

28
Q

What are the two components of BPH

A

STATIC : Testosterone —> DHT
DYNAMIC: mediated by α 1a receptor

29
Q

Which drugs used in medical management of BPH

A

Alpha 1a blocker (Tamsulosin , Alfuzolin) and
5 α reductase inhibior (Finasteride,Dutasteride)

30
Q

Alpha one blocker acts on on which component

A

Dynamic component

31
Q

Five alpha reductase, inhibitor acts on which component

A

Static component

32
Q

Which fluid are associated with increased incidence of TURP syndrome

A

Hypotonic fluid

33
Q

What is the most common complication of TURP?

A

Hemorrhage

34
Q

What is the most common vessels bleed during TURP ?

A

Badenoch’s artery

35
Q

Badenoch’s artery arising from

A

Inferior vesicle artery (5 and 7 o’clock position)

36
Q

TURP syndrome Is AKA

A

Water intoxication / dilutional, hyponatremia

37
Q

What is the management of TURP syndrome?

A

If sodium is <120 mEq/L , then it is severe hyponatremia, (3% hypertonic saline infusion gradually),
if sodium is >120 mEq/L : fluid restriction

38
Q

If more than 500 cc of glycemic gets absorbed, it can increase risk of

A

MI

39
Q

Retropubic approach is also known as

A

Millin’s approach

40
Q

Most common gene responsible for prostate, cancer is

A

GSTP-1 gene

41
Q

What are the risk factors for prostate cancer?

A

Increasing age 90% chance if 90 years increase in testosterone
African-American
BRCA2 > BRCA1
obesity

42
Q

What is the IOC for prostate cancer?

A

TRUS guided trucut biopsy

43
Q

MC vertebral spread in Prostate cancer

A

Lumbar vertebrae

44
Q

Bone scan should be done in prostate cancer if

A

Osteoblastic > Osteolytic

FPS > 10 ng/ML
Gleason’s score >/= 7
if symptomatic

45
Q

Prostate cancer is an

A

Heterogeneous adenocarcinoma

46
Q

In nerve preserving, RALP surgeries, which never is preserved, and why

A

Cavernous nerve because it is Responsible for erection

47
Q

Name some of the anti-androgens drug

A

Flutamide
Enzulatamide
Abiraterone

48
Q

Tumor marker for prostate cancer

A

PSA

49
Q

A patient is planned for TRUS guided TRUcut biopsy OF prostate for suspected prostate cancer . how many cores should be taken while performing the procedure?

A

12

50
Q

When should we carry out biopsy?

A

If PSA value is >3 with symptoms of had prostate 

51
Q

If that is BPH how the prostate will feel on DRE

A

Firm rubbery mucosa

52
Q

What is the normal value of PSA

A

0-3 ng/ml

53
Q

What happens if we do rapid correction of sodium

A

Central Pontine demyelinosis
central Pontine myelinolysis

54
Q

Most important prognostic factors for prostate cancer is

A

Stage of the disease

55
Q

What are the storage symptoms?

A

Urgency
enuresis
frequency

56
Q

What is the distal most border of the reception in TURP?

A

Verumontanum

57
Q

What is the proximal limit of reception in TURP?

A

Bladder neck

58
Q

What is the mechanism of retrograde ejaculation?

A

Description of the bladder leak

59
Q

Which vaccine is used in the treatment of prostate cancer

A

Sipuleucel-T

60
Q

Which laser is used in the laser in the enucleation of prostate

A

Ho-YAG laser

Surgery (30 decks)

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