Brainscape's Knowledge GenomeTM

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


See full index

Year 3 Conditions: Renal and Urolgy > Prostate cancer (Complete) > Flashcards

Prostate cancer (Complete) Flashcards

1
Q

How common is prostate cancer in comparison to other cancers in males?

A

2nd most common cause of cancer

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

How does prostate cancer tend to present in early stages?

A

Presents mostly assymptomatic

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

What are the three main zones of the prostate?

A

Central zone: 25% of glandular tissue and contains ejaculatory ducts

Periphral zone: 70% of glandular tissue and largest zone

Transitional zone: 5% of glandular tissue and contains portion of prostatic urethra. [Composed mainly of transitional cells]

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

What zone of the prostate is typically enlarged in patients with benign prostatic hyperplasia?

A

Transitional zone

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

What are the main cell types which form glandular tissue in the prostate?

A

Basement membrane

Basal cells

Luminal cells

Neuroendocrine cells

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

Prostatic cancer is caused by gene mutations in which cell types?

A

Basal cells

or

Luminal cells

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

What gene mutations are involved in development of prostate adenocarcinoma?

A

BRCA1

BRCA2

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

Which region of the prostate does most prostate cancers tend to arise from?

A

Peripheral zone

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

Where does lymphatic spread of prostatic cancer first occur in?

A

Obturator nodes

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

Spread to which local extra prostatic region is associated with distant disease?

A

Spread to seminal vesicles

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

What are the main risk factors of prostate cancer?

A

Non-modifiable:
BRCA mutation
African ethnicity
Family history
Increasing age

Modifiable:
Obesity
High fat/milk diet
Smoking

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

What are the main signs/symptoms of prostate cancer in later stages?

A

Problems urinating (nocturia and increased frequency)

Poor stream of urine

Blood in semen

Discomfort in the pelvic area (Back, perineal or testicular pain)

Bone pain (Bone metasteses)

Erectile dysfunction

Abnormal DRE

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

What findings from DRE are suggestive of prostate cancer?

A

Feel a nodular which is:
Assymetric
Hard
Enlarged

Loss of median sulcus

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

What are the main investigations to consider in patients suspected of prostate cancer?

A

Bedside:
Urine dipstick

Digital rectal examination: Hard assymetrically enlarged nodule

Bloods:
PSA: Considered but poor sensitivity/specificity

Imaging/invasive:

MRI: Now considered first line

Transrectal ultrasound-guided biopsy [TRUS]: Used to be first line but now only done after MRI confirms likelihood of prostate cancer

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

What factors can result in elevated PSA?

A

Acute urinary retention

Benign Prosthetic Hypertrophy

Recent ejaculation

PR examination

Urethral instrumentation

Urinary tract infection

Prostatitis

Prostate cancer

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

Which men should be reffered for further prostate cancer investigations?

A

Men with abnormal DRE

Men 50-69 years of age with PSA > 3.0ng/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What scale is used when interpreting MRI findings to determine likelihood of prostate cancer?

A

Likert scale

18
Q

What score on Likert scale is should indicate further testing is needed to check for prostate cancer?

A

3 or more

19
Q

List complications of TRUS biopsy

A

Sepsis (1% of cases)

Fever (5% of cases)

Haematuria and rectal bleeding

Pain lasting >2 weeks (15%) and can be severe in 7% of cases

20
Q

What does NICE reccomend to inform patients of who have Likert scale of 1-2?

A

Inform them of consequences of having a biopsy

21
Q

What further investigations are ordered after MRI?

A

Biopsy: Confirms diagnosis of prostate cancer

CT: If metastatic disease suspected

Bone isotope scan: If bone metasteses suspected

22
Q

What scoring system is used to grade prostate cancer?

A

Gleason grading system

23
Q

How should gleason scores be interpreted?

A

Lower gleason score associated with better prognosis and less intervention

Higher gleason score associated with poor prognosis and more aggresive

24
Q

What are some management options for patients diagnosed with localised prostate cancer?

A

Depends on life expectancy and patient choice

Conservative:
Watchful waiting or active monitoring

Surgical/Invasive:

Radical prostatectomy

Radiotherapy (Curative or palliative)

25
Q

Active surveillance is reccomended for which types of patients and why?

A

Patients with low-grade prostate cancer

This helps to prevent overtreatment of this patient group and treatment can then be re-assesed if grade changes overtime

26
Q

What investigations are involved in active monitoring for patients with low-grade prostate cancer?

A

PSA

DRE

Biopsies

27
Q

What management options are reccomended for patients with locally advanced prostate cancer?

A

Hormonal therapy

Radical prostatectomy

Radiotherapy

28
Q

What is a common complication of radical prostatectomy?

A

Erectile dysfunction

29
Q

What are complications of radiotherapy in treatment of prostate cancer?

A

Increased risk of:

Bladder cancer

Colonrectal cancer

Proctitis

30
Q

What is the reccomended mangement plan for patients with metastatic prostate cancer?

A

Hormonal therapy

OR

Chemotherapy with docetaxel

31
Q

What is the main aim of hormonal therapy?

A

Reduce androgen levels

32
Q

What are the three main hormonal therapy treatment options?

A

GnRH analouges: e.g. Gosereline and leuprolide

Androgen antagonists: E.g. Bicalutamide and Enzalutamide.

GnRH antagonsists: E.g. Degarelix

33
Q

What is the role of GnRH analouges?

Name 2 examples of GnRH analougues

A

Paradoxically block LH and FSH due to overstimulation.

Goserelin

Leuprolide

34
Q

What are issues of GnRH analouges?

A

Can initially progress disease activity due to transient rise in testosterone

35
Q

What is offered alongiside GnRH analougues to minimise complications?

A

Androgen antagonsists

Prevent an increase in disease activity following a transient surge in LH & FSH

36
Q

Name 2 examples of androgen antagonists

A

Bicalutamide

Enzalutamide

37
Q

Name an example of a GnRH antagonist

A

Degarelix

38
Q

What are sexual side effects of hormonal therapy in treatment of prostate cancer? (4)

A

Decreased labido

Impotence

Infertility

Gynecomastia

39
Q

What are metabolic side effects of hormonal therapy in treatment of prostate cancer?

A

Weight gain

Osteoporosis

Diabetes

Ischaemic heart disease

40
Q

What haematological side effects is asscoiated with hormonal therapy?

A

Anaemia

Year 3 Conditions: Renal and Urolgy (13 decks)

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