8.7 Penis Prostate

Question 1

carcinoma in situ on shaft of penis called

Answer 1

Bowen disease

Question 2

younger patients with carcinoma in situ

Answer 2

Bowenoid papulosis

Question 3

SCC of penis mets to what LN

Answer 3

inguinal

Question 4

characteristics of verrucous carcinoma (scc variant)

Answer 4

well differentiated, locally aggressive, but doesn’t met

Question 5

epispadias more likely to get what other congenital anomaly

Answer 5

undescended testes

Question 6

condyloma acuminatum caused by

- and what histo

Answer 6

HPV 6, 11

koilocytes

Question 7

2 epithelial cell layers of prostate

Answer 7

secretory cells

basal cells (not present in prostate CA)

Question 8

fever, chills, dysuria, prostate tender and boggy/soft

• dx
• confirm dx
• cause

Answer 8

acute bacterial prostatitis

culture (NOT BIOPSY)

bacteria (E. coli, etc, like UTIs)

Question 9

low back pain, suprapubic discomfort, recurrent UTI, lymphocytes and plasma cells

• dx
• confirm dx

Answer 9

chronic bacterial prostatitis

prostatic secretions of leukocytes and positive cultures

Question 10

low back pain, suprapubic discomfort, no history of recurrent UTI

• dx
• confirm dx

Answer 10

chronic abacterial prostatitis

prostatic secretions of leukocytes and negative cultures

Question 11

nodules in central periurethral region

Answer 11

nodular hyperplasia / BPH

Question 12

growth of prostate is stimulated by… & explain mechanism

Answer 12

dihydroxytestosterone (DHT)

binds nuclear androgen receptor in stromal cells (increase prolif) and epithelial cells (decrease death)

Question 13

nodule in posterior, peripheral zone

Answer 13

prostate ca

Question 14

how to treat BPH

Answer 14

Mild: decr fluids, avoid alcohol/caffeine, timed voiding

meds:
- alpha blockers (decrease prostate smooth muscle tone)
- 5alpha reductase inhibitors (block DHT stimulation)

mod/severe: trasurethral resection of prostate (TURP)

Question 15

prostate ca if mets to LN, go to

Answer 15

obturator LN

Question 16

hematogenous spread of prostate cancer

Answer 16

goes to axial skeleton and produces osteoblastic lesions

Question 17

premalignant lesion of prostate ca

Answer 17

prostatic intraepithelial neoplasia (PIN)

Question 18

most prostate ca are what type of ca

Answer 18

adenocarcinoma

Question 19

how to grade prostate ca

Answer 19

Gleason grading system

• uses primary and secondary grades
• combined for a “gleason score”

Question 20

prostate: closely packed glands w/ little intervening stroma

Gleason grade:

Answer 20

1

Question 21

prostate: intervening stroma less than width of a gland, enlarged round nuclei w/ prominent nucleoli
Gleason grade:

Answer 21

2

Question 22

prostate: increased stroma greater than width of gland

Gleason grade:

Answer 22

3

Question 23

prostate: fusiform glands

Gleason grade:

Answer 23

4

Question 24

prostaste: perineural invasion, infiltrative cords of tumor w/o glandular formation
Gleason grade:

Answer 24

5

Question 25

characteristics of Gleason score 2-4 (well diff)

Answer 25

small incidental tumors found in TURP

Question 26

characteristics of Gleason score 5-7 (mod diff)

Answer 26

treatable tumors found on needle core bx due to screening

Question 27

characteristics of Gleason score 8-10 (poor diff)

Answer 27

advanced tumor unlikely to be cured

Question 28

elevated PSA can be

Answer 28

BPH prostatitis prostate ca

Question 29

PSA useful for

Answer 29

FU after treatment of prostate ca if increases, should raise suspicion

Question 30

problems with PSA

Answer 30

some pts with prostate CA have neg PSA