BPH/Prostate CA Flashcards Preview

Foundations-Urology > BPH/Prostate CA > Flashcards

Flashcards in BPH/Prostate CA Deck (21)
Loading flashcards...
1

BPH clinical presentation

Lower Urinary Tract Sx's:
1. Weak urinary stream
2. Urinary hesitancy
3. Stream intermittency
4. Post void dribbling
5. Nocturia
6. Recurrent UTI's
7. Hx of cystolithiasis

2

Uroflow study findings in BPH

Low flow rate

3

Post void residual findings

high residual

4

Cystoscopy findings

1. Trabeculation
2. Obstructive prostate encroaching into urinary outlet lumen
3. "kissing lobes"

5

Urodynamic study findings

1. Low flow
2. Elevated intravsical pressures

6

What OTC meds do you want to avoid in BPH?

1. Pseudoephedrine/ alpha agonists (Sudafed)
2. Anticholinergics (Benadryl):-Cause urinary retention

7

Pharmacologic treatment in BPH

1. Phytotherapy
2. Alpha-blockers
3. 5-alpha-reductase inhibitors (5-ARI)

8

List a phototherapy

Saw palmetto

9

Alpha blocker MOA

Causes relaxation of smooth muscle of the stroma that allows freer passage of urine

10

What is a disadvantage of 5-alpha-reductase inhibitors

Can take 6 months to see effect

11

What does 5-alpha-reductase inhibitors decrease?

PSA by 50%

12

Who are 5-alpha-reductase inhibitors most beneficial in?

larger volume prostates >40 cc
PSAs greater than 1.4

13

What is gold standard surgical treatment of BPH?

Transurethral Resection of Prostate (TURP)

14

Complications of TURP

1. Retrograde ejaculation
2. TUR Syndrome
3. Hematuria

15

Define TUR Syndrome

1. Hyponatremia
2. Mental confusion
3. HTN
4. Visual changes

16

What is the main risk factor in Prostate CA

Strong family hx

17

What are other conditions that can elevate the PSA?

1. Acute urinary retention
2. BPH
3. Prostatitis
4. Prostatic infarction
5. Prostatic intraepithelial neoplasia (PIN)
5. Cath

18

Genome testing in prostate CA

PCA 3
4K Score

19

Radical prostatectomy indications

Lesions clinically confined to the prostate

20

List the hormonal manipulation options

1. B/L orchiectomy
2. LH-RH Analogs
3. Antiandrogens

21

List the LH-RH Analogs

1. Leuprolide
2. Goserelin