Flashcards in BPH/Prostate CA Deck (21)
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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
