BPH1 Flashcards

1
Q

what are the top 5 conditions too embarrassing to talk about with PCP (in order)?

A
  1. impotence
  2. STDs
  3. Physical and sexual abuse
  4. prostate problems
  5. incontinence
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2
Q

what is the age relation to BPH

A
  1. uncommon under 50 (50% of men over 50)
  2. peaks at 63-65
  3. guaranteed if lig long enough
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3
Q

what is hyperplasia?

A

increased number of cells

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4
Q

what is hypertrophy?

A

increased size of cells

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5
Q

is BPH an example of hyperplasia, hypertrophy or both?

is it malignant?

A

hyperplasia, not hypertrophy
increase in cells, not size of cells
not malignant

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6
Q

define BPH

A

nonmalignant enlargement of prostate gland

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7
Q

BPH sometimes leads to what anatomical problem?

A

compression of the urethra and urine flow obstruction

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8
Q

what are the 3 normal prostate tissues

A
  1. epithelial - grandular tissue
  2. stromal - smooth muscle tissue
  3. capsule
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9
Q

what are the two types of pathophysiology involved with BPH? briefly describe each

A
  1. static - androgens cause hyperplasia

2. dynamic - andrenergic tone causes transient effect

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10
Q

what type of pathophysiology is involved in blocking bladdr neck and urinary flow?

A

static symptoms

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11
Q

what type of pathophysiology includes constriction of urethra and narrowing of lumen

A

dynamic symptoms

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12
Q

what sympathetic transmitters lead to dynamic symptoms of BPH?

A

epinephrine and norepinephrine

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13
Q

5-alpha reductase inhibitors deals with what pathophysiology of BPH?

A

androgens leading to static symptoms

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14
Q

adrenergic receptor blockers deal with what pathophysiology of BPH?

A

adrenergic tone leading to dynamic symptoms

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15
Q

cholenergics have what effect on bladder

A

contract bladder muscles

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16
Q

LUTS refers to what?
what are two causes of this?
how does it correlate to age?

A
lower urinary tract symptoms
Causes:
-bladder outlet obstruction
-overactive bladder
rates of these symptoms progress with age
17
Q

hesitancy, intermittency, and terminal dribbling are what type of symptoms

A

static LUTS symptoms

18
Q

frequency, urgency, dysuria and incontinence are symbpoms of what

A

dynamic LUTS symptoms

19
Q

what is most common reason people don’t report BPH to doctor

A

compensation

20
Q

what are the most common complications of untreated BPH?

A
Gross hematuria
Overflow urinary incontinence/ unstable bladder
Bladder diverticula
Bladder stones
Acute or chronic renal failure
Recurrent UTI
21
Q

what are the clinical signs of BPH?

A
  1. digital rectal exam (DRE) reveals enlarged prostate

2. greater than 20 gram prostate that is smooth, soft, symmetrical and mobile

22
Q

what lab values indicate BPH?

A
  1. BUN
  2. SCr
  3. elevate prostate specific antigen
  4. urinalysis
  5. peak urinary flow rate
    6 post void residual urine volume
23
Q

what peak urinary flow rate indicates BPH

A

less than 10 ml per second

24
Q

what post-void residual volume (PVR) level indicates bph

A

more than 25-50 ml

25
describe the American urological association symptom index?
a self administered, quantitative measure of extent of symptoms. not a diagnostic tool 7 questions, then add up score
26
what are the 3 stages and ranges of AUASI?
1. mild = 0-7 2. moderate = 8-19 3. severe = 20-35
27
what is considered clinically significant change in AUASI?
a change in score of 3 or more
28
what are 5 alpha blockers used for BPH?
1. doxazosin 2. Terazosin 3. Tamsulosin 4. Alfuzosin 5. Silodosin
29
True/False 1. Size of prostate is directly correlated with symptoms 2. PSA is directly correlated with symptoms
1. false | 2. false
30
what are 4 goals of treatment of BPH
1. improvement of voiding symptoms 2. improve quality of life 3. prevent disease infection 4. prevent complication and treatment related effects
31
what does PSA stand for?
prostate specific antigen