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MIDS 137 > Ch 5a (prostate pathology) > Flashcards

Ch 5a (prostate pathology) Flashcards

1
Q

Are cysts in male pelvis common?

A

No, rare

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2
Q

Symptoms of cysts in male pelvis?

A

Ranging from urinary retention - perineal pain

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3
Q

Where would cysts occur in male pelvis?

A

-prostate
-seminal vesicles
-vas deferens

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4
Q

Types of cysts that can occur in male pelvis?

A

-mullerian duct cysts
-utricle systs
-seminal vesicle cysts
-prostatic cysts
-ejaculatory duct cysts
-vas deferen cysts

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5
Q

What 2 cysts are m/c in male pelvic cysts?

A

-mullerian duct
-utricle

(discussed together b/c almost identical locations)

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6
Q

Why do mullerian duct cysts occur?

A

Failure of regression of mullerian ducts

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7
Q

SF of mullerian duct cysts?

A

-anechoic
-may have debris/calcifications

(is a fluid collection left behind when the mullerians disappear)

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8
Q

Why do utricle cysts occur?

A

When prostatic utricle is dilated

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9
Q

SF of utricle cysts?

A

-smaller than mullerian duct cysts
-may have calcifications
-unilateral renal agnesis can occur with cystic formation in prostate

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10
Q

Are seminal vesicle cysts common?

A

No, less than 0.005% of males have them

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11
Q

Most cases of seminal vesicle cysts are associated with what?

A

Ipsilateral renal agenesis

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12
Q

SF of seminal vesicle cysts?

A

Paramedian anechoic structures

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13
Q

Can prostatic cysts be congenital or acquired?

A

Yes
(congenital = retention or inclusion cysts,
acquired = cystic change from BPH)

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14
Q

SF of retention prostatic cysts?

A

-small (1-2cm)
-simple
-smooth walled
-completely anechoic

(clinically not significant)

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15
Q

M/c type of prostatic cyst?

A

Aquired cystic changes in transition zone due to BPH

(they are m/c because BPH is common)

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16
Q

SF of prostatic cysts due to BPH?

A

-occur within hyperplastic nodules
-very small

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17
Q

Prostatic abscesses are associated with what?

A

-acute bacterial prostatitis
-diabetic males

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18
Q

Symptoms of prostatic abscess?

A

Fever, chills, urinary frequency, urgency, lower back pain, dysuria, hematuria

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19
Q

SF of prostatic abscess?

A

-Focal or diffuse complex areas in any part of prostate
-CD or PD may show hyperemic flow

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20
Q

M/c symptomatic tumor-like condition in males?

A

BPH - benign prostatic hyperplasia

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21
Q

What age m/c gets BPH?

A

Men over 40 y/o, peaks around 60 y/o

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22
Q

SF of BPH?

A

-Diffuse nodular enlargement within transition zone of prostate
-Enlarged central gland in anteroposterior direction
-No longer crescent shape, more rounded
-Up to 4x original size of prostate

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23
Q

Cause of BPH?

A

Not well understood, related to hormonal changes due to aging process tho

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24
Q

Symptoms of BPH?

A

Urinary symptoms! B/c transition zone lies around urethra. Includes:
-frequency
-nocturia
-dribbling
-difficulty starting stream

(causes obstructive process to flow of urine)

25
Q

Is BPH m/c found on TA or TRUS exam?

A

TRUS - on men over 40

26
Q

What is transurethral resection of the prostate (TURP)?

A

Procedure done to relieve symptoms caused by compression of prostatic urethra

Removal of excess tissue creates the TURP defect which is a lg defect at level of bladder

27
Q

When would we typically encounter prostate calcifications?

A

Incidentally, usually in urologic practice

28
Q

Do prostate calcification’s usually have symptoms?

A

No

29
Q

Are prostate calcification’s common?

A

Yes, very common

30
Q

2 groups prostate calcification’s are classified into?

A

-Endogenous
-Exogenous

31
Q

What are endogenous calcifications?

A

-Calculi found within substance of prostate, from the prostatic fluid

-True prostatic stones (meaning pathologies such as BPH or prostatitis can cause this type of calculi)

32
Q

What are exogenous calcifications?

A

-Calculi found in urethra
-Derived primarily from urine

33
Q

SF of prostate calcification’s ?

A

-easily identified
-occur in parenchyma of gland
-range in size
-acoustic shadowing
-CD artifact

34
Q

What type of u/s would ejaculatory duct calcification’s be best seen?

A

TRUS - transrectal u/s

35
Q

Do ejaculatory duct calcification’s cause symptoms?

A

Yes, hematospermia or painful ejaculation

(they can be an incidental finding as well if no symptoms occur)

36
Q

Is prostatitis easy to diagnose?

A

No, hard to both clinically + sonographically

37
Q

A clinical diagnosis of prostatitis is made by evaluating what?

A

Evaluation of expressed prostatic secretion (EPS) for either positive bacterial cultures or inflammatory cells

38
Q

4 categories of prostatitis?

A

-acute bacterial
-chronic bacterial
-chronic abacterial/chronic pelvic pain syndrome (CP/CPPS)
-asymptomatic

39
Q

Symptoms with acute bacterial prostatitis?

A

Acutely ill with:
-fever
-severe lower urinary tract symptoms (LUTS)

40
Q

How is acute bacterial prostatitis easily diagnosed?

A

Urine test

41
Q

Symptoms with chronic bacterial prostatitis?

A

-discomfort in penis, scrotum + perineum
-irritative voiding symptoms such as dysuria, urgency + frequency
-recurrent UTIs

42
Q

What is chronic bacterial prostatitis characterized with?

A

UTIs

43
Q

What do asymptomatic patients with prostatitis appear to have?

A

An inflammatory disease

44
Q

What is CP/CPPS prostatitis?

A

Inflammation of prostate with unknown etiology/cause

45
Q

Which type of prostatitis has highest incidence rate?

A

CP/CPPS has 8x higher rate than bacterial prostatitis

46
Q

What are the symptoms with CP/CPPS prostatitis?

A

Same as pt’s with bacterial prostatitis

47
Q

SF of prostatitis?

A

-hypoechoic halo in periurethral area (m/c)!!!
-heterogeneous echo pattern of peripheral gland with capsular thickening + irregularity
-calculi may be seen in gland if pt has chronic prostatitis

48
Q

How common is prostate cancer?

A

-2nd m/c
-5th most aggressive neoplasm among men worldwide

49
Q

3 main RF’s of prostate cancer?

A

-African descent
-Genetic abnormalities
-Obesity

50
Q

Approx 75% of prostate cancers are detected by what?

A

An abnormal PSA (blood test) - this is the primary test to check for prostate cancer

51
Q

Does PSA check for anything other than prostate cancer?

A

Yes, can be elevated with BPH + prostatitis as well

52
Q

Pt’s sent for a TRUS exam to check for prostate cancer present with what?

A

Either:
-bladder outlet obstruction
-abnormal PSA level
-Abnormal DRE (digital rectum exam)

53
Q

SF of prostate cancer?

A

Hypoechoic lesion m/c in peripheral zone (70%)

(remember the majority of hypoechoic areas in this zone are a result from a benign cause like inflammation, fibrosis, infarction, etc. Need a biopsy to detect cancer)

54
Q

U/s guided biopsies of the prostate use what approach?

A

Endorectal approach

55
Q

M/c type of anesthesia used with prostate biopsies?

A

-Periprostatic nerve block (m/c)
-Lidocaine gel also used

56
Q

Why do pt’s often need multiple prostate biopsies done?

A

B/c don’t target the right areas in the prostate (often biopsies come back negative due to this), so pt’s must have repeat biopsies which is why the cancer can go undiagnosed for a while

57
Q

How does u/s guidance help during a biopsy?

A

-help localize a nonpalpable suspicious lesion
-assist in staging prostate cancer by obtaining tissue from areas where microscopic ECE (extracapsular extention) is likely present

58
Q

What does a biopsy needle look like on u/s?

A

Echogenic linear structure

MIDS 137 (14 decks)

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