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Biology 253 > Genitourinary Disorders: Benign Prostatic Hyperplasia > Flashcards

Genitourinary Disorders: Benign Prostatic Hyperplasia Flashcards

(61 cards)

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1
Q

What is Benign Prostatic Hyperplasia (BPH)?

A

gradual periurethral benign enlargement

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2
Q

BPH is the most common _________ disorder in older ____

A

reproductive

men

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3
Q

BPH increased with ____ but takes ______ to progress

A

Age

years

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4
Q

Do symptoms appear quick of gradually?

A

quick

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5
Q

What does hyperplasia mean?

A

increase in numbers of granular cells

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6
Q

Pressing manifestations occurs beyond _____ y/o

A

50

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7
Q

Prevalence above 40 y/o?Prevalence above 60 y/o?

Prevalence above 80 y/o?

A

~20% –>less common in this age range

~50%

~90%

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8
Q

T or F: Aging causes BPH

A

NO!

aging accompanies BPH

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9
Q

Etiology (5/6)

A
  1. unclear
  2. aging is a primary risk factor
  3. hormonal influence
  4. genetics
  5. race, diet
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10
Q

Etiology: What are the 3 hormones that influence BPH?

A
  1. testosterone
  2. DHT: dihydrotestosterone
  3. estrogen
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11
Q

What is androgens?

What are 2 the primary androgen? What do they support?

A

male sex hormones

  1. testosterone
  2. dihydrotestosterone

reproductive structures

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12
Q

What is DHT and its fxn?

How is it produced?

A

a metabolite of testosterone

supports growth and fxn of the prostate gland by allowing prostate to continue to produce secretion

testosterone convert to DHT with 5 alpha-reductase

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13
Q

Men have ________ but requires less than woman. What is it’s fxn in regard to male reproductive sysrem?

A

Estrogen

sensitizes prostatic cells to DHT

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14
Q

No estrogen = cells in __________ will not respond to ________

A

prostate

DHT

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15
Q

Etiology: genetics ___________ BPH to men but the kind of _______ is not known

A

predisposes

gene

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16
Q

Etiology: What race is more prone to BPH? Who is less prone? Give one reason why regarding diet? Give example of diet?

A

Afrikan American

Japanese men

Japanese men diet has abundance of yellow veggies which is protective of BPH

eg seawood

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17
Q

Patho: What H decline as men age? How does it cause BPH?

A

testosterone

decr. in testosterone results in decr. of DHT

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18
Q

Patho: How does Testosterone and Estrogen Ratio cause BPH?

A
  • this ratio decr. as T prod decr. and E prod. remains about the same
  • w/ decr. in ratio, E’s effect are more pronounced meaning E will make prostatic cells more sensitized to DHT
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19
Q

With age, there is a ________ increase in _________ and _______ decline in _________

A

relative increase in E

absolute decline in T

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20
Q

relative _______ in E —> _______ sensitize cells to _____ —> ______ _______ enlarges

A

increase

over

DHT

prostate gland

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21
Q

Prostatic _____-_____ ______ _______ plays a role but the mechanism is _____. What does this do?

A

insulin-like growth factor

unclear

stimulate the proliferation of prostatic cells –> enlargement

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22
Q

Enlargement is _________ which means the urethra is __________. What prob occurs?

A

periurethral

compressed

impedes voiding of urine

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23
Q

What are 2 structural changes?

A
  1. thickened bladder wall

2. trabeculations and diverticula

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24
Q

Why does the bladder wall thickens?

A

to compensate for retention of urine d/t inability to release urine thru obstructed prostatic urethra -

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25
Is thickened bladder wall a comp mech? Explain
Yes to prevent bladder wall from bursting d/t increase vol of urine
26
What are trabeculations and diverticula? Why does this occur?
trabeculations = thickened bladder muscle wall and l/o elasticity and muscle tone diverticulas = foldings in wall of bladder to increase storage in bladder and prevent rupture
27
What are the 3 adaptive changes/consequences of BPH?
1. hydroureters 2. ureter loops and fishhooks 3. hydronephrosis
28
What is hydroureters?
ureters becomes distended by dilation because they get filled with urine to allow more capacity
29
What are ureters loop and fishhooks?
ureters gets filled with urine and begin to loop downward due to increase weight resembling a fishhooks
30
What is hydronephrosis?
distension of renal pelvis and calyces d/t urine backing up into the kidneys
31
What are 2 other changes in BPH? 2 complications?
1. urine accum on kidneys 2. urine stasis 1. calculi = kidney stones 2. UTI
32
Urine stasis can form ________.
calculi
33
Urine may flow into ________ but w/ compression from ________ _______ it is squeezed back into ___________. How does this cause UTI?
urethra prostate gland bladder brings normal flora from urethra into bladder (urine is normally sterile)
34
Manifestations of BPH (5)
1. frequency 2. hesitancy 3. weak urine stream 4. terminal driblling 5. obstruction and urine retention
35
Mnfst relate to the fact that _______ is __________
urethra is compressed
36
BPH mnfst occurs ________ over years and can lead to renal _______
gradual failure
37
What is frequency? Hesitancy?
Frequency = not complete voiding b/c there's not enough pressure in urethra to force urine so residual vol causes an urge to void shortly after Hesitancy = urge to empty bladder b/c with BPH there is a difficulty to start a urine stream
38
What is a weak urine stream?
trickling of urine
39
What is terminal dribbling?
droplets of urine continue to pass in end of urine stream
40
Complete obstruction of urethra would result in ___ urine _____.
NO flow
41
Urine retention leads to ___________ of _______
complications kidney
42
Diagnosis of BPH
1. mnfsts 2. px - DRE screen 3. PSA 4. BUN, creatinine 5. Urinalysis
43
Diagnostic tests done only those whose ______ indicate ____
mnfst BPH
44
What is the DRE?
digital rectal exam is a screening tool to detect abnormality of the prostate by palpating it
45
What is the PSA stand for? What is it? How does it detect BPH?
prostate specific antigen a protein produced by prostate and is secreted and entered in circulation and is measured using a blood test elevated levels tells you prostatic cells have increase in size and numbers
46
Why is it not routinely used?
elevated PSA could mean BPH or prostate CA some pt w/ prostate CA or BPH do NOT have elevated levels and some w/ elevated levels do not have CA/BPH
47
What are additional markers for BPH?
``` PSA = total PSA PSAd = density of prostate (# of cells) PSAv = velocity (speed) @ which prostate is enlarging ```
48
PSA is proportional to the mass of ______. What does this mean?
prostate increase PSA = increase in mass
49
PSA is used as ____
a screening tool
50
How does creatinine and BUN detect BPH?
both are excreted by kidneys and elevated levels could mean compromised kidney fxn eg hydronephrosis
51
What is BUN and creatinine?
BUN = measures urea nitrogen in blood creatinine = waste product that is excreted by kidneys (produced by breakdown of muscles)
52
What are 2 markers for renal injury?
BUN creatinine
53
What is urinalysis and how does it diagnosis BPH?
looks for evidence of stones and blood in urine (eg hematuria) it is r/t the complications of BPH eg kidney stones and infections
54
Treatment of BPH (4)
1. behavioural approach 2. pharmaceuticals 3. TURP 4. Laser prostatectomy
55
What are the behavioural approach? (2)
1. avoid fluids a few hours before so bladder doesn't fill | 2. avoid alcohol and caffeine
56
What are the 2 drugs used for BPH? What gives the greatest benefits
1. 5 alpha reductase inhibitors (long term) 2. alpha adrenergic antagonists (acts on muscles) two drugs used in combination for long term
57
What does 5 alpha reductase inhibitors do? How does it treat BPH? Long or short term?
inhibits 5 alpha reductase, an enzyme that converts T to DHT decreases prod of DHT to inhibit growth of prostate must use long term
58
What does alpha adrenergic antagonists do? How does it treat BPH? Long or short term effects?
relax muscle in urethra resulting in decrease obstruction and improve urination for short term effects
59
What is TURP? How does it treat BPH?
transurethral resection of the prostate a section of the prostate is removed by inserting a resectoscope thru the urethra to the prostatic urethra
60
In TURP, bleeding is controlled with _______ and _______ and _____ is used to flush out ______ during recovery
cautery Catheter and controlled bladder irrigation is used to flush out blood
61
How does laser prostatectomy treat BPH?
removal of prostate gland

Biology 253 (39 decks)

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