Pathoma: Prostate Flashcards
What are the most common etiologies of acute prostatitis?
Similar to orchitis, the most common causes of acute prostatitis in young men are N. gonorrhoeae and C. trichomonas and in old men it is E. coli and P. aeruginosa.
What are presenting signs and symptoms of acute prostatitis?
A “tender and boggy” prostate on digital rectal exam and dysuria with fever and chills
How is chronic prostatitis distinct from acute?
It more often presents with lower back pain and cultures are negative (whereas acute prostatitis often leads to positive cultures).
True or false: BPH does not increase the risk of cancer.
True. This is unique because generally hyperplasia does increase risk of cancer.
Which tissue – stromal or glandular –increases in BPH?
Both!
Super high yield: where in the prostate does BPH usually occur?
In the periurethral zone
What extra-prostatic complication often results from BPH?
Hypertrophy of the bladder wall, with a potential for diverticuli, can occur due to the increased force needed to expel urine. This can even back up into the kidney and cause dilation of the ureter or hydronephrosis.
Which alpha-1 antagonist is selective for the urethra?
Tamsulosin (“TAm TArgets!”)
How soon will you see results in using 5-alpha reductase inhibitors?
Months
When should screening for prostatic adenocarcinoma begin?
Whoa, that’s a hot topic. Current guidelines mostly agree on age 50, though.
What are the ranges for normal and worrisome PSAs?
Normal: 0-4
Slightly elevated: 4-10
Worrisome: greater than 10
Cancer makes what kind of PSA?
Bound
What cellular sign is typical of prostatic adenocarcinoma?
Dark nucleoli (think: the nucleus almost looks like a prostate with a lesion in it!)
Gleason scoring is based on _______________.
architecture, not nuclear atypia
To where does prostatic adenocarcinoma often metastasize?
The lumbar spine, specifically with lumbar osteoblastic lesions (as opposed to the osteoclastic lesions commonly seen in metastatic cancer)
