Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med GI > Prostate Disorder > Flashcards

Prostate Disorder Flashcards

(55 cards)

Start Studying
1
Q

Where does the prostate sit and what is it’s job?

A

Liquid portion of semun
Sits at the base of the penis (which is why ED is common with prostatis) inferior to the bladder (which is why UTIs are common)

DRE allows you to feel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gross vs microscopic hematuria. Also initial, terminal, total

A

Gross = visible to naked eye, more blood (concerning of cancer)

Microscopic = you need a microscope

initial (blood after first voiding)
Terminal (at the end of urinating)
Total (throughout urination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Irritative voiding symptoms

A

Inflammation in the bladder

Urgency
Dysuria (painful)
Frequency
Nocturia (waking up in the middle of the night)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Obstructive voiding symptoms

A

Hesitancy
Dribbling (still leak after peeing)
Decreased force ((low water pressure in water hose) or caliber of stream (more pinpoint with high pressure)
Interruption of stream (randomly stops)

Means that there is an obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Urinary incontinence

A

Overflow
Urge (involuntary and pee w/out
Stress (laughing, coughing)
Total (no mental switch, just randomly void with no triggers and no control over bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is acute bacterial prostatitis?

A

ascent up urethra
Can occur in setting of cystitis, urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the risk factors for prostatitis?

A

factors predisposing to GU infections
Catheter, prostate biopsy, urethral stricture
Anecdotal risks - no strong evidence to support
Trauma (bike riding, horseback riding)
Dehydration
Sexual abstinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the MC causative agent of acute bacterial prostatitis?

A

G- rods are most common pathogen
E. coli - 58-88%,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the s/s of acute bacterial prostatitis?

A

Fever, chills, malaise - common
Pain - perineal, sacral, or suprapubic
Irritative voiding s/s
Occasionally obstructive voiding s/s

DRE - Hot, exquisitely tender prostate
Prostatic massage contraindicated - risk of septicemia!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the labs of acute bacterial prostatits?

A

CBC - leukocytosis and left shift
Urinalysis - pyuria, bacteriuria, hematuria
Urine culture - + for causative agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When do you order imaging for acute bacterial prostatits?

A

If no response to abx in abx

Pelvic CT or transrectal US to assess for prostatic abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the IV treatment for acute bacterial prostatitis that is not nosocomial?

A

fluoroquinolone +/- aminoglycoside , or ampicillin/gentamicin empirically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the IV treatment for acute bacterial prostatitis that is nosocomial?

A

IV carbapenem or IV broad-spectrum PCN/cephalosporin +/- aminoglycoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the two categories used for oral therapy of ABP?

A

Bactrim or fluoroquinolone (cipro)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MC causitive organism of chronic bacterial prostatits?

A

E coli climbing up the urethra

sometimes no hx of acute prostatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the s/s of prostatitis?

A

Some are asymptomatic
Most - irritative voiding symptoms; may see obstructive voiding s/s
Pain - dull, poorly located, in suprapubic, perineal or low back regions
History of recurrent bacteriuria or UTIs

DRE - often normal (because we only feel a small part of the tissue)
May see boggy (spongy), mild tender, enlarged, and/or indurated prostate

NOT hot, not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the texture of a prostate/cervix?

A

Tip of the nose

boggy/spongy feels like a sponge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the labs of CBP?

A

UA - normal unless cystitis also present
Prostatic secretions - Increased WBCs (>10 per hpf) with + culture
Lipid-laden macrophages
Urine culture - negative
+ for causative organism after prostatic massage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the imaging of CBP?

A

usually not needed
Prostatic calculi may be visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the treatment for CBP?

A

Same as acute

fluroquinolones or bactrim for 6-12 weeks (but prolonged treatment may need to C dif)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why is CBC normal for chronic prostatitis vs

A

Puss is already in collecting ducts

chronic = walled off puss in microabcesses = not show up in CBC (massage releasese this though)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a non-pharm treatment for CBP?

A

sitz bath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is non-bacterial prostatits?

Study These Flashcards
A

MC cause of prostatitis

similar symptoms to chronic prostatits

often neurologic, but as inflammatory markers

24
Q

what are the s/s of non-bacterial prostatis?

Study These Flashcards
A

Irritative voiding or obstructive voiding
Pain - perineal, lower abdominal, or low back
Often dull and poorly localized as with CBP
May have hx of other pain syndromes (e.g. IBS, fibromyalgia)
Less likely to have hx of UTI than in CBP
DRE - tenderness in 50% of pts

25
What is the UA and prostatic secretion analysis of nonbacterial prostatits?
UA - unremarkable Prostatic Secretions increased WBC if inflammatory (chronic/nonbacterial prostatitis) normal if noninflammatory negative culture Urine culture - negative Imaging - mainly to rule out other pathology e.g., obstruction in pts with obstructive voiding s/s
26
How do you treat nonbacterial prostatits?
hard to treat, but actually use antibiotics for 2 weeks (stop if they are not improving) fluoroquinolones often treated based on symptoms (pain = NSAIDs) -alpha blockers -osin 5-𝛼-reductase inhibitors - finasteride, dutasteride -sitz baths -acupuncture, cernilton Pelvic floor physical therapy Treatment of psych disorders
27
What are the selective alpha blockers?
-osin tamsulosin is MC
28
What is benign prostatic hyperplasia?
MC benign tumor in men (increases with age) -increases glandular and stromal components over 80% over 80 have it! But often asymptomatic
29
Apart from age, what are risk factors for benign prostatic hyperplasia?
Black men - more likely to have severe s/s and to need surgery Asian men - less likely than black or white men to have BPH Increased risk - higher free PSA levels, prostatitis, heart disease, beta-blocker use, lack of exercise, obesity Decreased risk - NSAIDs, excessive ETOH use, smoking, exercise
30
Why does age lead to BPH?
Aging prostate seems to become more sensitive to androgens and growth factors Aging prostate may also stop normal cell death Testosterone, dihydrotestosterone, and estrogen may be involved in development
31
What are the two ways that BPH leads to obstruction?
Mechanical (stopping urine flow) Muscles are constricted due to excessive stimulation of alpha-receptor
32
How does BPH typically come on?
Comes on slowly
33
What are the s/s of obstructive voiding of BPH?
Obstructive voiding - mechanical blockage Urine hesitancy Decreased force and caliber of stream Sensation of incomplete bladder emptying Double voiding (urinating within 2 hours) Straining to urinate Postvoid dribbling
34
What are the s/s of irritative voiding in BPH?
urgency, frequency, nocturia Due to secondary response of bladder to increased outlet resistance Detrusor muscle hypertrophy and hyperplasia, collagen deposition
35
How can you determine how bad the BPH of a patient is?
AUA symptom score based on symptoms - and asks if it effects them
36
What is the DRE for BPH?
- smooth, firm, symmetric, elastic enlargement of prostate Induration or asymmetric enlargement β†’ possible cancer
37
What are the s/s of a neuro exam for BPH?
normal, but r/o neurogenic bladder
38
What are the s/s of lower abdominal exam for BPH?
might have a distended bladder
39
What are the labs for BPH?
UA - often normal May see hematuria PSA - may help screen for prostate cancer Can be elevated in BPH even when no cancer is present Prostate Bx - usually only done if concern for cancer Transrectal or transperineal
40
When is BPH imaged?
often not needed US - may be indicated if high serum Cr or UTI Upper GU tract imaging - only if complications arise or comorbid GU disease present
41
When do you do watchful waiting for BPH?
mild symptoms (score 0-7) or pts who do not want tx Not all pts will experience s/s progression! Up to 50% have spontaneous regression Limited data on natural course of disease
42
When are you not a candidate for BPH?
basically if no major s/s Refractory urinary retention Large bladder diverticula Recurrent UTI or gross hematuria Bladder stones CKD
43
What are the 3 types of alpha blockers?
πžͺ1a - 70% of adrenoreceptors in prostate, bladder neck πžͺ1b - smooth muscle of vasculature πžͺ1d - prostate, bladder neck, detrusor, sacral spinal cord
44
What are the a1-blockade agents?
Prazosin Doxazosin Terazosin
45
What are the selective a1a
silodosin tamsulosin alfuzosin
46
What are the SE of a1 blockers?
orthostatic hypotension, dizziness, tiredness, retrograde ejaculation, rhinitis, and headache Floppy Iris Syndrome - cataract surgery complication in pts taking πžͺ1-blockers
47
What are the DDI of a1 blockers?
antihypertensives, PDE-5 inhibitors can cause significant drops in BP when taken with alpha blockers
48
What is the MOA of 5-πžͺ-reductase inhibitors?
5-πžͺ-reductase - converts testosterone to dihydrotestosterone Inhibiting this enzyme reduces size of prostate gland Takes ~6 months of treatment to see full benefit Reduces prostate size by ~20% - may reduce need for surgery
49
when are 5-πžͺ-reductase inhibitors used?
More effective in men with larger prostates All 5-πžͺ-reductase inhibitors reduce PSA by 50% Should double PSA value when comparing to pre-treatment PSA May reduce risk of prostate cancer (reduces testosterone level)
50
What are the two 5-πžͺ-reductase inhibitors?
Finasteride Dutasteride
51
What are the SE of Finasteride and Dutasteride
similar to low T Decreased libido, erectile or ejaculatory dysfunction
52
What is first-line therapy of BPH?
alpha blocker + 5-alpha-reductase inhibitor is considered first-line and superior to either treatment alone
53
What is the PDE 5 inhibitor and what is it used for?
Tadalafil Approved for use in men with BPH + ED symptoms Not superior to alpha-blockers, no extra benefit as adjunct it's expensive though :(
54
What surgery is used for BPH?
Transurethral Resection of the Prostate (TURP) leads to retrogade ejaculation sometimes
55

Clin Med GI (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions