prostate gland diseases

Question 1

where is the prostate gland

Answer 1

at the base of the bladder and surround the urethra

Question 2

prostate histology

Answer 2

fibromuscular tissue and glandular epithelial cells

Question 3

prostatitis

Answer 3

inflammation of the prostate gland that can be infectious or noninfectious

Question 4

most common bacteria associated with acute prostatitis for men >35

Answer 4

E. coli

Question 5

most common bacteria causing acute prostatitis in men <35

Answer 5

chlamydia and gonorrhea

Question 6

most common bacterial cause of chronic prostatitis

Answer 6

E. coli

Question 7

general prostatitis irritative voiding symptoms

Answer 7

frequency
urgency
dysuria

Question 8

general prostatitis obstructive symptoms

Answer 8

hesitancy
poor or interrupted stream
straining to void
incomplete emptying
malaise
arthralgias

Question 9

acute prostatitis symptoms

Answer 9

fever
chills
perineal pain
lower back/abdominal pain

Question 10

chronic prostatitis symptoms

Answer 10

recurrent UTIs or intermittent dysfunction

Question 11

acute prostatitis PE

Answer 11

very tender boggy prostate

warm and swollen

Question 12

chronic prostatitis PE

Answer 12

contender boggy prostate

Question 13

acute prostatitis diagnostic tests

Answer 13

urinalysis

blood tests

Question 14

acute prostatitis urinalysis and lab findings

Answer 14

pyuria and bacteruria (E. coli!)
increased PSA
increased inflammatory markers

Question 15

when to use prostatic massage

Answer 15

chronic prostatitis to increase bacterial yield on UA and culture

Question 16

chronic pelvic pain syndrome sx

Answer 16

ED
painful ejaculation
bloody same
moderate an diffuse pain

Question 17

bacterial prostatitis treatment

Answer 17

fluoroquinolone or TMPSMX

Question 18

refractory chronic prostatitis tx

Answer 18

Transurethral resection of the prostate (TURP)

Question 19

BPH definition

Answer 19

benign glandular and stromal hyperplasia in the periurethral or transitional zone of the prostate leading to bladder outlet obstruction

Question 20

BPH is most common in ___ because…

Answer 20

older men because prostate hyperplasia is part of normal aging

Question 21

hormones involved in BPH

Answer 21

DHT
estrogens
both are prostatic growth factors

Question 22

testosterone is converted to ____ by _____

Answer 22

DHT by 5alpha reductase enzyme

Question 23

estrogen is ______ in BPH

Answer 23

elevated

Question 24

testosterone levels are ______ in BPH because

Answer 24

decreased because it is converted to DHT which leads to hyperplasia of prostate

Question 25

_______ causes irritative symptoms of BPH

Answer 25

detrusor overactivity

Question 26

static component of BPH

Answer 26

enlargement of the prostate gland

Question 27

dynamic component of BOH

Answer 27

increase in smooth muscle tone of prostate and bladder neck that is mediated through alpha 1 adrenergic receptors

Question 28

what happens to the detrusor muscle in BPH?

Answer 28

bladder muscle thickens due to increased pressure while voiding

Question 29

FUNWISE sx of BPH

Answer 29

``` frequency urgency nocturia weak stream intermittent stream straining emptying not complete ```

Question 30

DRE BPH findings

Answer 30

symmetrically enlarged smooth firm prostate with rubbery texture

Question 31

IPSS

Answer 31

international prostate symptom score that categorizes symptoms "bother" in the past 30 days

Question 32

AUASI

Answer 32

American Urological Association Symptom Index determine prostate disease severity and response to tx

Question 33

mild IPSS score tx

Answer 33

reassurance and watchful waiting for 1 year

Question 34

TURP

Answer 34

removes excess prostate tissue relieving obstruction in BPH

Question 35

TURP AEs

Answer 35

sexual dysfunction | urinary incontinence

Question 36

rapid symptom relief of BPH

Answer 36

alpha 1 blockers like tamsulosin

Question 37

suppresses prostate growth and can decrease prostate size

Answer 37

5 alpha reductase blockers like finasteride

Question 38

BPH complications

Answer 38

``` recurrent UTI bladder calculi hydronephrosis CKD hematuria ```

Question 39

hydronephrosis is

Answer 39

dilation of renal pelvis, calyces or proximal ureter due to a distal obstruction leading to oliguria

Question 40

detrusor muscle hypertrophy can lead to

Answer 40

bladder trabeculation and pseudodiverticula formation

Question 41

irritative symptoms are due to

Answer 41

urinary storage

Question 42

obstructive urinary symptoms are due to

Answer 42

voiding issues from obstruction

Question 43

first line pharmacotherapy for symptomatic BPH

Answer 43

alpha blockers (-zosin)

Question 44

decrease bladder neck and retrial sphincter tone results in

Answer 44

decreased resistance to urinary outflow (more pee) improves LUTS