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Flashcards in Prostate Pathology: Norton Deck (50):
1

what are the 4 zones of the prostate

1. peripheral
2. central
3. transitional
4. anterior fibromuscular stroma

2

what zone of the prostate is the most common site for carciomas? hyperplasia?

carcinoma: peripheral
hyperplasia: transitional

3

What are the 2 layers that line the prostate gland

1. basal layer of cuboidal epithelium
2. inner layer of columnar secretory epithelium

4

What separates the prostate glands

fibromuscular stroma

5

What role does prostatic fluid play

protects and increases motility of sperm

6

what control growth and survival of prostate cells

testicular androgens

7

what are 3 pathological processes that occur in prostate

1. inflammation
2. Benign prostatic hyperplasia (BPH)
3. protsatic hyperplasia

8

What are 4 types of prostate inflammation

acute bacterial prostatitis
chronic bacterial prostatitis
chronic abacterial prostatitis
granulomatous prostatitis

9

what are common bacteria that cause acute bacterial prostatitis

same as UTI
- E.coli
- other gram -
- enterococci
- staph

10

clinical features of acute bacterial prostatitis

fever
chills
dysuria
prostate TENDER

11

what is the urinalysis for acute bacterial prostatitis

positive leucocytes
positive bacteria

12

clinical features of chronic bacterial prostatitis

mild symptoms
back pain
dysuria
pernieal and suprapubic discomfort
asymptomatic

13

a male with chronic bacterial prostatitis may have a history of what

recurrent UTI

14

urinalysis for chronic bacterial prostatitis

positive leucocytes
positive bacterial

15

What is the most common form of prostatitis

chronic abacterial prostatitis

16

urinalysis of chronic abacterial prostatitis

positive leucocytes
negative bacterial culture

17

clinical symptoms for chronic abacterial prostatitis

similar to chronic bacterial prostatitis

18

How can a male get Granulomatous prostatitis

from Bacillus Calmette-Guerin (BCG) instilled into bladder to treat superficial bladder cancer

19

what is the main prostate hormone

DHT dihydrotestosterone

20

What converts testosterone to DHT

type 2
5 alpha reductase

21

What does DHT bind to in prostate

androgen receptors on nuclei of stormal and epithelial cells

22

What is the etiology of BPH ( benign prostatic hyperplasia)

increased number of epithelial cells and stromal components influenced by DHT

23

Benign prostatic hyperplasia originates in what part of the prostate

transition zone (periurethral)

24

What are late and early nodules of prostate in BPH composed of

early: stromal cells
late: epithelial cells/glands

25

What is a clinical feature for benign prostatic hyperplasia

urethral obstruction causes
- bladder hypertophy and distension
- urine retention
- sudden acute urinary retention

26

what are some conservative treatment options for benign prostatic hyperplasia

decrease fluids before bedtime
decrease caffeine and alcohol

27

what are 2 medication options for moderate to severe symptoms of BPH

1. alpha blockers
2. 5-alpha reductase inhibitors

28

How do alpha-blockers help with BPH

decrease smooth muscle tone

29

how do alpha blockers help with BPH

decrease smooth muscle tone

30

what is a surgical option for BPH

transurethral resection of prostate

31

What type of diet can give you a greater risk for prostate adenocarcinoma

high fat diet

32

What are 3 things that can cause prostate adenocarcinoma

diet
androgens
genetics

33

What is a precursor lesion to prostate adenocarcinoma

porstate intraepithelial neoplasia (PIN)

34

prostate intraepithelial neoplasia is seen in what zone

peripheral zone

35

how do PIN glands differ from prostate adenocarcinoma

- larger than cancer glands with branching/folding
- surrounded by patchy layer of basal cells and intact basement membrane

36

what is histo for prostate adenocarcinoma

- glands small
- croweded
- no branching/folding
- no stroma
- "back-to-back" glands

37

What lines the glands in prostate adenocarcinoma

single layer of cuboidal or columnar cells
OUTER BASAL CELL LAYER IS ABSENT

38

where does prostate adenocarcinoma spread to

periprostatic tissues
seminal vesicles
base of bladder

39

what are 2 routs of mestastasis for prostate adenocarcinoma

lymphatics
blood

40

if prostate adenocarcinoma mets via lymph , where does it go

obtruator nodes then to paraaortic nodes

41

if prostate adenocarcinoma mets via blood, where does it go? what is formed?

bones
-lumbar spine
-proximal femur
-thoracic spine
- ribs

forms osteoblastic lesions

42

how is prostate adnenocarcinoma scored

adding
1. prominent pattern
2. second most prominent pattern
OR
1. prominent pattern
2. highest grade pattern

43

what is the lowest grade for prostate adnenocarcinoma

gleason 1

44

what is the highest grade for prostate adnenocarcinoma

Gleason 5

45

What are 2 methods that detect what is the lowest grade for prostate adnenocarcinoma

1. digital rectal exam (DRE)
2. tranrectal ultrasonography

46

what confirms diagnosis of prostate adenocarcinoma

transrectal needle biopsy

47

what is clinical feature of local prostate cancer

asymptomatic
- later urinary symptoms
- back pain

48

for prostate adnenocarcinoma what is most important test for screening

PSA
prostate specific antigen

49

what is most common treatment for localized prostate adnenocarcinoma

surgery: radical prostatectomy

50

what are treatment options for prostate adnenocarcinoma

radiation
hormone manipulation
acute surveillance of PSA