Trigger - prostate disorders

Question 1

risk factors for this condition includes catheters, prostate biopsy, urethral stricture

Answer 1

acute bacterial prostatitis

Question 2

DRE showing red hot tender prostate

Answer 2

acute bacterial prostatitis

Question 3

leukocytosis showing left shift. UA showing pyuria, bacteriuria, hematuria. UC - + causative agent.

Answer 3

acute bacterial prostatitis

remember you have to get a culture in these patients so you can use the right abx

Question 4

in acute bacterial prostatitis, if there is no response to abx in 24-48 hrs what should be done

Answer 4

pelvic CT or transurethral US to assess for abscess

Question 5

treatment is amp/gent or fluoroquinolones +/- aminoglycoside

Answer 5

acute bacterial prostatitis that is NOT nosocomial

quinolones - cipro/levo/moxi
aminoglycosides ex- gentamicin, tobramycin, streptomycin

Question 6

treatment includes carbapenem, broad spectrum PCN +/- aminoglycoside, broad spectrum ceph +/- aminoglycoside

Answer 6

nosocomial acute bacterial prostatitis

ceph - cefdinir, cefipime
pcn - ampicillin

Question 7

treatment includes bactrim, levo, cipro.

Answer 7

oral abx tx for acute bacterial prostatitis

Question 8

pain that is dull, poorly located, in suprapubic, perineal or low back regions.

Answer 8

chronic bacterial prostatitis

this could also be in nonbacterial prostatitis, CPPS

Question 9

DRE showing boggy/spongy, tender, enlarged and/or indurated prostate

Answer 9

chronic bacterial prostatitis

Question 10

positive urine culture AFTER prostatic massage

Answer 10

chronic bacterial prostatitis

Question 11

lipid laden macrophages and WBCs in prostate secretions

Answer 11

chronic bacterial prostatitis

Question 12

flouroquinolones or bactrim is used in treatment of what

Answer 12

chronic bacterial prostatitis

Question 13

all negative tests except perhaps WBCs on the prostatic secretions MAYBE

Answer 13

nonbacterial prostatitis or CPPS

Question 14

treated with 5-a reductase inhibitors

Answer 14

nonbacterial prostatitis or CPPS

Question 15

which alpha blockers are used for urinary symptoms that have less SE?

Answer 15

tamsulosin
sildosin
alfuzosin

Question 16

this medication causes relaxation in bladder neck and smooth muscle in the prostate

Answer 16

alpha blockers (tamsulosin, sildosin, alfuzosin)

Question 17

not recommended in young men d/t decreased semen volume

Answer 17

5-a-reductase inhibitors
finasteride
dutasteride

Question 18

what parts of the prostate are increased in BPH

Answer 18

glandular and stromal components

Question 19

presents with mainly obstructive voiding that is slow onset and gradually progresses

Answer 19

BPH

Question 20

hypertrophy, hyperplasia and collagen deposition are the causes of what

Answer 20

BPH irritative voiding s/s

Question 21

DRE showing smooth, firm, symmetric, elastic enlargement of prostate

Answer 21

BPH

Question 22

induration or assymetric enlargement of prostate

Answer 22

cancer

Question 23

normal UA, may see slight elevation in PSA

Answer 23

BPH

Question 24

when is US indicated in BPH

Answer 24

high serum Cr or UTI

Question 25

watchful waiting indicated when

Answer 25

mild BPH = AUA score of 0-7

Question 26

SE for orthostatic hypotension, dizziness, and floppy iris syndrome

Answer 26

alpha 1 blockers

Question 27

DDI with antihypertensives and PDE-5 inhibitors

Answer 27

alpha blockers

Question 28

converts testosterone to dihydrotestosterone

Answer 28

5-4-redutase inhibitor

Question 29

takes 6 months to see the full benefits of this drug

Answer 29

5-a-reductase inhibitors

Question 30

reduces prostate side by 20%

Answer 30

5-a-reductase inhibitors

Question 31

SE decreased libido and erectile/ejaculatory dysfunction

Answer 31

SE of 5-a-rductase inhibitors

Question 32

what is the affect of NSAIDS, smoking and ETOH on risk of BPH

Answer 32

decreases risk of developement

Question 33

if a patient has gross hematuria or recurrent UTIs how would it affect their treatment plan for BPH

Answer 33

they would NOT be a candidate for watchful waiting also not a candidiate: - refractory urinary retention - large bladder diverticula - bladder stones - CKD

Question 34

MC used surgical tx for BPH

Answer 34

TURP

Question 35

pt after surgery has complaints of HTN, confusion, NV, and seiuzres

Answer 35

transurethral resection syndrome also see: bradycardia coma visual disturbances spasms

Question 36

what sugircal intervention is used if the prostate is over 100 grams

Answer 36

open/robotic simple prostatectomy

Question 37

which minimally invasive prostate treatments use heat to treat BPH

Answer 37

* TULIP (i guess cuz technically its a laser) * TU - electrovaporization * TUNA (radiofrequency waves) * hyperthermia * rezume (vapor thermal treatment)

Question 38

a patient presents with obstructive voiding s/s and hx of multiple vertebral fractures

Answer 38

probs prostate cancer

Question 39

elevated alk phos/hypercalcemia

Answer 39

bony metastases in prostate cancer

Question 40

a patient has prostate cancer that is confined to the prostate and is palpable on exam. what stage is it?

Answer 40

stage T2 reminder: T1 - Clinically inapparent (not seen on imaging or palpated on exam) - elevated PSA only T2 - Tumor confined within prostate, visible or palpable T3 - Tumor extends through prostate capsule, may invade seminal vesicles T4 - Tumor is fixed or invades adjacent structures

Question 41

removal of seminal vesicles, ampulla of vas deferens and the prostate is known as what

Answer 41

radical prostatectomy

Question 42

glycoprotein produced only by cells of the prostate gland

Answer 42

PSA

Question 43

when should you discontinue DRE and PSA screening

Answer 43

* PSA <1.0 at age 65 * PSA <3.0 at age 75 * Life expectancy < 10 years

Question 44

thiazides, statins, NSAIDS and 5-a reductase inhibitors all have this in common

Answer 44

they all reduce PSA!!!!!!