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Flashcards in Unit 13 Deck (67):
1

at what age does bph begin to dev

>55

2

main risk factor for bph

aging

3

characteristic of prostatic growth with age

slow, gradual growth

4

how is growth of prostate characterized in bph

periurethral growth, originating in center of gland

5

what type of growth is bph and what cells areinvolved

hyperplasia and hypertrophy
m. and exocrine epith tissue

6

number one risk of bph

aging

7

what change does age cause in bph

change in androgen levels

8

et of bph

aging
genetic predisposition
race (inc in blacks, dec in asian)
diet (directly linked to genes and race)

9

what are the 2 male androgens

T
DHT

10

what percent of t is converted to dht

95

11

how is t converted to dht

via ez 5 alpha reductase

12

what is dht responsible for

str, fx, growth of prostate

13

what is the physiologic fx of E in men

facilitates action of DHT on cells by sensitizing them -> inc effect of DHT

14

what happens to the T:E ratio as men age

qualatative dec in T while E remains the same

15

what happens to E when T decreases

it makes E relatively more significant

16

what does the inc significance of E do to prostatic cells

makes them more sensitive, so DHT has more effect

17

why does urethral compression occur in BPH

inc in tissue size is space occupying -> urethral compression

18

when does urine accum occur

with inc urethral compression

19

what happens when urine accums

inc urge to urinate, inability to enter bladder,, residual badder volume

20

what 2 compensatory changes occur to prevent ballder rupture

1. bladder wall thickens
2. diverticula/trabeculae in bladder expand to inc bladder size

21

why is thickening of the bladder wall worsening the problem

we can now retain urine longeer

22

why is increassing bladder size worsening the problem

promotes urine stasis

23

2 complications of urine stasis

UTI/infc
renal calculi

24

why may renal calculi occur with urine stasis

rt percipitable components in urine

25

what happens when the bladder is full of urine

backs up into urine and kidney

26

hydrouretur

distention of uretur to accomodate inc urine vol

27

fish hook uretur

occurs at point where uretur attatches to bladder. inc P on this points pulls uretur downwards making hook apperance

28

2 consequences of hydroeuretur

urine begins to accum in kidney
hydronephrosis

29

what happens when urine accums in kidney

inc p pushing out on glomerulus, inc P in capsule > P of filtrate entering capsule -> no filtration

30

what leads to hydronephrosis

no filtration rt to no P gradient to faciliate filtration

31

hydronephrosis

distention of renal pelvis/calculi

32

mfnts of bph

frequency with nocturia
hesistancy
weak stream rt compression
terminal dribbling
urine retention of obstr is complete

33

dx of bph

hx, mnfts, px
digital rectal exam
PSA
kidney fx tests
urinalysis

34

PSA

prostate spec androgen

35

how is psa measured

in blood or in prostatic fluid

36

what is total psa porprortional too

total size of prostate

37

PSAv and PSAd

psa velocity
psa dencity

38

how is psav and psad calculated

using total psa

39

what are issues with psa

may have false positives or negatives
mixed up in prostate ca

40

what is tx of bph dependent on

s and s, sev, complicatiosn

41

tx for bph

no tx often
lifestyle mod
alpha andregenic antagonist
5 a reductase inhibit
sx

42

what lifestyle mod might be done in bph

no fluids 2-3 h prior HS
no caffiene or alcohol

43

fx of aplha andregent antagonist

relax m. in gland to improve voiding by acting on obstr to improve urination

44

when is an alpha adregenic antagonist used

short term

45

fx of 5 alpha reductase inhibitor

dec DHT by inhibiting conversion of t to Dht

46

when is 5 alpha reductase inhibitor used

long term

47

what drugs do we use if cases of bph are sev

both

48

what 2 sx are used as a last resort for bph tx

transurethral resec of prostate
laser prostectomy

49

which population has in inc risk for prostate ca

men >65 yo

50

risks for prostate ca

age
diet
ethinicity
family hx
androgens

51

what type of carcinoma is in prostate ca

adenocarcinoma

52

what is adenocarcinoma rt to in prostate ca

glandular epith

53

characteristics of prostate ca

subcapsular, peripheral, multisite

54

why is prostate ca have a delayed dx

no early mnfts dt peripheral origin of ca

55

normal prostate size

2-3cm

56

prostate size in ca

4cm

57

prostate size in bph

5-6cm

58

when do mnfts appear in prostate ca

if it is well established

59

where do mets occur in prostate ca

bone liver lung

60

where do bone mets in prostate ca usually mnfts

back, hip, spine

61

where does prostate ca extend regionally

seminal vesicles,
bladder

62

mnfts of prostate ca

prostatisis
late back/hip pain rt to mets

63

dx prostate ca

hx, px
DKE (inc in men >50yo)
PSA
biopsy sample

64

what is tx of prostate ca based on

stage, age, grade

65

tx for beningn prostate ca

inc in men with inc age, no tx, activley monitor

66

tx for prostate ca

prevent cell griwth via DHT
radical prostectomy/remove seminal vesicles
combo tx (radiation)

67

how do we prevent cell growth via dht in prostate ca

admin estrogen/antiandrogenic drugs