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PAtho > Unit 13 > Flashcards

Unit 13 Flashcards

1
Q

at what age does bph begin to dev

A

> 55

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2
Q

main risk factor for bph

A

aging

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3
Q

characteristic of prostatic growth with age

A

slow, gradual growth

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4
Q

how is growth of prostate characterized in bph

A

periurethral growth, originating in center of gland

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5
Q

what type of growth is bph and what cells areinvolved

A

hyperplasia and hypertrophy

m. and exocrine epith tissue

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6
Q

number one risk of bph

A

aging

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7
Q

what change does age cause in bph

A

change in androgen levels

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8
Q

et of bph

A

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

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9
Q

what are the 2 male androgens

A

T

DHT

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10
Q

what percent of t is converted to dht

A

95

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11
Q

how is t converted to dht

A

via ez 5 alpha reductase

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12
Q

what is dht responsible for

A

str, fx, growth of prostate

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13
Q

what is the physiologic fx of E in men

A

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

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14
Q

what happens to the T:E ratio as men age

A

qualatative dec in T while E remains the same

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15
Q

what happens to E when T decreases

A

it makes E relatively more significant

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16
Q

what does the inc significance of E do to prostatic cells

A

makes them more sensitive, so DHT has more effect

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17
Q

why does urethral compression occur in BPH

A

inc in tissue size is space occupying -> urethral compression

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18
Q

when does urine accum occur

A

with inc urethral compression

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19
Q

what happens when urine accums

A

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

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20
Q

what 2 compensatory changes occur to prevent ballder rupture

A
  1. bladder wall thickens

2. diverticula/trabeculae in bladder expand to inc bladder size

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21
Q

why is thickening of the bladder wall worsening the problem

A

we can now retain urine longeer

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22
Q

why is increassing bladder size worsening the problem

A

promotes urine stasis

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23
Q

2 complications of urine stasis

A

UTI/infc

renal calculi

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24
Q

why may renal calculi occur with urine stasis

A

rt percipitable components in urine

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25
Q

what happens when the bladder is full of urine

A

backs up into urine and kidney

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26
Q

hydrouretur

A

distention of uretur to accomodate inc urine vol

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27
Q

fish hook uretur

A

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

28
Q

2 consequences of hydroeuretur

A

urine begins to accum in kidney

hydronephrosis

29
Q

what happens when urine accums in kidney

A

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

30
Q

what leads to hydronephrosis

A

no filtration rt to no P gradient to faciliate filtration

31
Q

hydronephrosis

A

distention of renal pelvis/calculi

32
Q

mfnts of bph

A 
frequency with nocturia
hesistancy
weak stream rt compression
terminal dribbling
urine retention of obstr is complete
33
Q

dx of bph

A 
hx, mnfts, px
digital rectal exam
PSA
kidney fx tests
urinalysis
34
Q

PSA

A

prostate spec androgen

35
Q

how is psa measured

A

in blood or in prostatic fluid

36
Q

what is total psa porprortional too

A

total size of prostate

37
Q

PSAv and PSAd

A

psa velocity

psa dencity

38
Q

how is psav and psad calculated

A

using total psa

39
Q

what are issues with psa

A

may have false positives or negatives

mixed up in prostate ca

40
Q

what is tx of bph dependent on

A

s and s, sev, complicatiosn

41
Q

tx for bph

A 
no tx often
lifestyle mod
alpha andregenic antagonist
5 a reductase inhibit
sx
42
Q

what lifestyle mod might be done in bph

A

no fluids 2-3 h prior HS

no caffiene or alcohol

43
Q

fx of aplha andregent antagonist

A

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

44
Q

when is an alpha adregenic antagonist used

A

short term

45
Q

fx of 5 alpha reductase inhibitor

A

dec DHT by inhibiting conversion of t to Dht

46
Q

when is 5 alpha reductase inhibitor used

A

long term

47
Q

what drugs do we use if cases of bph are sev

A

both

48
Q

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

A

transurethral resec of prostate

laser prostectomy

49
Q

which population has in inc risk for prostate ca

A

men >65 yo

50
Q

risks for prostate ca

A 
age
diet
ethinicity
family hx
androgens
51
Q

what type of carcinoma is in prostate ca

A

adenocarcinoma

52
Q

what is adenocarcinoma rt to in prostate ca

A

glandular epith

53
Q

characteristics of prostate ca

A

subcapsular, peripheral, multisite

54
Q

why is prostate ca have a delayed dx

A

no early mnfts dt peripheral origin of ca

55
Q

normal prostate size

A

2-3cm

56
Q

prostate size in ca

A

4cm

57
Q

prostate size in bph

A

5-6cm

58
Q

when do mnfts appear in prostate ca

A

if it is well established

59
Q

where do mets occur in prostate ca

A

bone liver lung

60
Q

where do bone mets in prostate ca usually mnfts

A

back, hip, spine

61
Q

where does prostate ca extend regionally

A

seminal vesicles,

bladder

62
Q

mnfts of prostate ca

A

prostatisis

late back/hip pain rt to mets

63
Q

dx prostate ca

A

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

64
Q

what is tx of prostate ca based on

A

stage, age, grade

65
Q

tx for beningn prostate ca

A

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

66
Q

tx for prostate ca

A

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

67
Q

how do we prevent cell growth via dht in prostate ca

A

admin estrogen/antiandrogenic drugs

PAtho (31 decks)

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