14.4 - Prostate

Question 1

the prostate secretes what type of fluid?

Answer 1

milky, alkaline fluid

Question 2

the glands and stroma of the prostate are maintained by _______________

Answer 2

androgens

Question 3

how does acute prostatitis present?

Answer 3

• dysuria
• fever and chills
• tender, boggy DRE

Question 4

what are the lab results of acute prostatitis? how does this differ from chronic prostatitis?

Answer 4

ACUTE:

• WBCs present
• culture reveals bacteria

CHRONIC:

• WBCs present
• cultures are NEGATIVE

Question 5

how does chronic prostatitis present?

Answer 5

• dysuria

- pelvic or low back pain

Question 6

BPH is due to ____________ (hyperplasia / hypertrophy) of what structural component(s)?

Answer 6

• hyperplasia

- stroma and glands

Question 7

testosterone is converted to DHT by _________

Answer 7

5a reductase

Question 8

what is the role of 5a reductase?

Answer 8

converts testosterone to DHT

Question 9

BPH occurs in what part of the prostate?

Answer 9

periurethral zone

Question 10

what are the treatment options for BPH? what are their MOAs?

Answer 10

• a1 antagonists: relax smooth muscle

- 5a reductase inhibitors: blocks conversion of testosterone to DHT

Question 11

what is the role of selective a1 antagonists? what is an example of this drug type?

Answer 11

• used in normotensive patients to avoid a1B effects on blood vessels
• tamsulosin

Question 12

terazosin is what type of drug?

Answer 12

a1 antagonists (NON-selective)

Question 13

in a normotensive patient with BPH, what would be an appropriate drug choice?

Answer 13

selective a1 antagonist (tamsulosin)

Question 14

prostate adenocarcinoma arises in what part of the prostate?

Answer 14

peripheral, posterior region

Question 15

what is required to confirm presence of prostate carcinoma?

Answer 15

biopsy

Question 16

what is seen on histology in prostate adenocarcinoma?

Answer 16

small, invasive glands with prominent nucleoli

Question 17

the grading system for prostate adenocarcinoma is based on ___________ alone

Answer 17

architecture (NOT nuclear atypia)

Question 18

metastases in prostate cancer exhibit what type of lesion?

Answer 18

osteoblastic bone lesions

Question 19

what are the serum markers seen in osteoblastic metastasis of prostate cancer?

Answer 19

• increased serum alkaline phosphatase
• increased PSA
• increased prostatic alkaline phosphatase (PAP)

Question 20

how is advanced prostate cancer treated? what are the MOAs?

Answer 20

• continuous GnRH analogs: shut down anterior pituitary gonadotrophs (LH and FSH are reduced)
• flutamide: acts as a competitive inhibitor at the androgen receptor