BPH1

Question 1

what are the top 5 conditions too embarrassing to talk about with PCP (in order)?

Answer 1

1. impotence
2. STDs
3. Physical and sexual abuse
4. prostate problems
5. incontinence

Question 2

what is the age relation to BPH

Answer 2

1. uncommon under 50 (50% of men over 50)
2. peaks at 63-65
3. guaranteed if lig long enough

Question 3

what is hyperplasia?

Answer 3

increased number of cells

Question 4

what is hypertrophy?

Answer 4

increased size of cells

Question 5

is BPH an example of hyperplasia, hypertrophy or both?

is it malignant?

Answer 5

hyperplasia, not hypertrophy
increase in cells, not size of cells
not malignant

Question 6

define BPH

Answer 6

nonmalignant enlargement of prostate gland

Question 7

BPH sometimes leads to what anatomical problem?

Answer 7

compression of the urethra and urine flow obstruction

Question 8

what are the 3 normal prostate tissues

Answer 8

1. epithelial - grandular tissue
2. stromal - smooth muscle tissue
3. capsule

Question 9

what are the two types of pathophysiology involved with BPH? briefly describe each

Answer 9

1. static - androgens cause hyperplasia

2. dynamic - andrenergic tone causes transient effect

Question 10

what type of pathophysiology is involved in blocking bladdr neck and urinary flow?

Answer 10

static symptoms

Question 11

what type of pathophysiology includes constriction of urethra and narrowing of lumen

Answer 11

dynamic symptoms

Question 12

what sympathetic transmitters lead to dynamic symptoms of BPH?

Answer 12

epinephrine and norepinephrine

Question 13

5-alpha reductase inhibitors deals with what pathophysiology of BPH?

Answer 13

androgens leading to static symptoms

Question 14

adrenergic receptor blockers deal with what pathophysiology of BPH?

Answer 14

adrenergic tone leading to dynamic symptoms

Question 15

cholenergics have what effect on bladder

Answer 15

contract bladder muscles

Question 16

LUTS refers to what?
what are two causes of this?
how does it correlate to age?

Answer 16

lower urinary tract symptoms
Causes:
-bladder outlet obstruction
-overactive bladder
rates of these symptoms progress with age

Question 17

hesitancy, intermittency, and terminal dribbling are what type of symptoms

Answer 17

static LUTS symptoms

Question 18

frequency, urgency, dysuria and incontinence are symbpoms of what

Answer 18

dynamic LUTS symptoms

Question 19

what is most common reason people don’t report BPH to doctor

Answer 19

compensation

Question 20

what are the most common complications of untreated BPH?

Answer 20

Gross hematuria
Overflow urinary incontinence/ unstable bladder
Bladder diverticula
Bladder stones
Acute or chronic renal failure
Recurrent UTI

Question 21

what are the clinical signs of BPH?

Answer 21

1. digital rectal exam (DRE) reveals enlarged prostate

2. greater than 20 gram prostate that is smooth, soft, symmetrical and mobile

Question 22

what lab values indicate BPH?

Answer 22

1. BUN
2. SCr
3. elevate prostate specific antigen
4. urinalysis
5. peak urinary flow rate
   6 post void residual urine volume

Question 23

what peak urinary flow rate indicates BPH

Answer 23

less than 10 ml per second

Question 24

what post-void residual volume (PVR) level indicates bph

Answer 24

more than 25-50 ml

Question 25

describe the American urological association symptom index?

Answer 25

a self administered, quantitative measure of extent of symptoms. not a diagnostic tool 7 questions, then add up score

Question 26

what are the 3 stages and ranges of AUASI?

Answer 26

1. mild = 0-7 2. moderate = 8-19 3. severe = 20-35

Question 27

what is considered clinically significant change in AUASI?

Answer 27

a change in score of 3 or more

Question 28

what are 5 alpha blockers used for BPH?

Answer 28

1. doxazosin 2. Terazosin 3. Tamsulosin 4. Alfuzosin 5. Silodosin

Question 29

True/False 1. Size of prostate is directly correlated with symptoms 2. PSA is directly correlated with symptoms

Answer 29

1. false | 2. false

Question 30

what are 4 goals of treatment of BPH

Answer 30

1. improvement of voiding symptoms 2. improve quality of life 3. prevent disease infection 4. prevent complication and treatment related effects

Question 31

what does PSA stand for?

Answer 31

prostate specific antigen