Case 5: Benign Prostatic Hyperplasia – Flashcards
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Where is the prostate gland located?
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The prostate gland is located at the base of the bladder, completely encircling the urethra
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What happens to the prostatic urethra as the prostate gland enlarges?
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The prostatic urethra becomes compressed leading to bladder outlet obstruction
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What are some of the symptoms of BPH?
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Need to frequently urinate in small amounts, feeling of incomplete bladder emptying, slow urinary flow, hesitation, needing to void at night, and in extreme cases complete urinary retention
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What are cases where prostate biopsy is recommended?
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If there is an elevation of PSA, or if there is nodularity of the prostate
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What should be included in the differential for BPH?
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Prostate cancer, urethral stricture, UTI, prostatitis, and neurological conditions
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What is the definition of micturition?
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Physiologic act of voiding that involves contraction of the detrusor muscle and relaxation of the bladder neck and urinary sphincters
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What are examples of the alpha-1 blockers that can be used to help relaxthe bladder neck and prostatic urethra?
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Alfuzosin, doxazosin, tamsulosin, terazosin, and silodosin
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What is the enzyme that is responsible for converting testosterone to the more potent dihydrotestosterone?
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5 alpha reductase
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What is an example of a 5 alpha reductase inhibitor?
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Finasteride
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What should be included in a physical exam when assessing for BPH?
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A digital rectal exam, and a UA and PSA should be ordered
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What are some states that call for urgent urological intervention?
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Renal compromise, elevated creatinine, and a palpable bladder on physical exam
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If medical management is not effective for BPH what is the surgical intervention that can be performed?
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Transurethral resection of the prostate, or TURP.
