Prostate Health and Disease Quiz

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Questions and Answers

What is a common causative organism of acute prostatitis?

E. coli (correct)

Streptococcus pneumoniae

Staphylococcus aureus

Mycobacterium tuberculosis

Which of the following is associated with benign prostatic hyperplasia (BPH)?

Dihydrotestosterone exposure (correct)

Increased levels of estrogen

Chronic bacterial infections

Complete prostate gland removal

What histopathologic finding is commonly seen in chronic bacterial prostatitis?

Fibrosis of the gland

Necrosis of prostatic tissue

Presence of many leukocytes (correct)

Absence of inflammation

In which type of prostatitis is granulomatous reaction typically observed?

Chronic non-specific granulomatous prostatitis Signup and view all the answers

What are the common clinical symptoms of acute prostatitis?

Nausea and vomiting with fever Signup and view all the answers

Which statement about benign prostatic hyperplasia (BPH) is true?

Nodular enlargement of the prostate occurs Signup and view all the answers

Which of the following conditions is considered a chronic specific prostatitis?

Tuberculosis Signup and view all the answers

What type of prostatitis can be asymptomatic?

Chronic non-specific prostatitis Signup and view all the answers

Which of the following symptoms is NOT associated with benign prostatic hyperplasia (BPH)?

Blood in the urine Signup and view all the answers

What role does age play in prostate cancer development?

The incidence increases, especially after age 55 Signup and view all the answers

Which type of cancer is most commonly associated with the prostate?

Adenocarcinoma Signup and view all the answers

What is a common morphological characteristic of prostate tumors?

They are typically yellowish gray and homogeneous Signup and view all the answers

Which of the following factors is NOT considered a potential contributor to prostate cancer?

Vitamin D deficiency Signup and view all the answers

Which of the following is a common complication of chronic urinary obstruction due to BPH?

Acute urinary retention Signup and view all the answers

What defines the clinical diagnosis of prostate cancer?

Digital rectal exam (DRE) and PSA blood test Signup and view all the answers

Which of the following statements about squamous metaplasia in the prostate is true?

It may occur in areas affected by BPH. Signup and view all the answers

Which histological feature is indicative of prostatic carcinoma?

Absence of basal cell layer in some glands Signup and view all the answers

What does a lower modified Gleason score indicate about prostatic carcinoma?

The cancer is slower growing and less aggressive Signup and view all the answers

Which of the following descriptors best defines the architecture seen in prostatic carcinoma?

Infiltrative architecture with loss of polarity Signup and view all the answers

How is the modified Gleason score calculated?

By adding the two most common grades together Signup and view all the answers

Which characteristic is NOT typically seen in prostatic carcinoma?

Presence of distinct basal cells Signup and view all the answers

Which of the following classifications represents the least aggressive prostatic carcinoma?

Gleason 6 or less Signup and view all the answers

What type of staining is associated with amphophilic cytoplasm?

Staining with both acidic and basic dyes Signup and view all the answers

The presence of which feature would be atypical in normal prostate tissue?

Nucleolar prominence and hyperchromatic nuclei Signup and view all the answers

Study Notes

Diseases of Male Genital Organs - Prostatic Disorders

Prostate disorders are common in men, including inflammation (prostatitis), enlarged prostate (benign prostatic hyperplasia (BPH)), and prostate cancer.

Disorders of the Prostate Gland (DPG)

Common prostate disorders include inflammation (prostatitis), enlarged prostate (BPH), and prostate cancer.

Acute Prostatitis

The infection-causing organism reaches the prostate from the posterior urethra.
Common causative organisms include gonococci, E. coli, Klebsiella, Proteus, and Pseudomonas.

Prostate Gland

Located between the bladder and the penis.
Diagram shows its anatomical position relative to surrounding structures like the bladder, urethra, and testicles.

Morphology (Acute Prostatitis)

Grossly, the prostate gland is enlarged, swollen, and tender.
Microscopically, there is infiltration of prostatic tissue by many polymorphnuclear leucocytes.
Edema and vascular dilation are also observed.

Clinically (Acute Prostatitis)

Symptoms may include fever, chills, body aches, nausea, vomiting, dysuria (painful urination), frequent or urgent need to urinate, difficulty urinating, weak urine stream, and lower abdominal pain, sometimes with tenderness to the prostate.

Chronic Prostatitis (non-specific)

May be asymptomatic or associated with pain in the genital area, lower abdomen, or lower back, alongside dysuria.
Men with chronic bacterial prostatitis often have recurring urinary tract infections (UTIs).
Examination of prostatic secretions after massage reveals many leukocytes.
Histopathologic diagnosis isn't crucial; most cases develop gradually without prior acute prostatitis.

Chronic Specific Granulomatous Prostatitis

Includes conditions like Tuberculosis (TB) and schistosomiasis.

Chronic Non-Specific Granulomatous Prostatitis

Relatively common.
A reaction to secretions from ruptured prostatic ducts and acini.
Microscopic examination shows a granulomatous reaction.

Benign Prostatic Hyperplasia (BPH)

Highly prevalent after age 50 and increases with age.
The precise cause is unknown but linked to dihydrotestosterone (DHT) exposure in aging men, triggering certain prostate cell proliferation, leading to gland enlargement.

Morphology (BPH)

Grossly, the gland is enlarged with nodules of varying sizes.
The urethra lumen is often compressed, becoming narrow.
The median lobe may protrude into the bladder, leading to obstruction.
The common method of examining the enlarged gland for gross assessment was once a one-piece prostatectomy, but this is less common now.

Microscopic (BPH)

Transurethral resection of the prostate (TURP) is usually performed for microscopic analysis.
Nodules consist of hyperplastic glands and fibromuscular stroma, often with gland dilation and cyst formation.
Areas of squamous metaplasia and infarcts might occasionally occur.

Clinical Effects and Complications of BPH

Frequent urination, especially at night (nocturia).
Difficulty initiating or stopping urination stream.
Acute urinary retention episodes.
Chronic urinary tract infections due to urinary stasis (slowed urine flow).
Urinary bladder hypertrophy and hydronephrosis (kidney infection) are potential complications of prolonged obstruction.

Carcinoma of the Prostate

Among the most common malignant tumors in men.
Predominantly affects men over 50.
Unrelated to benign prostatic hyperplasia (BPH).
Almost all prostate cancers are adenocarcinomas, with other rare types including small cell neuroendocrine carcinoma, large cell carcinoma, transitional cell carcinoma, and sarcomas.

Etiology (Prostate Cancer)

Cause is unknown but multiple factors may play a role:
- Increasing age, usually after age 55.
- Higher incidence among Black men compared to White men.
- High testosterone levels.
- Genetic factors.
- Environmental factors (geographic variations).
- Prostatic intraepithelial neoplasia (PIN)

Clinical Diagnosis (Prostate Cancer)

Based on patient symptoms, a digital rectal exam (DRE), blood tests (prostate-specific antigen (PSA)), and a urinalysis.

Symptoms of Prostate Cancer

Difficulty initiating or stopping urine flow, weak urine stream.
Frequent urination, especially at night.
Pain or burning during urination and ejaculation.
Blood in the urine or semen.
Persistent pain in the back, hips, or pelvis.

Digital Rectal Exam (DRE)

A physical examination method used to assess the prostate gland through the rectum.

Morphology (Prostate Cancer)

Tumor usually arises from the periphery of the gland, frequently situated in the posterior section, and sometimes doesn't encompass the entire gland.
Forms nodular masses (single or multiple), displaying a yellowish-gray, homogeneous cut surface.

Microscopic (Prostate Cancer)

Clinical and radiological features are usually not specific enough for diagnostic criteria.
Nontargeted biopsies are frequently performed to assess elevated serum prostate-specific antigen (PSA) levels.
Most prostate cancers are adenocarcinomas, ranging from well-differentiated to undifferentiated forms.
Key microscopic characteristics aiding diagnosis include: presence of closely packed small glands, absence of basal layer at points in the glands, infiltrative architecture (loss of polarity), large hyperchromatic nuclei, prominent nucleoli, amphophilic cytoplasm (staining with both acid and basic dyes), circumferential perineural invasion, presence of intraluminal contents like crystalloids, blue mucin, or pink amorphous materials.

Grading of the Tumor (Prostate Cancer)

Based on the modified Gleason score (replacement for the previous 5-point system).
Focuses on overall glandular patterns and cellular atypia (assessed via low power microscopy), without considering cytologic details present in higher power microscopy.
Modified Gleason score is determined by adding the numerical values of the two most prevalent grades and is helpful in assessing how likely the cancer will spread. Lower grade indicates slower growth and less aggressive nature.

Staging of the Tumor (Prostate Cancer)

Based on the TNM staging system.
- Stage T1: Cancer discovered incidentally during transurethral resection of the prostate (TURP). Further subdivided into T1a, T1b, and T1c.
- Stage T2: Cancer confined to the prostate gland.
- Stage T3a and T3b: Shows extra-prostatic extension, possibly involving the seminal vesicles.
- Stage T4: Directly invades adjacent organs.

Prognosis (Prostate Cancer)

Based on the tumor's grading and staging.
Grade 5 (Gleason 9 or 10) is the worst prognosis group.
T1 and T2 are usually treated via surgery and radiotherapy, with approximately a 90% 15-year survival rate.
Advanced tumors with metastasis generally have a worse prognosis.

Prostate Specific Antigen (PSA)

Used in diagnosis and management of prostate carcinoma.
A product of the prostatic epithelium.
Normal serum PSA level is roughly 4 ng/mL.
Organ-specific, but not cancer-specific.
Monitoring PSA levels aids in assessing therapy response and disease progression.

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Description

Test your knowledge on various aspects of prostate health, including acute prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. This quiz covers causative organisms, histopathological findings, clinical symptoms, and risk factors associated with prostate diseases. Ideal for students in medical or health science courses.