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IPDM I WK 4 BPH Part 1

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alchemist04's version from 2016-05-05 04:13

Section

Question Answer
What are the BPH Obstructive Symptoms ? (1)Decrease bladder emptying
What are the BPH Obstructive Symptoms? (2)Hesitancy b4 beginning to urinate
What are the BPH Obstructive Symptoms? (3)Straining
What are the BPH Obstructive Symptoms? (4)Weak Urine stream
What are the BPH Obstructive Symptoms? (5)Post void dribbling
What are the BPH Obstructive Symptoms? (6)Bladder always feel full even after voiding
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Question Answer
What are the 2 factors of BPH?Static and Dynamic
Static factor (obstructive) of BPH?(1) Anatomical enlargement of prostrate gland (2) Obstructs urinary outflow (3) due to androgen stimulation of epithelia tissue
Dynamic (irritative) factor of BPH?(1) Contraction of prostate around the urethra (2) Narrowing of the urethral lumen (3) due to excessive alpha adrenergic tone of the stromal tissue
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Question Answer
What are the Irritative Symptoms associated with BPH? (1)Need to urinate urgently/urgency
What are the Irritative Symptoms associated with BPH? (2)Urinating often especially at night (nocturia)
What are the Irritative Symptoms associated with BPH? (3)Bed wetting
What are the Irritative Symptoms associated with BPH? (4)Frequency
What are the Irritative Symptoms associated with BPH? (5)Mimics symptoms of overactive bladder
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Question Answer
Lab/Diagnosis tests for BPH? (1)Symptoms evaluation (mild/moderate/severe)
Lab/Diagnosis tests for BPH? (2)Urinalysis (renal infection. kidney stone)
Lab/Diagnosis tests for BPH? (3)Prostate Specific Antigen (PSA)
Lab/Diagnosis tests for BPH? (4)Digital Rectal Exam (DRE)
Lab/Diagnosis tests for BPH? (5)Radiologic and Imaging studies (TRUS or Transrectal Ultrasound)
Lab/Diagnosis tests for BPH? (6)Urodynamic testing. (Post-Void Residual [PVR])
Lab/Diagnosis tests for BPH? (7)Uroflometer
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Question Answer
What is PSA?Prostate Specific Antigen. Not a specific marker for cancer or BPH
When do you obtain PSA?patients that are 40 yo or above 40 yo with at least 10 years life expectancy (i.e. not seriously sick)
How do you adjust PSA when a patient is on 5 alpha reductase inhibitor?Double the actual measured PSA in a patient taking 5 Alpha reductase inhibitor after 6 month to approximate true PSA level. If a patient PSA was 4g and after 6 month it shrinks to 2 g, the baseline is 4g. If after 6 months it still remains 4g, the base line is 8 g
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Question Answer
What are the treatment options of BPH?(1) Watchful waiting (for mild case) (2) Pharmacological treatment like Alpha 1 adrenergic antagonist /alpha 1-blocker, 5-alpha reductase inhibitor, PDE5 inhibitor (3) Surgery like Transuretheral resection of the prostate (TURP) and Transurethral incision of the prostate (TUIP)
What is the role of Alpha 1- Adrenergic Receptors?decrease urinary bladder emptying
What is the role of 5 alpha reductase?produces DHT which induces growth and enlargement of the gland
What is the role of Phosphodiesterase 5 inhibitor (PDE5 inhibitor)?It is use to treat BPH that has erectile dysfunction
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Question Answer
What is AUA?American Urological Association
What is AUA Score Index for Mild symptom?equal or less than 7
What is AUA Score Index for Moderate symptom?8 - 19
What is AUA Score Index for Severe symptom?>/ 20
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Question Answer
What is the treatment option for BPH with mid Sx, Watchful waiting. No treatment is required
What is the treatment option for BPH with MODERATE sx, btw 8-19, small prostrate and low PSA?Use Alpha 1 blocker
What is the treatment option for BPH with MODERATE sx, btw 8-19, large prostrate and increase PSA?use 5 alpha-reductase inhibitor OR combined with alpha 1-blocker
What is the treatment option for BPH with MODERATE sx, btw 8-19, with erectile dysfunction?use Phosphodiesterase inhibitor, Alpha 1-blocker or both (with caution due to DDI)
What is the treatment option for BPH with SEVERE sx, btw >/ 20, complications of BPH?minimally invasive surgery or prostectomy
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