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18 Cards in this Set

  • Front
  • Back
Glands that arise from urethra move in what pattern?
Curved pattern away from urethra
How many cell layers do prostatic glands have?
TWO! Apical cell and basal cell.

Apical cells secrete different liquids. Apical cells secrete PSA.

Basal cell layer DISAPPEARS in neoplasia
What are the three zones of the prostate?
Central zone - Resistant to inflammation and carcinoma.

Transition zone - Lies around urethra...Site of benign prostatic hyperplasia (BPH). Proximity to urethra = painful urination.

Peripheral zone - Site of prostatic carcinomas (CAP)
Does the prostate contain endocrine glands?
Yes, some paracrine glands
When does BPH start?
Around age 45. Incidence by age 80 is ~80%.

Strong family history.
What happens to the bladder wall during BPH?
Increased urethral compression results in increased back pressure.

Bladder walls adapts via hypertrophy and hyperplasia.
What androgens are responsible for prostatic growth?
DHT from testosterone via 5a-reductase.
Why is there hyperplasia of prostate as we age?
Relative estradiol levels increase, which increases androgen receptors. This in turn increases intracellular levels of DHT.

Increased DHT drives prostatic hyperplasia.
What is the hallmark of BPH.
NODULAR ENLARGEMENT OF TRANSITION ZONE. Glands and stroma become hyperplastic.

Stroma hyperplastic first.
What are the 3 CONFIRMED risk factors for CAP (prostate carcinoma)?
1) Age

2) Family history

3) Race (african americans higher)
Where do CAP's arise? How is it noticed on exam?
CAP's arise in peripheral zone of prostate.

Palpable firm posterior prostatic nodule.

Yellow, tan and compact.
What are some histological features of CAP?
REMEMBER: basal layer of prostate glands DISAPPEAR during neoplasis

1) MORE ACINI. Little to no stroma in between glands. Looked like squished donuts.

2) Abnormal secretions.

3) As opposed to normal prostate architecture which has curved glands coming out from urethra, in CAP, there is zero sum vectors of glandular arrangements. Glands point in all different directions.
What do abnormal protein secretions from prostate look like?
Crystalline structures found in lumen. Can also be AMORPHOUS.

NORMAL LOOK: Lamellar.
What is the Gleason grading in CAP?
Gleason grade is a prognostic scale for CAP based on histology of prostate.

Grade 1: Tightly cohesive nodule of well formed glands

Grade 2: Loosely cohesive nodules of well formed glands

Grade 3: Haphazard infiltration of irregular glands.

Grade 4: Starting to lose glandular lumens

Grade 5: Total loss of gland formation.
Why is PSA used as a marker for CAP?
PSA is one of many prostatic secretions. Apical cells from prostate glands secrete PSA.

in CAP, there is an INCREASE in acini, which means more glands, which means more PSA secretion.

PSA liquefies semen to enhance sperm motility.
When should men start prostate screening?
At 50 y/o...unless #1) family history or #2) race (esp. african americans...then start at 40.
What factors are prognostic of CAP?
Gleason score greater than 7-10.

Metastases to local lymph nodes. Seminal vesicle invasion. Margins