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1000+ Senile enlargement of the prostate Multiple Choice Question Answer [Solved]

Thursday 9th of March 2023

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1. TURP carries an incidence of retrograde ejaculation of:
A. 62 - 78%
B. 48 - 61%
C. 79 - 93%
D. 34 - 47%
Answer : C
2. Which drug reduces the incidence of prostate cancer by 23% with a small increase in high-grade tumor incidence?
A. cetrorelix
B. flutamide
C. dutasteride
D. zanoterone
Answer : B
3. Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
A. bladder stones
B. prostate cancer
C. renal insufficiency
D. bladder diverticula
Answer : B
4. On measuring the prostate volume during endoscopy:
A. each centimeter over the normal 2-cm prostate urethral length equates
B. an additional 12 g in prostate weight
C. each centimeter over the normal 2.5-cm prostate urethral length equates
D. an additional 10 g in prostate weight
Answer : B
5. What is false concerning the diagnosis of BPH?
A. IPSS cannot be used to establish the diagnosis of BPH/LUTS
B. prostate biopsy is essential in diagnosing BPH and excluding cancers
C. PSA and uroflowmetry help diagnose the condition
D. none of the above
Answer : A
6. What is the capsular perforation rate in prostate vaporization surgery?
A. 0.2 1%
B. 1.2 2.1%
C. 2.3 3.4%
D. 3.7 5.6%
Answer : D
7. In BPH patients, follow up PSA is of value because:
A. it helps predict the response to 5?-reductase inhibitors
B. it monitors LUTS/BPH progression
C. BPH patients are at higher risk of developing prostate cancer
D. a & b
Answer : D
8. as adjuncts therapy in BPH cases?
A. men with storage symptoms
B. men with ED
C. failed combination of ?-adrenergic blocker and 5?-reductase inhibitor
D. a & b
Answer : D
9. What prostatic lobe(s) can be assessed during DRE?
A. anterior
B. median
C. left lateral
D. all of the above
Answer : C
10. a. operation cost
A. smaller incisions with a shorter hospital stay
B. lower risk for blood transfusion
C. none of the above
D. . What is the first-line management of uncomplicated LUTS due to large prostate?
Answer : B
11. The lowest re-treatment rate of BPH is for:
A. TUIP
B. TURP
C. HoLEP
D. HoLRP
Answer : A
12. What is the likelihood that PSA level in men with acute urinary retention due to urethral stricture will decrease after catheterization?
A. never
B. unlikely
C. likely
D. always
Answer : D
13. c. each centimeter over the normal 2.5-cm prostate urethral length equates
A. an additional 15 g in prostate weight
B. each centimeter over the normal 1.5-cm prostate urethral length equates
C. an additional 5 g in prostate weight
D. . When comparing suprapubic to retropubic prostatectomy for removing prostatic adenoma, the former allows:
Answer : A
14. In men with obstructive BPH, what will NOT resolve after TURP?
A. bladder trabeculation
B. significant PVR
C. low peak flow rate
D. high IPSS
Answer : A
15. What drug prevents recurrent gross hematuria secondary to BPH?
A. enoxaparin
B. silodosin
C. finasteride
D. tolterodine
Answer : C
16. In BPH patients, total PSA level correlates to:
A. the glandular component of the prostate
B. the IPSS questionnaire points
C. the PVR
D. the transitional zone volume
Answer : A
17. Which of the following is NOT classified as a complicated LUTS?
A. LUTS with neurologic disease
B. LUTS with post-void dribble
C. LUTS with suspicious DRE
D. LUTS with hematuria
Answer : D
18. What is false regarding BPH genetics?
A. BPH is an inheritable and progressive disease
B. familial BPH presents at an older age when compared to sporadic cases
C. approximately 90% of men in their 80s have histologic evidence of BPH
D. BPH tends to be more severe and progressive in black men when compared to whites
Answer : B
19. In an 80 yrs. diabetic man on insulin for 35 yrs.; what would be the proper sequence of developing the following obstructing BPH/LUTS?
A. frequency, over-flow incontinence, straining, retention
B. straining, frequency, over-flow incontinence, retention
C. straining, frequency, retention, over-flow incontinence
D. frequency, straining, retention, over-flow incontinence
Answer : D
20. When comparing HoLEP to open prostatectomy for a 70 g prostatic adenoma removal; what parameter goes in favor of the latter?
A. operation time
B. duration of in-hospital stay
C. amount of blood transfused
D. time to catheter removal
Answer : A
21. What is (are) the indication(s) of upper urinary tract imaging in men with LUTS? A. hematuria
B. recurrent urinary tract infection
C. renal insufficiency
D. all of the above
Answer : D
22. IPSS decreases after successful TURP because:
A. PSA decreases
B. the prostate size decreases
C. the complaints resolve
D. the Q.O.L improves
Answer : C
23. What is false concerning needle ablation therapy of the prostate (TUNA)?
A. prostate sizes of up to 70 ml can be treated
B. not recommended in patients with metallic artificial hip
C. retreatment rates are lower than for TURP
D. can be performed in an office-based setting
Answer : C
24. Which statement is false regarding TURP syndrome?
A. occurs because of absorption of non-sodium-containing irrigating fluid
B. occurs only on using unipolar TURP
C. results in brain edema due to dilutional hyponatremia
D. positioning the patient in anti-Trendelenburg helps prevent the syndrome
Answer : D
25. a. management of concomitant Hutch diverticulum
A. removing small bladder stones
B. better access to prostatic fossa
C. technically, easier trigonization
D. . When comparing retropubic to suprapubic prostatectomy for removing prostatic adenoma, the former has the advantage of:
Answer : B
26. a. urethral stricture
A. bladder stones
B. BPH
C. prostatitis syndrome
D. . What is (are) the indication(s) of antimuscarinic agents and PDEIs
Answer : D
27. What is false concerning IPSS questionnaire?
A. is specific for prostate symptom
B. is a seven-question, self-administered questionnaire that yields a total score that ranges from 0 to 35
C. a sum of 20 on IPSS scale is severe
D. it covers both voiding and storage symptomatology
Answer : A
28. A 50% reduction of prostate size is expected after a 6-month therapy with:
A. alfuzosin
B. silodosin
C. finasteride
D. tamsulosin
Answer : C
29. Which statement is false regarding laser enucleation of the Prostate (HoLEP)?
A. provides tissue preservation for pathological examination
B. treats any size of prostatic adenoma
C. follows anatomic planes to remove the prostate in lobes
D. urinary incontinence is a significant drawback after HoLEP
Answer : D
30. How to manage priapism that occurs during endoscopic surgery?
A. corporal aspiration
B. corpora injection with an ?-adrenergic agent
C. corpora injection with an ?-adrenergic blocker
D. no treatment required
Answer : B
31. BPH patients with severe irritative symptoms or microscopic hematuria should:
A. go for urine cytology testing
B. go for PSA testing
C. go for TRUS
D. use anticholinergic medication
Answer : A
32. To achieve better hemostasis in prostate laser surgery, what is the ideal wavelength that is easily absorbed by hemoglobin?
A. 532 nm
B. 694 nm
C. 755 nm
D. 1064 nm
Answer : A
33. What class(es) of medications decrease(s) IPSS questionnaire points?
A. calcium channel blockers
B. antihistamines
C. antidepressants
D. cold medications containing pseudoephedrine
Answer : A
34. What is (are) the favorite criterion (criteria) to prescribe 5?- reductase inhibitors for BPH cases?
A. PSA > 1.5 ng/dL
B. prostate volume > 40 ml
C. IPSS > 19
D. a & b
Answer : D
35. What is true regarding the use of ?-blockers and the development of Intraoperative Floppy Iris Syndrome (IFIS)?
A. complicates approximately 0.7% of cataract surgery cases
B. manifests as poor preoperative pupil dilation, iris prolapse, and progressive intraoperative miosis
C. it could persist long after the discontinuation of tamsulosin
D. intraoperative lidocaine reduces its incidence in patients taking ?- adrenergic inhibitors
Answer : C
36. What is (are) the possible complication(s) of prostate stents?
A. hematuria and infections
B. migration and encrustation of the stent
C. irritative urinary symptoms and painful ejaculation
D. all of the above
Answer : D
37. BPH/LUTS patients when present with mild creatinine elevation, are advised to do:
A. total and free PSA
B. renal ultrasonography
C. creatinine clearance
D. uroflowmetry
Answer : B
38. Preferably, what is the last part of the prostate to be removed while performing TURP?
A. bladder neck
B. apex
C. median lobe
D. para-collecular
Answer : B
39. What is true regarding BPH and androgens?
A. as a man ages, the responsiveness of prostate cells to androgenic stimuli decreases
B. adrenal androgens have no role in BPH development
C. type-1 steroid 5 ?-reductase is functionally active in the hair follicle
D. all of the above
Answer : C
40. Which statement best describes the natural history of BPH:
A. worsening of LUTS and BPH over time
B. patients die of other reasons before serious complications occur
C. physically, the space of prostatic fossa limits the gland enlargement
D. ultimately, the gland will degenerate and undergo apoptosis
Answer :
41. What is (are) the indication(s) to prescribe ?-adrenergic inhibitors for BPH patients?
A. peak flow rate of ? 12 mL/sec
B. prostate volume > 40 ml
C. PSA > 1.5 ng/dL
D. b & c
Answer : A
42. On treating BPH, which procedure carries the risk of morcellator injury to the bladder?
A. PVP
B. HoLEP
C. HoLRP
D. TUMT
Answer : B
43. Open prostatectomy is preferred in treating BPH with:
A. sizable bladder stones
B. Hutch diverticulum
C. a suspicion of cancer
D. a & b
Answer : D
44. Which statement(s) describe(s) the bladders response to an obstructing prostate?
A. it may develop detrusor instability with irritative LUTS
B. it may develop poor compliance with frequency and urgency symptoms
C. it may develop poor detrusor contractility with obstructive LUTS
D. all of the above
Answer : D
45. PSA value has a strong correlation with:
A. IPSS
B. post void residual
C. prostate volume
D. Q-max at uroflowmetry
Answer : C
46. What is false concerning TURP syndrome?
A. symptoms begin with a serum sodium of less than 120 mEq/L
B. the mortality is 2.7-5.8 %
C. manifestations rely on acute changes in the intravascular volume and plasma solute concentrations
D. the preferred height of irrigating fluid is 60 cm above the patient
Answer : B
47. What is false concerning the pathogenesis of BPH?
A. intra-prostatic levels of estrogen decrease in men with BPH
B. stimulation of the adrenergic nervous system results in a dynamic increase in prostatic urethral resistance
C. inflammation may play a role through cytokines to promote cell growth
D. hyperplasia occurs due to an imbalance between cell death and cell proliferation
Answer : D
48. a. lesser chance of post-operative urethral stricture
A. milder postoperative hematuria
B. tension-free bladder closure
C. extra-peritoneal approach
D. . When comparing TURP to open prostatectomy for removing prostatic adenoma, the latter has the following advantages, EXCEPT:
Answer : D
49. Transurethral incision of the prostate (TUIP):
A. is only indicated in small prostates
B. complications are related to the amount of lost blood and removed chips
C. is a minimal procedure where no risk of rectal injury or retrograde ejaculation have been reported
D. it entails making 1 or 2 incisions along all prostate lobes except the apical
Answer : A
50. What is the initial response of the detrusor muscle to obstruction?
A. increased intravesical pressure
B. increased detrusor pressure
C. increase collagen deposition in the detrusor
D. detrusor smooth muscle hypertrophy
Answer : A

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