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

1. On treating BPH, which procedure carries the risk of morcellator injury to the bladder?
A. PVP
B. HoLEP
C. HoLRP
D. TUMT
Answer : B

2. 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

3. What statement is true regarding post-void residual of urine (PVR)?
A. nearly all men have PVR of less than 12 ml
B. it predicts the outcome of surgical treatment
C. it correlates well with BPH/LUTS
D. it is diagnostic for bladder outlet obstruction
Answer : A

4. What is true regarding mirabegron, the ?3 agonist, in treating BPH?
A. achieves better results when combined with antimuscarinic
B. enhances detrusor contractility resulting in higher Q-max
C. enhance detrusor relaxation during bladder-filling phase
D. increases voiding pressure that poses risk on renal function
Answer : C

5. The probability of developing acute urinary retention is related to:
A. the neurological status of the patient
B. PVR
C. severity of obstructive LUTS
D. all of the above
Answer : D

6. 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

7. 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

8. What is (are) true concerning IPSS questionnaire?
A. it focuses on last month`s symptoms
B. scores of moderate symptoms suggest surgical treatment if the patient`s quality of life was poor
C. it has been validated and translated to many languages
D. all of the above
Answer : D

9. 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

10. 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

11. What is false regarding BPH symptomatology?
A. the size of the prostate correlates well to the degree of obstruction
B. a decrease of 3 points in IPSS is associated with a subjective perception of improvement
C. median lobe enlargement gives rise to serious obstructive symptoms
D. bladder trabeculation is not specific for an obstructing prostate
Answer : A

12. 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

13. TURP carries an incidence of retrograde ejaculation of:
A. 62 - 78%
B. 48 - 61%
C. 79 - 93%
D. 34 - 47%
Answer : C

14. Smooth muscle tension in the prostate is mediated by which receptors?
A. ?1-a
B. ?1-b
C. ?2-a
D. ?2-b
Answer : A

15. What is true concerning epithelial and stromal cells in BPH?
A. there is an increase in the number of epithelial and stromal cells
B. there is an increase in the size of epithelial and stromal cells
C. in BPH, epithelial to stromal cells ratio is 1:2
D. all of the above
Answer : A

16. A 50% reduction of prostate size is expected after a 6-month therapy with:
A. alfuzosin
B. silodosin
C. finasteride
D. tamsulosin
Answer : C

17. 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

18. a. small fibrous glands
A. the presence of prostate cancer
B. previous prostatectomy
C. all of the above
D. . Robot-assisted laparoscopic prostatectomy for prostatic adenoma has the following advantage over TURP:
Answer : C

19. 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

20. 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

21. A 55 yrs. male patient with familial BPH, IPSS 9, PSA 23ng/ml, prostate size 31 cc, PVR 54 cc, on watchful waiting management. Next step should be:
A. tamsulosin 0.8 mg
B. reassurance
C. repeat total and free PSA
D. diagnostic cystoscopy
Answer : C

22. 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

23. 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

24. What prostatic lobe(s) can be assessed during DRE?
A. anterior
B. median
C. left lateral
D. all of the above
Answer : C

25. 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

26. 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

27. 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

28. a. no risk of dilutional hyponatremia
A. operating on patients with multiple bladder diverticula
B. operating on patients who cannot flex their hips and/or knees
C. unfavorable tissue preservation for pathological examination
D. . What is (are) the contraindication(s) to open prostatectomy for prostatic adenoma?
Answer : D

29. 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

30. An ED patient on low-dose tadalafil develops BPH. What medication should he avoid?
A. tamsulosin
B. alfuzosin
C. doxazosin
D. silodosin
Answer : C

31. What is false concerning bladder and prostate histology in BPH?
A. obstruction results in bladder smooth muscle hypertrophy and myofibroblasts deposition
B. BPH occurs chiefly in the transitional zone and periurethral tissues
C. BPH microscopical changes begin in early thirties
D. histologic findings of chronic prostatitis are common in BPH
Answer : A

32. The most serious drawback of anticholinergic drugs on BPH patients is:
A. renal insufficiency
B. urinary retention
C. dry mouth
D. painless hematuria
Answer : B

33. 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

34. The most serious complication of TURP is:
A. damage to the internal sphincter
B. damage to the external sphincter
C. bladder perforation
D. damage to a ureteral orifice
Answer : A

35. On treating BPH, which procedure provides the best tissue preservation for pathological examination?
A. TURP
B. TUIP
C. HoLEP
D. HoLRP
Answer : C

36. TURP syndrome is more likely to occur when:
A. the irrigating fluid is at a pressure exceeding 10 mm Hg
B. the prostate volume is > 45 cc
C. the resection time is > 90 minutes
D. all of the above
Answer : B

37. 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

38. 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

39. What can NOT be assessed during DRE?
A. sacral cord integrity
B. pelvic hematoma
C. pelvic floor muscle tenderness
D. prostatic median lobe hypertrophy
Answer : D

41. 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

42. 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

43. 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

44. What drug prevents recurrent gross hematuria secondary to BPH?
A. enoxaparin
B. silodosin
C. finasteride
D. tolterodine
Answer : C

45. 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

46. 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

47. 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

48. Which statement is false concerning transurethral microwave therapy (TUMT) for BPH treatment:
A. induces nerve degeneration in the prostate and tissue necrosis
B. frequently results in transient urinary retention
C. frequently leads to erectile dysfunction
D. the high-energy platform is superior to the low-energy with regard to clinical efficacy
Answer : C

49. Prostatic nodules palpated on DRE might indicate:
A. tuberculous prostatitis
B. prostatic cancer
C. inspissated prostatic abscess
D. any of the above
Answer : D

50. 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