GMAT - Senile enlargement of the prostate 1000+ MCQ [Solved] PDF Download

1. PSA value has a strong correlation with:
A. IPSS
B. post void residual
C. prostate volume
D. Q-max at uroflowmetry
Answer : C

2. In BPH, the etiology of acute urinary retention includes:
A. prostatic infarction
B. prostate infection
C. bladder overdistention
D. all of the above
Answer : A

3. 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

4. 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

5. The lowest re-treatment rate of BPH is for:
A. TUIP
B. TURP
C. HoLEP
D. HoLRP
Answer : A

6. 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

7. 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

8. 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

9. 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

10. What is false concerning BPH and androgenic hormones?
A. the most potent androgenic hormones in BPH development is DHT
B. type-2 steroid 5 ?-reductase, is most commonly found in the prostate
C. castrated individuals before puberty will not develop BPH
D. as a man ages, the number of androgen receptors in the prostate decreases
Answer : D

11. 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

12. 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

13. 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

14. 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

15. 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

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. 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

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

19. What is false regarding prostate embolization for BPH?
A. the aim is to occlude the internal iliac vessels
B. there is a considerable radiation risk during the procedure
C. bilateral embolization provides better results
D. eye protection is not required
Answer : A

20. 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

21. 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

22. 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

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

24. 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

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

26. 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

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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

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

37. 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

38. In men with LUTS, which of the following is NOT a compelling indication for upper urinary tract imaging?
A. urolithiasis
B. receiving chemotherapy
C. upper tract surgery
D. painless hematuria
Answer : B

39. 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

40. Which statement is false regarding TURP syndroe?
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

41. 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

42. 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

43. 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

44. 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

45. 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

46. In BPH patients, which of the following measures reduces PSA value by one-half?
A. 2 weeks after performing prostatic urethral lift
B. 6-month treatment with 5?-reductase inhibitors
C. after placing a stent in the prostatic urethra
D. immediately after removing one-half of the prostate by TURP
Answer : B

47. 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

48. 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

49. 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

50. a. ?-adrenergic blocker
A. combination of ?-adrenergic blocker and 5?-reductase inhibitor
B. watchful waiting
C. TURP
D. . What is the commonest cause of LUTS in men beyond middle age?
Answer : C