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

1. 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

2. 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

3. 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

4. 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

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

6. 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

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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

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

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 throughcytokines to promote cell growth
D. hyperplasia occurs due to an imbalance between cell death and cell proliferation
Answer : D

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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

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

29. 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

30. 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

31. 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

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

33. 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

34. 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

35. 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

36. 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

37. A BPH patient presents with retention of urine. He is Catheterized. Later, he underwent TURP. When would the highest PSA value be?
A. before catheterization
B. after catheterization and before TURP
C. immediately after TURP
D. 2 weeks after TURP
Answer : C

38. 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

39. 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

40. 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

41. 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

42. 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

43. 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

44. 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

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

46. 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

47. 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

48. 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

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

50. 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