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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

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

33. 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

34. 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

35. 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

36. 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

37. 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

38. Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
A. bladder stones
B. prostate cancer
C. renal insufficiency
D. bladder diverticua
Answer : B

39. 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

40. 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

41. 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

42. 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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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