Senile enlargement of the prostate 1000+ MCQ with answer for NDA

1. Anticholinergic medications work best with BPH patients who have:
A. small prostate
B. mainly median lobe hypertrophy
C. history of urinary retention
D. mainly irritative symptoms
Answer : D

2. 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

3. 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

4. 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

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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

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

19. 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

20. 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. 55 nm
D. 1064 nm
Answer : A

21. 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

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

23. 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

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. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

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

39. 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

40. A BPH patient presents with retention of urine. He is Catheterized. Later, he underwent TRP. 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

41. 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

42. 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

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

46. 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

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

48. 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

49. 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

50. 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