20. TURP carries an incidence of retrograde ejaculation of:
A. 62 - 78%
B. 48 - 61%
C. 79 - 93%
D. 34 - 47%
Answer :
21. 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
22. 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
23. What prostatic lobe(s) can be assessed during DRE?
A. anterior
B. median
C. left lateral
D. all of the above
Answer : C
24. 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
25. 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
26. 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
27. 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
28. 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
29. 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
30. 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
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. 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
33. 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
34. 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
35. 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
36. 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
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. 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
39. On treating BPH, which procedure provides the best tissue preservation for pathological examination?
A. TURP
B. TUIP
C. HoLEP
D. HoLRP
Answer : C
40. 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
41. 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
42. 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
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 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
45. 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
46. 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
47. 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
48. 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
49. 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
50. 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