Senile enlargement of the prostate MCQ Solved Paper for SSC MTS

1. 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

2. 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

3. 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

4. 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

5. 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

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

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

8. 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

9. 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

10. 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

11. 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

12. 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

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

14. 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

15. 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

16. 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

17. Which statement best describes the natural history of BPH:
A. worsening of LUTS and BPH over time
B. patients die of other reasons before serious complications occur
C. physically, the space of prostatic fossa limits the gland enlargement
D. ultimately, the gland will degenerate and undergo apoptosis
Answer : B

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. 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

20. Preferably, what is the last part of the prostateto be removed while performing TURP?
A. bladder neck
B. apex
C. median lobe
D. para-collecular
Answer : B

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. A 55 yrs. male patient with familial BPH, IPSS 9, PSA 23ng/ml, prostate size 31 cc, PVR 54 cc, on watchful waiting management. Next step should be:
A. tamsulosin 0.8 mg
B. reassurance
C. repeat total and free PSA
D. diagnostic cystoscopy
Answer : C

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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 :

39. 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

40. 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

41. 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

42. 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

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

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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