In an 80 yrs. diabetic man on insulin for 35 yrs.; what would be the proper sequence of developing the following obstructing BPH/LUTS?
frequency, over-flow incontinence, straining, retention
straining, frequency, over-flow incontinence, retention
straining, frequency, retention, over-flow incontinence
frequency, straining, retention, over-flow incontinence
Correct Answer :
D. frequency, straining, retention, over-flow incontinence
frequency is the first obstructive LUTS in BPH condition. Retention, in this case, is chronic painless that could be complicated, lately, by overflow incontinence.
Related Questions
What drug prevents recurrent gross hematuria secondary to BPH?
enoxaparin
silodosin
finasteride
tolterodine
The most serious drawback of anticholinergic drugs on BPH patients is:
renal insufficiency
urinary retention
dry mouth
painless hematuria
What is (are) the indication(s) of upper urinary tract imaging in men with LUTS?
hematuria
recurrent urinary tract infection
renal insufficiency
all of the above
A 50% reduction of prostate size is expected after a 6-month therapy with:
alfuzosin
silodosin
finasteride
tamsulosin
Which statement is false regarding laser enucleation of the Prostate (HoLEP)?
provides tissue preservation for pathological examination
treats any size of prostatic adenoma
follows anatomic planes to remove the prostate in lobes
urinary incontinence is a significant drawback after HoLEP
In BPH patients, follow up PSA is of value because:
it helps predict the response to 5α-reductase inhibitors
it monitors LUTS/BPH progression
BPH patients are at higher risk of developing prostate cancer
a & b
Which statement best describes the natural history of BPH:
worsening of LUTS and BPH over time
patients die of other reasons before serious complications occur
physically, the space of prostatic fossa limits the gland enlargement
ultimately, the gland will degenerate and undergo apoptosis
What is the likelihood that PSA level in men with acute urinary retention due to urethral stricture will decrease after catheterization?
never
unlikely
likely
always
What is (are) the indication(s) to prescribe α-adrenergic inhibitors for BPH patients?
peak flow rate of ≤ 12 mL/sec
prostate volume > 40 ml
PSA > 1.5 ng/dL
b & c
What is the initial response of the detrusor muscle to obstruction?
increased intravesical pressure
increased detrusor pressure
increase collagen deposition in the detrusor
detrusor smooth muscle hypertrophy
An ED patient on low-dose tadalafil develops BPH. What medication should he avoid?
tamsulosin
alfuzosin
doxazosin
silodosin
Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
bladder stones
prostate cancer
renal insufficiency
bladder diverticula
IPSS decreases after successful TURP because:
PSA decreases
the prostate size decreases
the complaints resolve
the Q.O.L improves
What can NOT be assessed during DRE?
sacral cord integrity
pelvic hematoma
pelvic floor muscle tenderness
prostatic median lobe hypertrophy
What statement is true regarding post-void residual of urine (PVR)?
nearly all men have PVR of less than 12 ml
it predicts the outcome of surgical treatment
it correlates well with BPH/LUTS
it is diagnostic for bladder outlet obstruction
What is false concerning BPH and androgenic hormones?
the most potent androgenic hormones in BPH development is DHT
type-2 steroid 5 α-reductase, is most commonly found in the prostate
castrated individuals before puberty will not develop BPH
as a man ages, the number of androgen receptors in the prostate decreases
The lowest re-treatment rate of BPH is for:
TUIP
TURP
HoLEP
HoLRP
a. management of concomitant Hutch diverticulum
removing small bladder stones
better access to prostatic fossa
technically, easier trigonization
. When comparing retropubic to suprapubic prostatectomy for removing prostatic adenoma, the former has the advantage of:
A BPH patient presents with retention of urine. He is Catheterized. Later, he underwent TURP. When would the highest PSA value be?
before catheterization
after catheterization and before TURP
immediately after TURP
2 weeks after TURP
The most serious complication of TURP is:
damage to the internal sphincter
damage to the external sphincter
bladder perforation
damage to a ureteral orifice
What prostatic lobe(s) can be assessed during DRE?
anterior
median
left lateral
all of the above
What is false concerning the pathogenesis of BPH?
intra-prostatic levels of estrogen decrease in men with BPH
stimulation of the adrenergic nervous system results in a dynamic increase in prostatic urethral resistance
inflammation may play a role through cytokines to promote cell growth
hyperplasia occurs due to an imbalance between cell death and cell proliferation
c. each centimeter over the normal 2.5-cm prostate urethral length equates
an additional 15 g in prostate weight
each centimeter over the normal 1.5-cm prostate urethral length equates
an additional 5 g in prostate weight
. When comparing suprapubic to retropubic prostatectomy for removing prostatic adenoma, the former allows:
On treating BPH, which procedure provides the best tissue preservation for pathological examination?
TURP
TUIP
HoLEP
HoLRP
What is (are) true concerning IPSS questionnaire?
it focuses on last month`s symptoms
scores of moderate symptoms suggest surgical treatment if the patient`s quality of life was poor
it has been validated and translated to many languages
all of the above
The probability of developing acute urinary retention is related to:
the neurological status of the patient
PVR
severity of obstructive LUTS
all of the above
How to manage priapism that occurs during endoscopic surgery?
corporal aspiration
corpora injection with an α-adrenergic agent
corpora injection with an α-adrenergic blocker
no treatment required
What is true concerning epithelial and stromal cells in BPH?
there is an increase in the number of epithelial and stromal cells
there is an increase in the size of epithelial and stromal cells
in BPH, epithelial to stromal cells ratio is 1:2
all of the above
What is false regarding prostate embolization for BPH?
the aim is to occlude the internal iliac vessels
there is a considerable radiation risk during the procedure
bilateral embolization provides better results
eye protection is not required
On measuring the prostate volume during endoscopy:
each centimeter over the normal 2-cm prostate urethral length equates
an additional 12 g in prostate weight
each centimeter over the normal 2.5-cm prostate urethral length equates
an additional 10 g in prostate weight