Deck 47: Benign Prostatic Hypertrophy

Question 1

The size of the prostate, as determined during the digital rectal exam, can be expected to correlate with the severity of the symptoms of benign prostatic hyperplasia.

Answer 1

False

Question 2

Your 50-year-old male patient comes to the clinic with a complaint of hesitancy during voiding. After completing an appropriate history and physical, you diagnose him with benign prostatic hyperplasia. His American Urological Association (AUA) Symptom Index Score is less than seven. Your initial treatment plan should include:

A) Starting the patient on a low initial dose of an α-blocker
B) Referring the patient to urology for consideration of a transurethral resection of the prostate
C) Watchful waiting.
D) Starting the patient on a 5α-reductase inhibitor.

Answer 2

C

Question 3

You have just diagnosed your patient with benign prostatic hyperplasia. He has an AUA Symptom Index score of 18. You discuss starting pharmacotherapy with your patient and he states that he has heard that saw palmetto is a safe and effective wonder-drug from his herbalist friend and so he wants to treat his symptoms with saw palmetto. Your evidence-based therapeutic response would be:

A) Encourage the patient to follow his herbalist friend's recommendations because many phytotherapeutic agents have been proven to be effective in reducing symptoms of benign prostatic hyperplasia.
B) Discuss with the patient that although many phytotherapeutic agents such as saw palmetto, African prune tree extract, and rye pollen are on the market, reliable research to date has not demonstrated any of them to be effective in relieving the symptoms of benign prostatic hyperplasia.
C) Advise the patient that phytotherapeutics and dietary supplements should never be considered when addressing a real medical problem.
D) Give the patient a prescription for doxazosin 1mg by mouth every day at bedtime and tell him to "just take the medication."

Answer 3

B

Question 4

Your 60-year-old male patient has just been diagnosed by you with benign prostatic hyperplasia. He states he wants a transurethral resection of the prostate, because that's what his brother had "and it took care of the problem right away." You provide him with appropriate education regarding his treatment options, but he continues to insist on invasive treatment. It would be most appropriate to:

A) Insist that the patient take the medications you are prescribing regardless of the patient's insistence on invasive treatment
B) Refer the patient to urology services for a consult
C) Refer the patient to psychiatric services for a cognitive screen
D) Refuse to discuss the patient's desire to have his benign prostatic hyperplasia symptoms addressed with invasive methods

Question 5

Appropriate screening tests for benign prostatic hyperplasia (BPH) include:

A) Prostate-specific antigen testing.
B) Urinalysis.
C) Renal function testing.
D) There are no screening tests for BPH.

Question 6

With respect to the prevalence and incidence of benign prostatic hyperplasia, which of the following statements is true?

A) BPH is very uncommon though it is to predict who will develop the problem.
B) BPH is very common and it is difficult to predict who will develop the problem.
C) BPH is very uncommon and it is difficult to predict who will develop the problem.
D) BPH is very common though it is to predict who will develop the problem.

Question 7

Goals of clinical management of benign prostate hyperplasia include:

A) Choosing a cost-effective approach for diagnosing BPH
B) Choosing a treatment plan that maximizes client adherence
C) Selecting a treatment plan that returns the client to a symptom-free state in a safe and effective manner
D) All of the above

Question 8

There is a clear correlation between the development of BPH and getting prostatic cancer.

Question 9

More recent studies have indicated that ___________ and _____________ increase the risk of BPH and BPH symptom progression.

A) Alcohol consumption and exercise
B) Sexual activity and tobacco use
C) Diabetes and obesity
D) Environmental toxins and family history

Question 10

Per the warnings of the Food and Drug Administration, it is important to insure that your patient's ophthalmologist is aware that your patient is taking an α₁-blocker because the medication puts the patient at risk for:

A) Intraoperative floppy iris syndrome
B) Retinal detachment
C) Macular degeneration
D) Cataracts

Question 11

Which of the following statements is not true?

A) Benign prostatic hyperplasia is generally considered to be a progressive disease.
B) Benign prostatic hyperplasia always requires medications or surgery as treatment.
C) Benign prostatic hyperplasia is considered to be the most common benign tumor in men.
D) Not all men who have histologic benign prostatic hyperplasia will have symptoms.