1. Which of the following statements about transurethral laser is TRUE?
Α. Transurethral laser can reduce prostatic volume even up to 45%
Β. Transurethral laser can reduce IPSS by 60-92%
C. Transurethral laser can reduce post-void residual urine by 60-88%
D. Α and Β
Ε. Α , Β and C
2. The use of KTP (Greenlight Laser) may lead to the following complication/s:
Α. urinary incontinence <1%
Β. urethral stricture <1%
C. urinary tract infection (UTI) 15-20%
D Α and Β
Ε. A, B and C
3. Marginal factor/s that may lead to failure with α-blockers include the following:
Α. prostate size > 50ml
B. Qmax < 15 ml/s
C. PSA > 2,5ng/ml
D. None of the above
Ε. All the above
4. The transurethral use of Laser:
Α. does not affect erectile function drastically
Β. causes retrograde ejaculation in 12-56% of cases (Greenlight)
C. does not exclude the probability of biopsies
D. Α and Β
Ε. All the above are correct
5. Which of the following statements is TRUE?
Α. CaP is 5-7% likely to be found in adenoma resection with TURP.
Β. Within 3 years, almost half patients discontinue α-blockers.
C. Use of laser may increase Q max even up to 23 ml/s.
D. Β and C
Ε. A, B and C
6. According to latest studies in males, antimuscarinic agents:
Α. are contra-indicated for obstruction cases.
Β. can be administered in every case irrespective of the presence and severity of obstruction.
C. can be administered relatively safely when there is concomitant OAB, for there is minimal (only 2%) urinary retention.
D. have absolute criteria with reference to the degree of obstruction.
Ε. have no place in the treatment of males with OAB.
7. According to EAU Guidelines for LUTS in males with BPE:
Α. Surgery is the first-line treatment.
Β. Combination of α-blocker and 5a-reductase is the first-line treatment for high-risk patients.
C. Surgery is the second-line therapeutic treatment of LUTS-BPE, in case pharmacotherapy fails.
D. B and C are correct
8. Which of the following techniques is NOT used for removing the Foley catheter?
Α. Overfilling of the balloon.
Β. Cross-section οf the balloon filling lumen.
C. Balloon perforation through the filling lumen.
D. Transrectal ultrasound-guided balloon perforation
Ε. Mild continuous traction.
F. Through suprapubic cystotomy.
9. When complications of transvesical prostatectomy arise, there is need for blood transfusion in:
Α. < 1% of cases
Β. <5% of cases
C. 5‐15% of cases
D. >30% of cases
10. Revision surgery due to a newly-occuring obstruction after transvesical prostatectomy:
Α. is as likely as after transurethral prostatectomy
Β. as likely as after prostatectomy with the use of Greenlight Laser
C. is necessary in 1‐2% of cases
D. is necessary in 10‐20% of cases
11. Post-transurethral prostatectomy mortality rate in the 21st century is:
12. The most common complication from Greenlight Laser prostatectomy is:
Β. persistent irritating symptoms during urination
C. erectile dysfunction
D. urinary incontinence
13. Switching from original to generic 5a reductase inhibitors may:
Α. reduce PSA.
Β. increase PSA, if the patient had been taking an original drug before switching to a generic.
C. improve urinary flow.
D. reduce IPSS score.
Ε. reduce adverse events compared to the original drug.
14. Switching from original to generic α‐adrenergic blockers in BPH patients may:
Α. increase urinary flow.
Β. reduce post-void residual urine.
C. reduce adverse events.
D. reduce IPSS score.
Ε. None of the above.
15. Which of the following statements about bipolar TUR-P is TRUE?
Α. There is no risk for TUR-syndrome.
Β. Some studies demonstrate that intraoperative bleeding is less than in unipolar TUR-P.
C. The fluid used in the resection is normal saline.
D. All the above.
16. Which of the following statements about monopolar TUR-P is true?
Α. The mortality rate is about 3%.
Β. The TUR-P syndrome occurs in 3-4%.
C. Blood transfusion is necessary in about 5% of the cases.
D. Retrogade ejaculation occurs in 30% of the cases.
17. Which of the following is true?
Α. Erectile dysfunction after TUR-P occurs in 40% of the cases.
Β. Retrogade ejaculation after TUR-P occurs in 40% of the cases.
C. Retrogade ejaculation is less common following bipolar TUR-P.
D.TUR-P has no significant effect on erectile function.
18. With regard to long-term results following TUR-P:
Α. there is significant improvement of Qmax in 40-50% of cases.
Β. 8-10% of patients will undergo revision TUR-P within 12 years.
C. there is significant improvement of symptoms in 20-30% of cases.
D. all the above are true.
19. In PBE, the transition zone in the ultrasound image is:
D. of mixed echogenicity
Ε. all the above
F. none of the above
20. Which of the following statements about A-receptors (AR) is FALSE?
Α. α1ΑARs are the dominant receptors in the prostate gland.
Β. α1DARs are the dominant receptors in the detrusor.
C. Silodosin shows higher selectivity for α1ΑARs compared to α1ΒARs and α1DARs.
D. Alfuzosin shows higher selectivity for α1ΑARs compared to α1ΒARs -but not compared to α1DARs.
21. Which of the following statements about adrenergic blockers is true?
Α. They differ significantly with regard to their efficacy.
Β. They achieve 40-50% improvement of symptoms (IPSS).
C. They achieve 40-50% improvement of urinary flow.
D. They do not significantly reduce risk for symptom exacerbation.
22. Which of the following statements about a-adrenergic blockers is FALSE?
Α. The intraoperative floppy iris syndrome is caused by the presence of α1ΑAR in the iris.
Β. The risk for retrograde ejaculation recurrence is not the same in all α-blockers.
C. The most common adverse events from the use of α-blockers are fatigue, dizziness and orthostatic hypotension.
D. Alfuzosin, Tamsulosin and Silodosin are superselective α-blockers, while Doxazosin and Terazosin are not.
23. When investigating LUTS with U/S ......
Α. only the lower urinary tract needs to be screened with U/S.
Β. the lower urinary tract needs to be screened only after urination,so as to measure the prostate volume and residual urine.
C. not only the lower urinary tract but also the upper urinary tract need to be screened.
D. the bladder should contain at least 350ml, so that the results are reliable.
24. Post-void residual urine (PVR)......
Α. should always be assessed.
Β. should be measured with a catheter in order to have a reliable assessment of urine volume.
C. should be measured after every urination with urine volume>300ml.
D. All answers are correct
Ε. All answers are wrong
25. Ultrasound screening (U/S) of the urinary tract and the other diagnostic tests:
Α. set the diagnosis of a urological disease.
Β. are all conducted and then studied by the physician who sets the diagnosis.
C. aim at answering specific diagnostic questions, in order to draw close to a diagnosis or exclude a diagnosis.
D. All above answers are correct.
Ε. All above answers are wrong.
26. Photoselective Vaporization of Prostate (PVP) with Greenlight Laser (KTP) gives results that are:
Α. equivalent to the results of Transurethral Prostatectomy (TURP)
Β. equivalent to the results of Transurethral Prostatectomy (TURP) but not equivalent to the results of Open Prostatectomy.
C. satisfactory only in prostate glands < 50ml
D. are equivalent to pharmacotherapy with α-adrenergic inhibitors
Ε. not possible to assess, for the method is still new.
27. Photoselective Vaporization of Prostate (PVP) with Greenlight Laser (KTP) .....
Α. is a safe method but the risk for the TURP syndrome still remains.
Β. is practically a non-invasive method and the catheter usually stays for less than 24 hours.
C. is performed with the use of straight-emitting Laser optic fibers.
D. is performed with the use of side-emitting Laser optic fibers, and a resectoscope to achieve hemostasis.
Ε. has a big learning curve.