Men’s Health / Urology – Advanced Practice Mini Exam (25 Questions)
Case 1: Benign Prostatic Hyperplasia (BPH)
1. Pathophysiology:
Which hormone primarily drives prostate tissue hyperplasia in BPH?
A. Cortisol
B. Dihydrotestosterone (DHT)
C. Testosterone
D. Aldosterone
2. Pharmacotherapeutics:
Which drug provides the fastest symptom relief for BPH?
A. Finasteride
B. Tamsulosin
C. Dutasteride
D. Saw palmetto
3. Physical Assessment:
Which DRE finding supports BPH rather than malignancy?
A. Nodular irregular prostate
B. Symmetric, firm, non-tender enlargement
C. Boggy tender prostate
D. Atrophic prostate
Case 2: Prostate Cancer
4. Pathophysiology:
Which of the following is the greatest risk factor for prostate cancer?
A. Obesity
B. African American race
C. Vasectomy
D. Caffeine intake
5. Pharmacotherapeutics:
A 72-year-old man with localized, low-risk prostate cancer chooses active surveillance.
Which is the rationale?
A. High rate of spontaneous regression
B. Prostate cancer often progresses slowly in older men
,C. PSA levels do not predict disease course
D. Radiation is never an option in elderly men
6. Physical Assessment:
Which DRE finding is most concerning for cancer?
A. Diffuse boggy prostate
B. Symmetric enlargement
C. Hard, irregular nodule
D. Smooth, rubbery gland
Case 3: Erectile Dysfunction (ED)
7. Pathophysiology:
The most common etiology of ED in men with diabetes and HTN is:
A. Hypogonadism
B. Endothelial dysfunction with impaired arterial inflow
C. Psychogenic inhibition
D. Pituitary adenoma
8. Pharmacotherapeutics:
Which patient should not receive sildenafil?
A. Patient on hydrochlorothiazide
B. Patient on nitrates for angina
C. Patient on metformin
D. Patient with mild renal impairment
9. Physical Assessment:
Which physical exam finding suggests a hormonal cause of ED?
A. Gynecomastia and testicular atrophy
B. Diminished femoral pulses
C. Hypertension and obesity
D. Normal genital exam
Case 4: Acute Bacterial Prostatitis
10. Pathophysiology:
Most common causative organism?
A. Klebsiella pneumoniae
B. Enterococcus faecalis
,C. Escherichia coli
D. Proteus mirabilis
11. Pharmacotherapeutics:
Which oral antibiotic is first-line for outpatient acute bacterial prostatitis?
A. Nitrofurantoin
B. Ciprofloxacin
C. Amoxicillin
D. Doxycycline
12. Physical Assessment:
Which exam maneuver is contraindicated?
A. Gentle DRE
B. Suprapubic palpation
C. Prostatic massage
D. CVA percussion
Case 5: Testicular Cancer
13. Pathophysiology:
Most common tumor in men 15–35 years old?
A. Seminoma
B. Teratoma
C. Sertoli cell tumor
D. Leydig cell tumor
14. Pharmacotherapeutics:
Initial management for suspected testicular cancer?
A. Empiric antibiotics
B. Needle biopsy
C. Radical inguinal orchiectomy
D. Chemotherapy
15. Physical Assessment:
Which finding distinguishes tumor from hydrocele?
A. Painless, firm testicular mass that does not transilluminate
B. Swelling that enlarges with standing
C. Tender spermatic cord
D. Bilateral symmetrical enlargement
, Case 6: Testicular Torsion vs Epididymitis
16. Pathophysiology:
Testicular torsion pathophysiology involves:
A. Inflammation of epididymis
B. Twisting of spermatic cord → ischemia
C. Lymphatic obstruction
D. Viral orchitis
17. Pharmacotherapeutics:
Which is the correct management for testicular torsion?
A. Empiric antibiotics and NSAIDs
B. Manual detorsion + emergent surgery
C. Observation and scrotal support
D. Warm compresses
18. Physical Assessment:
Which exam finding favors torsion over epididymitis?
A. Positive Prehn’s sign (pain relief with elevation)
B. Cremasteric reflex absent
C. Tender posterior testis
D. Scrotal erythema
Case 7: Urinary Tract Infections (UTI) in Men
19. Pathophysiology:
Which statement is correct about UTIs in men?
A. They are always complicated
B. They are usually due to viral pathogens
C. They are less common than in women due to longer urethra
D. They rarely involve the prostate
20. Pharmacotherapeutics:
Which antibiotic is not effective for male UTIs due to poor prostatic penetration?
A. Ciprofloxacin
B. TMP-SMX
C. Nitrofurantoin
D. Levofloxacin
Case 1: Benign Prostatic Hyperplasia (BPH)
1. Pathophysiology:
Which hormone primarily drives prostate tissue hyperplasia in BPH?
A. Cortisol
B. Dihydrotestosterone (DHT)
C. Testosterone
D. Aldosterone
2. Pharmacotherapeutics:
Which drug provides the fastest symptom relief for BPH?
A. Finasteride
B. Tamsulosin
C. Dutasteride
D. Saw palmetto
3. Physical Assessment:
Which DRE finding supports BPH rather than malignancy?
A. Nodular irregular prostate
B. Symmetric, firm, non-tender enlargement
C. Boggy tender prostate
D. Atrophic prostate
Case 2: Prostate Cancer
4. Pathophysiology:
Which of the following is the greatest risk factor for prostate cancer?
A. Obesity
B. African American race
C. Vasectomy
D. Caffeine intake
5. Pharmacotherapeutics:
A 72-year-old man with localized, low-risk prostate cancer chooses active surveillance.
Which is the rationale?
A. High rate of spontaneous regression
B. Prostate cancer often progresses slowly in older men
,C. PSA levels do not predict disease course
D. Radiation is never an option in elderly men
6. Physical Assessment:
Which DRE finding is most concerning for cancer?
A. Diffuse boggy prostate
B. Symmetric enlargement
C. Hard, irregular nodule
D. Smooth, rubbery gland
Case 3: Erectile Dysfunction (ED)
7. Pathophysiology:
The most common etiology of ED in men with diabetes and HTN is:
A. Hypogonadism
B. Endothelial dysfunction with impaired arterial inflow
C. Psychogenic inhibition
D. Pituitary adenoma
8. Pharmacotherapeutics:
Which patient should not receive sildenafil?
A. Patient on hydrochlorothiazide
B. Patient on nitrates for angina
C. Patient on metformin
D. Patient with mild renal impairment
9. Physical Assessment:
Which physical exam finding suggests a hormonal cause of ED?
A. Gynecomastia and testicular atrophy
B. Diminished femoral pulses
C. Hypertension and obesity
D. Normal genital exam
Case 4: Acute Bacterial Prostatitis
10. Pathophysiology:
Most common causative organism?
A. Klebsiella pneumoniae
B. Enterococcus faecalis
,C. Escherichia coli
D. Proteus mirabilis
11. Pharmacotherapeutics:
Which oral antibiotic is first-line for outpatient acute bacterial prostatitis?
A. Nitrofurantoin
B. Ciprofloxacin
C. Amoxicillin
D. Doxycycline
12. Physical Assessment:
Which exam maneuver is contraindicated?
A. Gentle DRE
B. Suprapubic palpation
C. Prostatic massage
D. CVA percussion
Case 5: Testicular Cancer
13. Pathophysiology:
Most common tumor in men 15–35 years old?
A. Seminoma
B. Teratoma
C. Sertoli cell tumor
D. Leydig cell tumor
14. Pharmacotherapeutics:
Initial management for suspected testicular cancer?
A. Empiric antibiotics
B. Needle biopsy
C. Radical inguinal orchiectomy
D. Chemotherapy
15. Physical Assessment:
Which finding distinguishes tumor from hydrocele?
A. Painless, firm testicular mass that does not transilluminate
B. Swelling that enlarges with standing
C. Tender spermatic cord
D. Bilateral symmetrical enlargement
, Case 6: Testicular Torsion vs Epididymitis
16. Pathophysiology:
Testicular torsion pathophysiology involves:
A. Inflammation of epididymis
B. Twisting of spermatic cord → ischemia
C. Lymphatic obstruction
D. Viral orchitis
17. Pharmacotherapeutics:
Which is the correct management for testicular torsion?
A. Empiric antibiotics and NSAIDs
B. Manual detorsion + emergent surgery
C. Observation and scrotal support
D. Warm compresses
18. Physical Assessment:
Which exam finding favors torsion over epididymitis?
A. Positive Prehn’s sign (pain relief with elevation)
B. Cremasteric reflex absent
C. Tender posterior testis
D. Scrotal erythema
Case 7: Urinary Tract Infections (UTI) in Men
19. Pathophysiology:
Which statement is correct about UTIs in men?
A. They are always complicated
B. They are usually due to viral pathogens
C. They are less common than in women due to longer urethra
D. They rarely involve the prostate
20. Pharmacotherapeutics:
Which antibiotic is not effective for male UTIs due to poor prostatic penetration?
A. Ciprofloxacin
B. TMP-SMX
C. Nitrofurantoin
D. Levofloxacin
