Only (Questions With Factual Solutions)
Cryptorchidism Correct Answer - Why we feel up little baby boys in the
NICU nursery. We are checking for undescended testicles
BPH:Physical exam findings? Correct Answer - progressive benign
hyperplasia of the prostate
by the age of 80, about 80% of men will acquire this disorder.
most common cause of bladder obstruction in men over the age of 50
signs and symptoms are urinary frequency, nocturia, dribbling, retention.
On physical exam, the bladder may be distended.
The prostate is non-tender with either asymmetrical or symmetrical
enlargement. And the prostate will have a smooth rubber consistency with
possible nodules.
BPH:What does prostate gland feel like with DRE? Correct Answer -
digital rectal exam: prostate will have a smooth rubber consistency with
possible nodules- touching it will likely cause the sensation of needing to pee.
BPH:Management both pharmacologic and nonpharmacologic? Correct
Answer - "Fineste-ridin' dirty"-here are two main classes of medications.
5-alpha reductase inhibitors
finasteride 5 mg and finasteride 1 mg and dutasteride (marketed as Avodart).
Dutasteride is also available in combination with tamsulosin, under the brand-
name Jalyn and this rx is good for long-term mngmt
And this is alpha-adrenergic antagonists:
Alfuzosin.
Doxazosin.
Prazosin (inverse agonist)
Tamsulosin.
Terazosin.
Silodosin.
BPH:What are possible side effects of the medications? Correct Answer -
Affect the contraction of the smooth muscle in the prostatic, urethra and
bladder neck.
, -common adverse effects are orthostatic hypotension.
Typically take two to four weeks to show improvement.
They may affect blood pressure, require dose titration and blood pressure
monitoring. The American urology association recommends Alfuzosin,
Doxazosin and Tamsulosin, because they're thought to be more effective and
have less effect on blood pressure. Prazosin and Phenoxybenzamine have
insufficient evidence and are not recommended.
Treatment with 5a-Reductase inhibitors: Correct Answer - "Fineste-
ridin' dirty"
Erectile dysfunction.
Lower sex drive.
Retrograde ejaculation, when your semen goes backward into your bladder.
Side effects: erectile dysfunction.
Work by blocking the conversion of testosterone to dihydrotestosterone
gradually reducing the prostatic volume. Most benefit is when the prostate
volume exceeds 40 milliliters. Correct Answer - -5a-Reductase
inhibitors-"Fineste-ridin' dirty":
Requires six months to show clinical benefit, and there are two equally
effective options.
-This is Finasteride and Dutasteride.
-Show reduced risk of urinary retention, less need for surgical intervention
and fewer overall incidents of prostate cancer when these medications are
used.
"AAA "alpha-adrenergic antagonists are the first-line option for moderate to
severe? Correct Answer - -BPH but they have bothersome urinary tract
symptoms.
-affect blood pressure, require dose titration and blood pressure monitoring.
-Alfuzosin, Doxazosin and Tamsulosin, because they're thought to be more
effective and have less effect on blood pressure.