1. What type of tests are used to determine positive prostate enlargement? (C.McIntyre)
a. Digital Rectal Exam (DRE) and serum Prostate Specific Antigen (PSA) – Correct. Rationale: DRE is performed to palpate an enlarged prostate. An elevated PSA can be indicative of BPH and/or prostate cancer.
b. Post void residual (PVR) bladder scan and serum PSA – Rationale: PVR is used to determine urinary retention, which can be a differential diagnosis of BPH, but not used to diagnosis BPH itself.
c. Urine culture and urinalysis – Rationale: Helpful in determining a potential UTI, but not diagnosing BPH.
d. Flomax and Digital Rectal Exam – Rationale: Flomax is a commonly prescribed treatment for symptoms of BPH, but not used in diagnostics.
2. What symptoms was patient Mr. U. Rology exhibiting that would indicate prostate enlargement? (E. Fairand)
a. Constipation and lower abdominal pain – Rationale: while a patient might experience lower abdominal pain, constipation is not an associated symptom of BPH.
b. Frequent urinary tract infections (UTIs) and history of coronary artery disease (CAD) – Rationale: UTIs are common differential diagnoses associated with BPH, but there is no known link with CAD.
c. Urinary frequency, urinary retention, and nocturia – Correct. Rationale: these symptoms are associated with BPH.
d. Family history of BPH and hypertension (HTN) – Rationale: HTN is not associated with BPH.
3. Who is most susceptible to developing BPH? (E. Fairand & C. McIntyre)
a. African American female, aged 80 years – Rationale: BPH is only found in men.
b. African American male, aged 75 years – Correct. Rationale: BPH is only found in men and is prevalent in 90% of males ages 70 years or older in the U.S.
c. Hispanic male, aged 45 years – Rationale: Prevalence in men 60 years or older is about 50% while it is about 90% in males 70 years or older.
d. White male, aged 65 years – Rationale: Prevalence in men 60 years or older is about 50% while it is about 90% in males 70 years or older.
4. Bladder outflow obstruction symptoms include a boggy prostate, lower back pain and decreased urinary stream. (P. Garlinghouse)
a. True – Rationale: A decrease in the flow of the urine stream, the urge to urinate, and a delayed initiation of urination are bladder outflow obstruction symptoms.
b. False – Correct. Rationale: Lower back pain and a boggy prostate are symptoms of acute/chronic prostatitis, not bladder outflow obstruction.
5. The enlargement of the prostate in Benign Prostatic Hypertrophy is characterized by the following: (J. Garcia)
a. Nodular hyperplasia and glandular cells hypertrophy in the prostate. Correct. Rationale: These characterize prostate enlargement in BPH
b. Accumulation of urine in the prostate – Rationale: The prostate does not accumulate urine and this does not characterize the enlargement of the prostate in BPH
c. Nodular hyperplasia, glandular cells hypertrophy, and urine accumulation in the prostate. Rationale: The first two are correct but the latter is an incorrect characterization of prostate enlargement in BPH
d. Transition, Peripheral, Central Zones – Rationale: These are the three zones of the prostate and do not characterize prostate enlargement in BPH.