Question | Answer |
When prescribing antihypertensive therapy for a man with BPH and hypertension, the NP considers that... | alpha-antagonist should not be used as solo or first line agent |
When assessing a 78 yo male with suspected BPH the NP considers that... | prostate size does not correlate well w/ the severity of symptoms |
Which can contribute to acute urinary retention in an older man w/ BPH | **amitriptyline**
loratadine
enalapril
lorazepam |
78 yo male presents w/ 3d h/o new-onset fatigue and difficulty emptying bladder. Exam reveals a distended bladder, but otherwise is unremarkable. BUN is 88mg/dL (31.4 mmol/L); creatinine is 2.8mg.dL (347.5umol/L) The most likely dx is: | postrenal azotemia |
Surgical intervention in BPH should be considered with all of the following EXCEPT | recurrent UTI
bladder stones
persistent obstruction despite medical therapy
**acute tubular necrosis** |
Finasteride (Proscar, Propecia) and dutasteride (Advodart) are helpful in the treatment of BPH because of their effect on... | prostate size |
Which of the following is inconsistent with the description of BPH? | obliterated median sulcus
larger than 2.5x3cm
sensation of incomplete emptying
**boggy gland** |
Tamsulosin (Flomax) is helpful in the treatment of BPH because of its effect on... | activity at select bladder receptor sites |
Concerning BPH, which of the following statement is true? | DRE is accurate in diagnosis.
**validated patient symptom tool is an important part of diagnosing this condition**
Prostate size directly correlates with symptoms and bladder emptying.
Bladder distention is usually present in early disease. |
Concerning herbal and nutritional therapies for BPH which is FALSE? | **these therapies are safest and most effective when used with prescription medications** |
You examine a 32yo male with chancroid and anticipate finding a... | painful ulcer |
The causative organism of chancroid is | Haemophilus ducreyi |
Treatment options for chancroid include all of the following EXCEPT: | azithromycin
ciprofloxacin
ceftriaxone
**Amoxicillin** |
When ordering lab test to confirm chancroid the NP considers that: | concomitant infection with herpes simplex is often found |
The most common causative organism of lymphogranuloma venereum is... | C. trachomatis (Chlamydia trachomatis) types 1 to 3. |
Physical examination findings in lymphogranuloma venereum include: | lesions that fuse and create multiple draining sinuses. |
Treatment options for lymphogranuloma venereum include: | tetracycline |
The presentation of acute epididymitis includes | positive prehn sign |
The most likely causative pathogens in a 26yo male with acute epididymitis include... | C. trachomatis |
Which of the following is part of a reasonable treatment option for a 30yo male with epididymitis? | doxycycline
(Specifically ceftriaxone followed by doxycycline) |
Gram stain of urethral discharge of a 37yo male with dysuria shows gram negative cocci. This is most likely... | N. gonorrhoeae |
Treatment options for uncomplicated gonococcal proctitis include: | Ceftriaxone 125mg IM as a single dose |
Which of the following is recommended by the CDC for as single-dose therapy for uncomplicated urethritis caused by N. gonorrhoeae? | cefixime |
In gonococcal infection, which of the following statement is true? | **Risk of transmission to an infected female to a male sexual partner is about 20-30% with a single coital act** |
Incubation period for gonococcal infection is | SHORT: 1-5 days |
True or False
Most men with gonococcal infections are asymptomatic. | TRUE |
True or False:
N. gonorrhoeae frequently produces beta-lactamase | TRUE. Therefore agents with beta-lactamase stability such as a cephalosporin should be used (ceftriaxone or cefixime) |
When choosing an antimicrobial agent tor the treatment of chronic bacterial prostatitis the NP considers that: | choosing an antibiotic with gram-negative is critical |
All of the following are likely to be reported by patients with acute bacterial prostatitis EXCEPT: | PENILE PAIN
(actual symptoms include perineal pain, irritative voiding sympoms and fever) |
During acute bacterial prostatitis the digital rectal exam usually reveals a gland described as | boggy |
Symptoms in chronic bacterial prostatitis often include | low back pain |
Most common causative organisms in chronic bacterial prostatitis include: | gram-negative rods |
which of the following is the best choice of therapy in chronic bacterial prostatitis | ciprofloxacin for 4 weeks |
The best diagnostic test to identify the offending organism in acute bacterial prostatitis is: | Urine culture |
You perform a DRE on a 72yo male and find a lesion suspicious for prostate cancer. The findings are best described as.. | an area of prostatic induration |
Which of the following PSA results are most consistent with cancer? | a doubling of PSA in serial annual tests in the presence of a normal DRE |
Risk factors for prostate cancer include all of the following EXCEPT: | Hx of genital trauma
(Actual RF are African ancestry, family hx of prostate CA, high fat diet) |
The average American man ha an approximately ____% lifetime risk of prostate cancer and an approximately ____% likelihood of clinical disease. | 40;10 |
a 19 yo male presents with sudden onset of left sided scrotal pain and unilateral loss of the cremasteric reflex. THis most likely represents... | testicular torsion |
In assessing the male with testicular torsion the NP is most likely to note: | a tender swollen testicle |
Anicipated organ survival exceeds 85% with testicular decompression within how many hours of torsion? | 6 |
To prevent reoccurance of testicular torsion which of the following is recommended? | orchiopexy |
a 42 yo male has a nontender "bag of worms" mass within the left dcrotum that disappears when he is supine. This is consistent with... | varicocele |
What is a common finding in a man with varicocele? | lower sperm count with increased number of forms |
How long after contact does the onset of manifestations of syphilis occur? | 2-4 weeks |
What is not representative of presentation of primary syphilis? | painless ulcer
palpable inguinal nodes
**flu like symptoms**
spontaneous healing lesion |
What would be representative of the presentation in secondary syphilis | generalized rash |
What is seen in tertiary syphilis? | gumma |
Syphilis is the most contagious at what time | during the secondary stage |
first line tx for primary syphilis is | penicillin |
sequelae of genital HPV infection in males can include | anorectal carcinoma |
describe lesion of condyloma acuminatum | verruciform |
Name a tx option for condyloma acuminatum | imiquimod |
Which HPV types are most common to cause colorectal CA? | 16 & 18 |
Which HPV types are most common to cause conyloma acuminatum? | 6 & 11 |
Which is NOT a common risk factor for erectile dysfunction? | DM
HTN
cigarette smoking
**testosterone deficiency** |
Patient education about the use of sildenafil (viagra) needs to include: | with the use of this medication sexual stimulation is also needed to achieve an erection |
when discussion ED with a 70 yo male, the NP considers: | most cases have an underlying cause |
Which medication tx for ED has the longest half life? | tedalafil (Cialis) |