Transdermal Estrogen in Prostate Cancer
In patients with locally advanced prostate cancer, transdermal estradiol is noninferior to luteinizing hormone-releasing hormone agonists for 3-year metastasis-free survival.
- True
- False
Urology
Prostate Cancer
A 65-year-old man who is otherwise well presents for a periodic health examination. He has a friend who recently was diagnosed with prostate cancer. He is requesting a prostate specific antigen (PSA) test. After discussion of the benefits and risks, you order the test. His PSA comes back markedly abnormal and remains elevated on repeat testing
Volume 41.4 - Question 33
Lower Urinary Tract Symptoms in Men
Which one of the following statements about the pharmacological treatment of lower urinary tract symptoms in men is false?
- 5α-Reductase medications typically require 3 to 6 months for patients to experience clinical improvement.
- Tadalafil may increase postvoid urine dribbling.
- When a 5α-Reductase medication and α-blocker are taken in combination the α-blocker can usually be discontinued after 6 months.
- β3 agonists can cause nasopharyngitis.
Volume 41.2 - Question 32
Approach to Microhematuria
You are seeing a 52-year-old male in your family practice for a routine drivers medical. His urinalysis shows 5 RBCs/HPF. He has no history of gross hematuria and no urinary tract symptoms. He is a non smoker and in good health. His physical examination is unremarkable. Your working diagnosis is asymptomatic microscopic hematuria.
Volume 41.1 - Question 39
Testosterone Supplementation
Which one of the following statements concerning testosterone supplementation is false?
- It has no consistent, meaningful impact on sexual function.
- It does not increase prostate events.
- It increases myocardial infarction risk.
- Before supplementing, the best initial test is total testosterone from blood drawn in the morning.
Volume 41.1 - Question 34
Foreskin Management
Your next patient is a 2-month-old boy, accompanied by his mother. During his visit, the mother shares being worried about his foreskin, as it is adherent to the glans penis. The mother wants to know if she should forcibly retract it to clean his penis during bathtime, as she has noticed white particles inside his foreskin.
Volume 40.5 - Question 36
Testicular Cancer
Which one of the following statements about testicular cancer is false?
- Scrotal ultrasound can distinguish malignant from benign testicular masses with a sensitivity and specificity greater than 90%.
- Normal serum tumor markers rule out cancer.
- Patients suspected to have testicular cancer should undergo radical inguinal orchiectomy.
- Patients treated for stage I testicular cancer should undergo surveillance for at least 5 years.
Volume 40.5 - Question 33
Urine Testing for Infection in Older Adults
Which one of the following statements about urine testing to rule out infection in patients older than 65 is false?
- For patients with indwelling catheters, urine cultures should only be collected from the first void in a newly replaced catheter.
- Urine dipstick testing is not recommended to diagnose urinary tract infection (UTI) in adults living in long-term care.
- Treating asymptomatic bacteriuria (ASB) reduces the risk of developing a subsequent UTI.
- In the absence of urinary signs or symptoms or signs of sepsis, asymptomatic bacteriuria is an unlikely cause of delirium.
Volume 40.4 - Question 21
Prostate Cancer Screening
Performing a biopsy of the prostate only in men with an elevated prostate-specific antigen (PSA) level and visible lesions on MRI could reduce clinically insignificant prostate cancer diagnoses.
- True
- False
Volume 40.4 - Question 1
Renal Cancer Update
A 65-year-old woman presents with gross hematuria and no other symptoms. She is found on ultrasound to have a small renal mass.
Volume 40.1 - Question 40
Risk of Hypertension after Kidney Donation
Normotensive living kidney donors have a higher risk of hypertension than normotensive non-donors in the first 7 years following donation.
- True
- False
Volume 40.1 - Question 37
Benign Prostatic Hyperplasia
Low dose tadalafil is an effective option for the management of symptoms due to benign prostatic hyperplasia.
- True
- False
Volume 39.6 - Question 32
Uncomplicated Urinary Tract Infections
For uncomplicated urinary tract infections (UTIs) in cognitively intact, nonpregnant women, the patient’s perception that they have a UTI warrants treatment with antibiotics.
- True
- False
Volume 39.6 - Question 19
Urinary Incontinence in Adults
Diarrhea is associated with an increased risk of urge urinary incontinence in adults.
- True
- False
Volume 39.5 - Question 38
Melatonin for Nocturia
In prospective randomized controlled trials, melatonin shows a trend towards treatment response for nocturia in non neurogenic populations.
- True
- False
Volume 39.5 - Question 31
Probiotic Supplementation in the Prevention of Recurrent UTIs
In premenopausal women with recurrent urinary tract infections, use of a vaginal probiotic is associated with a lower incidence of recurrent episodes.
- True
- False
Volume 39.5 - Question 2
Testicular Torsion
A 12-year-old boy arrives at midnight at the emergency room with acute testicular pain. You suspect testicular torsion.
Volume 37.3 - Question 41
Microscopic Hematuria
Which one of the following statements about microscopic hematuria is false?
- A single urinalysis is sufficient for detection.
- A workup should be performed for patients on anticoagulation.
- Patients at high risk for bladder cancer should have cystoscopy.
- Urine cytology should be included in the initial evaluation.
Volume 37.3 - Question 15
Urethral Strictures
Less than 10 percent of men with urethral strictures treated with urethrotomy will develop recurrent strictures.
- True
- False
Volume 36.6 - Question 33
Scrotal Masses
Your next patient is 28 years old and new to your family practice. He has no known medical problems and considers himself healthy. During your visit, he tells you that he is worried about a new scrotal mass.
Volume 38.1 - Question 40
Quick Point-of-Care Ultrasound for Hydronephrosis
In using point-of-care ultrasound to diagnose hydronephrosis, longitudinal views of the kidney show good sensitivity and specificity compared with a combination of longitudinal and transverse views
- True
- False
Volume 38.2 - Question 10
Treatment of Epididymitis
For acute epididymitis in sexually active men not at risk for infection with enteric organisms, empiric treatment with a single dose of ceftriaxone plus oral doxycycline for 10 days is recommended.
- True
- False
Volume 38.2 - Question 6
Alpha Blockers for BPH
Which one of the following statements about alpha blockers in the treatment of benign prostatic hyperplasia is false?
- They are usually effective within days of starting treatment.
- They slow disease progression.
- Doxazosin and terazosin should be titrated slowly to reduce the risk of syncope.
- They are associated with an increased risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery.
Volume 37.5 - Question 27
Reductase Inhibitors
Which one of the following statements about 5α-reductase inhibitors in the treatment of benign prostatic hyperplasia is false?
- They decrease the size of the prostate over several months.
- Co-administration of tadalafil, a PDE-5 inhibitor, may mitigate some of the sexual adverse effects.
- Maximal symptomatic relief is always seen by two months from treatment initiation.
- They decrease prostate-specific antigen concentrations about 50%.
Volume 37.5 - Question 26
Treatment of Benign Prostatic Hypertrophy
Which one of the following statements about the treatment of benign prostatic hypertrophy (BPH) is false?
- Surgery is recommended for patients with recurrent urinary tract infections.
- Lifestyle modifications such as fluid restriction, frequent bladder emptying, and avoiding bladder irritants are recommended.
- Used as monotherapy, tadalafil is similar in efficacy to alpha blockers.
- Saw palmetto has been shown to significantly improve BPH symptoms.
Volume 37.5 - Question 15
Enuresis
A mother brings her 9-year-old child to you. He has started to wet the bed at night. The mother is concerned and asking for help with this problem.
Volume 38.4 - Question 36
Recent Updates to Clinical Practice Guidelines
Which one of the following is false regarding recent (since 2021) updates to Canadian clinical practice guidelines?
- The Canadian Task Force on Preventive Health Care recommends screening of sexually active individuals younger than 30 years for chlamydia and gonorrhea annually.
- The Canadian Urological Society recommends noncontrast computed tomography as the initial imaging modality for acute ureteral stones.
- The Society of Obstetricians and Gynecologists of Canada (SOGC) recommends that postmenopausal women with hypoactive sexual desire disorder can consider transdermal testosterone patches as a treatment option.
- The SOGC recommends consideration of hormone therapy for perimenopausal depression with or without concomitant vasomotor symptoms.
Volume 38.3 - Question 19
Posthumous Reproduction
Which one of the following statements about posthumous assisted reproduction is false?
- It is most frequently conducted in biological females.
- Oocytes can be retrieved through follicular aspiration.
- One method of sperm retrieval is testicular biopsy.
- It should occur within 24 – 36 hours after death.
Volume 39.1 - Question 2
Prostate Cancer
Prostate cancer-specific mortality rates for localized prostate cancer are similar regardless of the treatment provided (active monitoring, prostatectomy or radiotherapy).
- True
- False
Volume 38.6 - Question 40
Anticholinergic Drugs for Overactive Bladder
Which one of the following statements about anticholinergic drugs for overactive bladder is false?
- Extended-release formulations cause less dry mouth than immediate-release formulations.
- Patients who experience intolerable side effects with one anticholinergic drug do not benefit from switching to another.
- Solifenacin is selective for M3 muscarinic receptors.
- Long-term use of anticholinergic drugs has been associated with a dose-related increase in the risk of dementia.
Volume 38.6 - Question 28
Drugs for Overactive Bladder
Which one of the following statements about drugs for overactive bladder is false.
- Anticholinergic drugs are better tolerated than beta-3 agonists.
- Coadministration of a beta-3 agonist and an anticholinergic drug can increase the risk of urinary retention.
- Use of an anticholinergic drug and a beta-3 agonist may be more effective than either drug alone.
- Tadalafil may improve urinary symptoms in women with overactive bladder.
Volume 38.6 - Question 27
Hydrochlorothiazide and Kidney Stone Prevention
Among patients with recurrent calcium-containing kidney stones, the incidence of recurrence is reduced by taking hydrochlorothiazide.
- True
- False