MCQ 2nd week of May , 2015

11

 

  1. A 66 year old man with clinical T1c Gleason 6 prostate cancer  and PSA of 5 ng/ml desires active surveillance. He has a microscopic focus of cancer  in one of 12 biopsy cores. The size of the prostate is 50 cc. the next step is:

 

a.     Hormonal ablation.
b.    Repeat the biopsy only for raising PSA.
c.     Repeat the biopsy within one year.
d.    Treat prostate cancer
e.     Antibiotic, repeat the biopsy

 

  1. A 45 year old man has erectile dysfunction, decreased vibratory sensation in his feet and fasting blood sugars 320 mg/dl. The best treatment for his erectile dysfunction is:

 

a.     Penile prosthesis.
b.    Exogenous testosterone.
c.     A daily vitamin b-complex.
d.    Exogenous gonadotropins.
e.     Improved the diabetic control.

 

  1. A 32 year old patient with autosomal dominant polycystic kidney disease, pain, azotemia and hypertension. When He undergoes laproscopic marsupialization of these cysts, he will experience :

 

a.     Pain relief.
b.    Deterioration of renal function.
c.     Deterioration of Blood Pressure control.
d.    Improvement in Blood Pressure control.
e.     Improvement in renal function.

 

  1. A 50 year old man undergoes radical cystectomy with a studer type orthotopic urinary diversion. Three months later, he complains of frequency and incontinence (day & night) . Urodynamic study is done. The bladder capacity is 300 ml, Detrusor pressure is 10 cm. H2O (at capacity), Valsalve leak point pressure is 130 cm.H2O and residual urine volum of 75 ml. the next step is:

 

a.     CIC every 2-3 hours.
b.    Augmentation of his orthotopic bladder.
c.     Observation.
d.    Alpha blocker therapy.
e.     Artificial urinary sphincter placement.

 

  1. A 60 year old man with a serum creatinine of 1.7 mg/dl has a 5 cm upper pole left renal mass. He undergoes left partial nephrectomy. Frozen section reveals lymphoma with diffuse infiltration of normal renal paranchyma at the resection margins. His cold ischemic time was 18 minutes. The next step is:

 

a.     Radical nephrectomy.
b.    No further intervention.
c.     Re-excision of tumor bed.
d.    Biopsy of contralateral kidney.
e.     Cryotherapy of margins.

 

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