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WorksheetsBPH and ED pt 1
Total questions: 60
Worksheet time: 30mins
What is the major site of testosterone production in males?
Adrenal cortex
Corpus luteum
Testis
Liver
Which enzyme converts testosterone to dihydrotestosterone (DHT)?
Aromatase
3-β hydroxylase
5-α reductase
Cholesterol desmolase
Which form of 5-α reductase is found primarily in urogenital tissues?
Type I
Type II
Type III
Both Type I and II
DHT is more potent than testosterone because:
It circulates at higher concentrations
It is resistant to metabolism
It is converted from cholesterol
It has a hydrogen at position 5
Which hormone is the primary regulator of testosterone secretion in males?
FSH
LH
ACTH
Prolactin
Most circulating testosterone is transported in plasma bound to which protein?
Transferrin
Albumin
SHBG
Globulin A
Which is an androgenic effect of testosterone?
Increased erythropoiesis
Retention of sodium
Alteration in lean body mass
Closure of the epiphysis
Which is an anabolic effect of androgens?
Growth of the larynx
Stimulation of erythropoiesis
Increased body hair
Increased sebum secretion
Testosterone is aromatized to which compound?
Estrone
Estradiol
Progesterone
Cortisol
Aromatization of testosterone contributes to which physiological process?
Spermatogenesis
Skeletal growth
Muscle breakdown
Prostate enlargement
Hypergonadotropic hypogonadism is caused by dysfunction at which level?
Hypothalamus
Pituitary
Testis
Liver
What is a major risk of testosterone undecanoate therapy (boxed warning)?
Hepatic carcinoma
Stevens-Johnson syndrome
Pulmonary oil microembolism
Severe renal toxicity
Which adverse effect of testosterone results from its conversion to estrogen?
Acne
Aggression
Gynecomastia
Increased hematocrit
Erectile dysfunction is primarily caused by:
Excess testosterone
Reduced blood flow to the penis
High LH secretion
Increased venous return
Which of the following is not an organic cause of ED?
Vascular disease
Hormonal abnormalities
Medications
Performance anxiety
Which is a psychogenic cause of ED?
Neurogenic injury
Depression
Diabetes mellitus
Peripheral vascular disease
Which is a major risk factor for ED?
Low cholesterol
Aging
High fluid intake
Low blood pressure
Which statement best describes the mechanism of erection?
Contraction of penile smooth muscle
Arterial constriction
Increased blood inflow compared to outflow
Activation of 5-α reductase
What neurotransmitter is critically involved in promoting penile smooth muscle relaxation?
Dopamine
Serotonin
Nitric oxide
GABA
Which PDE-5 inhibitor is also used in BPH?
Sildenafil
Vardenafil
Tadalafil
Testosterone
PDE-5 inhibitors enhance erection by:
Increasing testosterone
Inhibiting cGMP breakdown
Increasing LH
Activating guanylyl cyclase directly
PDE-5 inhibitors should not be combined with which medication?
ACE inhibitors
Beta-blockers
Organic nitrates
Diuretics
A rare but serious adverse effect of sildenafil is:
Hyperkalemia
Acute hearing loss
Severe acne
Edema
During testosterone biosynthesis, cholesterol is converted to testosterone through multiple steps. What precursor contributes to testosterone synthesis?
Cortisol
DHEA
Acetate
Estradiol
Which androgenic effect results specifically from increased sebum production?
Gynecomastia
Acne
Alopecia
Vocal changes
What happens to epiphyseal plates under the influence of anabolic androgens?
They remain open longer
Closure is accelerated
Growth stops prematurely only in females
They are unaffected
In hypogonadotropic hypogonadism, both LH/FSH and testosterone are low due to:
Testicular failure
Pituitary or hypothalamic dysfunction
Excess prolactin
High SHBG
Which adverse outcome of testosterone therapy is associated with increased hematocrit?
Hyponatremia
Reduced clotting
Hyperviscosity and increased clot risk
Muscle wasting
Which event maintains penile rigidity during erection?
Venous dilation
Venous occlusion
Increased arterial resistance
NO inhibition
Which PDE-5 inhibitor has the longest duration of action?
Sildenafil
Vardenafil
Tadalafil
Testosterone
Which of the following correctly defines benign prostatic hyperplasia (BPH)?
Malignant enlargement of the prostate
Non-malignant increase in prostate size leading to urethral compression
Inflammation of the prostate due to infection
Enlargement of testicles leading to obstruction
Which factor is NOT a cause or contributor to BPH?
Excessive accumulation of dihydrotestosterone
Aging
Decreased estrogen stimulation
Hormonal alterations with endocrine changes
What is the main pathological outcome of enlarged prostate nodules compressing the urethra?
Increased urine acidity
Urinary retention due to obstruction
Increased kidney filtration
Decreased bladder pressure
Which of the following is a common irritative or obstructive symptom of BPH?
Polyphagia
Hesitancy in starting urination
Jaundice
Excessive sweating
Which symptom indicates incomplete bladder emptying?
Terminal dribbling
Chest pain
PhotophobiaHyperreflexia
BPH affects approximately what percentage of men over age 80?
10%
40%
60%
Over 80%
When should BPH be treated?
As soon as the prostate begins enlarging
Only if symptoms affect quality of life or complications occur
When PSA levels rise
When the patient develops nocturia alone
A majority of alpha-1 antagonists share which key structural feature?
Quinazoline ring and piperazine ring
Imidazole ring
Phenylalanine backbone
Dicarboxylic acid group
What is the primary mechanism of action of alpha-1 antagonists in treating BPH?
Shrinking prostate gland volume
Blocking 5-alpha reductase
Relaxing smooth muscle of the bladder neck and prostate
Increasing testosterone production
Which alpha-1 antagonist selectively targets the alpha-1A receptor subtype found in prostate smooth muscle?
Prazosin
Terazosin
Doxazosin
Tamsulosin
Which adverse effect is uniquely associated with tamsulosin and cataract surgery?
Stevens-Johnson syndrome
Intraoperative floppy iris syndrome
Gynecomastia
Hyperkalemia
What is the mechanism of action of 5-alpha reductase inhibitors?
Blocking testosterone receptors
Inhibiting conversion of testosterone to dihydrotestosterone
Stimulating PSA production
Increasing bladder muscle contractility
Which 5-alpha reductase inhibitor is selective for the type-2 isoenzyme?
Dutasteride
Finasteride
Tamsulosin
Doxazosin
Which agent inhibits BOTH type-1 and type-2 5-alpha reductase?
Finasteride
Tamsulosin
Dutasteride
Terazosin
Which structural feature is shared by finasteride and dutasteride?
Quinazoline core
Azasteroid-17-amide derivatives
Piperazine ring
Beta-lactam ring
A major clinical consideration with 5-alpha reductase inhibitors is:
They increase PSA by 50%
They lower PSA levels by up to 50%
They have no effect on PSA
They cause rapid improvement within 24 hours
Which adverse effect is MOST associated with 5-alpha reductase inhibitors?
Hypertension
Erectile dysfunction and lowered libido
Weight loss
Tachycardia
What pathophysiologic change contributes to weakened bladder function in BPH?
Increased acidity of urine
Decreased muscle tone and bladder capacity
Excessive urine production
Hypertrophy of the urethral sphincter
Why does urinary retention predispose patients to infection in BPH?
Urine becomes alkaline and supports bacterial growth
Urine becomes acidic and damages urethral tissue
Prostate tissue releases inflammatory toxins
DHT increases bacterial resistance
Which symptom is most consistent with severe obstruction?
Increased diarrhea
Nocturia
Acute urinary retention
Shoulder pain
Which medication type provides the most rapid symptom relief?
5-alpha reductase inhibitors
Alpha-1 antagonists
Antibiotics
Antimuscarinics
Which patients benefit MOST from 5-alpha reductase inhibitors?
Men with small prostates and mild symptoms
Men with demonstrable prostate enlargement
Men with normal PSA
Men with acute infections
Which factor related to lifestyle may increase the risk of BPH?
High protein intake
Intense exercise
Obesity and higher BMI
Excessive caffeine consumption
Which condition results from prolonged urinary retention due to BPH?
Hypoglycemia
Renal failure
Pancreatitis
Liver fibrosis
Which of the following symptoms is classified as an irritative LUTS symptom?
Hesitancy
Intermittency
Pain during urination
Sensation of incomplete bladder emptying
Tamsulosin differs from other alpha-1 antagonists because it is:
Non-selective for all alpha-1 receptors
A competitive blocker of alpha-1B receptors only
Selective for alpha-1A receptors in prostate smooth muscle
A steroid derivative
Which drug can reduce the need for BPH-related surgery?
Alpha-1 antagonists only
Finasteride/dutasteride
Antimuscarinics
Testosterone blockers
Which symptom may improve most rapidly after starting alpha-1 antagonist therapy?
Prostate size
PSA levels
Urinary flow rate
Libido
Which of the following lifestyle factors may reduce BPH risk?
Lack of exercise
Weight gain
Sedentary lifestyle
Regular physical activity
Which of the following best explains why BPH may lead to recurrent UTIs?
Hypertonic urine kills bacteria
Patients void too frequently
Alkaline urine from retention supports bacterial growth
Increased prostate blood flow promotes inflammation
