NMS Q&A Family Medicine

chap ter 19Urological Problems Uniqueto MalesExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 At what age should a man of average risk for prostatecarcinoma begin screening?(A) 35 years(B) 40 years(C) 50 years(D) 60 years(E) 70 years2 Each of the following is a method of improving ascreening method for carcinoma of the prostate forthe reason given except for which one?(A) Measure bound to free prostate specific antigen(PSA) ratio to improve specificity(B) Increase intervals between PSA drawings toreduce cost and inconvenience(C) Lower the PSA cut-off to increase specificity(D) Determine the rate of increase of PSA to predictaggressiveness of the cancer(E) Lower PSA cut-offs for younger blacks toimprove sensitivity3 A 45-year-old white male complains of painlessapparent red urine. He is a cigarette smoker with a30-pack-year history, and he notices increased frequencyof voiding and mild irritation. You decide toorder a three glass analysis of his urine, that is, thefirst 3 mL in glass 1; the bulk of the voided urine inglass 2; and only the very last few mL in glass 3. Whichof the following patterns of the three-glass urinalysisindicates a bladder source for the hematuria?(A) Positive test for blood in the first glass(B) Positive test for blood in the second glass(C) Positive test for blood in the third glass(D) Positive test for blood in all three glasses(E) Negative test for blood in all three glasses4 In treating a 55-year-old man for erectile dysfunctionwhich of the following constitutes an absolutecontraindication in taking any of the three phosphodieterase5 inhibitors [sildenafil (Viagra), vardenafil(Levitra), and tadalafil (Cialis)].(A) A diagnosis of coronary artery disease(B) Hypertension(C) Diabetes(D) Benign prostatic hyperplasia(E) Taking nitrates5 A 14-year-old boy has the rapid onset ( 2 hours ago)of severe right testicular pain associated with rightflank pain and nausea and vomiting. Upon examinationthe right testicle is riding higher than the left andis markedly tender within an edematous scrotum.Each of the following may be reasonably included inthe differential diagnosis of this case, except for whichone?(A) Epididymitis(B) Testicular trauma(C) Torsion of the testicle(D) Varicocele(E) Testicular cancer6 Regarding the patient in Question 5, which of thefollowing may yield the quickest office diagnosis?(A) Urinalysis(B) Complete blood count (include white blood cellcount and differential)(C) Doppler stethoscope(D) Testicular technetium scan(E) Intravenous pyelogram7 Which of the following dispositions is most appropriatefor the patient in Question 1, assuming a positiveDoppler result?(A) Intramuscular ceftriaxone 250 mg followed by100 mg of oral doxycycline bid for 10 days(B) Elective exploration of the scrotum to obtaingross and microscopic evidence to rule out amalignancy(C) Emergency exploration to perform bilateralorchiopexy119