Oet Practice 2.0 PDF

Benign Prostatic Hyperplasia:
Texts A
A62-year-old man with a 4-year progressive history of:
• Increasing lower urinary tract symptoms (LUIS, American Urological Association

(AUA) symptom score: 21
• flow rate: 11 ml/s
• Post-void residual. mL
• Prostate volume (on transrectal ultrasonography (TRUSJ): 65 mi.
• Prostate-specific antigen (NA, level: 3.2 ng/mL
• The patient states that he is not bothered significantly by his sy s J11tl does not desire
active therapy.
What is his risk of progression?

This patient isat significant risk for benign prostatic
• Deterioration of symptoms.
• Deterioration of flow rate.
• Risk of acute urinary retention (AUR)
• Risk of surgery
What is the most appropriate medical therapy?

5-α-Reductase inhibitor therapy, combination 5-α-reductase inhibitor and α-blocker therapy, or
very careful watchful waiting.
Treatment:
The patient Declines therapy.
Implications of treatment:
When deciding between watchful waiting and active treatment, this patient should be aware of
his increased risk of BPH progression and unfavorable outcomes. Close follow-up is required to
detect significant progression.
Text B
The high prevalence of histologic BPH, bothersome LUTS, BPE, and BOO has been
emphasized, and the number of patients presenting with these symptoms to health care providers
engaged in the care of such patients will likely increase significantly over the next decades.
Estimates from the United Nations demonstrate that the percentage of the population aged 65
years or older increased significantly between 2000 and 2005, both in underdeveloped and more
developed regions, and from 7% to 11% worldwide (Figure 2A). In addition, life expectancy has
changed worldwide from 56 years for the observation period 1965 to 1970 to 65 years for 2000
to 2005. Again, the more developed regions have a longer life expectancy, but the incremental
increase is greater in Africa, Asia, and Latin America and the Caribbean regions (Figure 2B).
Text C
For men who have BPH and have a large prostate or a high PSA at baseline combination therapy
can prevent about 2 episodes of clinical progression per 100 men per year over 4 years of
treatment. There is no additional benefit within the first year of treatment. Most men who take
combination therapy will have no additional benefit, and about 4 additional patients per 100 will
become impotent who would not have taking an alpha blocker alone. Combination therapy can
also be instituted after clinical progression occurs, but this strategy, while used widely, has not
been studied.
Text D
Despite the deceptively simple description of benign prostatic hyperplasia (BPH), the actual
relationship between BPH, lower urinary tract symptoms (LUTS) benign prostatic enlargement,
and bladder outlet obstruction is complex and requires a solid understanding of the definitional
issues involved. The etiology of BPH and LUTS is still poorly understood, but the hormonal
hypothesis has many arguments in its favour. There are many medical and minimally invasive
treatment options available for affected patients. In the intermediate and long term, minimal
invasive treatment options are superior to medical therapy in terms of symptom and flow rate
improvement tissue ablative surgical treatment options are superior to both minimally invasive
and medical therapy.
Benign Prostatic Hyperplasia: - Questions
Question 1-7:
For each question, 1-7, decide which text (A, B, C or D) the information comes from. You
May use any letter more than once.
In which text can you find information about.
1. About combination therapy. 1…………………………………….

2. Changes in the life expectancy. 2…………………………………….
3. Etiology of BPH is not clear.
3…………………………………….
4. Patients with urinary tract infection will increase
in the future. 4…………………………………….
5. Patient denies active treatment. 5…………………………………….

6. Risk of BPH progression.
6…………………………………….
7. Lab investigation for BPH
7…………………………………….
Questions 8-14:
Answer each of the questions, 8-14, with a word or short phrase from one of the texts.
Each answer may include word, number or both.
8. What are the treatment options for BPH?
……………………………………………………………………………………......
9. List two risks of BPH?
……………………………………………………………………………………......
10. What treatment is widely used after progression occurs, but has not been studied?
……………………………………………………………………………………......
11. What is BPH?
……………………………………………………………………………………......
12. What is the appropriate medical therapy?
……………………………………………………………………………………......
13. As per 2005, what is the change in life expectancy since 1970?
……………………………………………………………………………………......
14. What is the appropriate treatment for long term BPH patients
……………………………………………………………………………………......
Questions 15-20:
Complete each of the sentences, 15-20, with a word or short pharase from one of the texts.
Each answer may include words, numbers or both.
15. …………………. Regions have a longer life expectancy.
16. …………… treatment options are superior to both minimally invasive and medical
therapy options.
17. Cause of BPH is not clear, but ……………………. has many points in its favour.
18. ………………………. Must be done in patients with BPH to rule out its progression.
19. Increase in percentage of population aged 65 years or older is …………………. in 5

years.
20. ………………………….. can be used for patients with BPH progression.

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What are the risks of BPH progression?

What treatment options are available for BPH?

Benign Prostatic Hyperplasia:

• Increasing lower urinary tract symptoms (LUIS, American Urological Association

What is his risk of progression?

What is the most appropriate medical therapy?

1. About combination therapy. 1…………………………………….

5. Patient denies active treatment. 5…………………………………….

8. What are the treatment options for BPH?

9. List two risks of BPH?

11. What is BPH?

12. What is the appropriate medical therapy?

15. …………………. Regions have a longer life expectancy.

19. Increase in percentage of population aged 65 years or older is …………………. in 5

20. ………………………….. can be used for patients with BPH progression.

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