Prostate

Question 1

How long should patients be advised to avoid exercise for, prior to PSA testing?

Answer 1

48 hours

Question 2

Cut-off IPSS scores?

Answer 2

0-7 mild
8-19 moderate
20-30 severe

Question 3

Abnormal post-micturition residual?

Answer 3

> 100ml

Question 4

Management of mild BPH symptoms?

Answer 4

Watchful waiting + lifestyle advice

Question 5

Management of troublesome BPH symptoms?

Answer 5

Alpha-blocker

If enlarged prostate, offer 5-alpha reductase inhibitor e.g. finasteride

Question 6

Management options in men with “storage” symptoms?

Answer 6

Offer an antimuscarinic

Question 7

Exclusion period for PSA testing- vigorous exercise

Answer 7

48 hrs

Question 8

Exclusion period for PSA testing- proven UTI

Answer 8

1 month

Question 9

Exclusion period for PSA testing- ejaculation

Answer 9

48 hrs

Question 10

Exclusion period for PSA testing- prostate biopsy

Answer 10

6 weeks

Question 11

False-negative rate for psa

Answer 11

15%

Question 12

False-positive rate for psa

Answer 12

75%

Question 13

Management of acute bacterial prostatitis?

Answer 13

4 week course of oral ciprofloxacin

Question 14

Management of chronic prostatitis? (4)

Answer 14

NSAIDs + paracetamol for pain relief
Stool softener
Alpha-blocker if significant LUTS
Single course of Abx if symptoms present < 6 months

Question 15

Risk factors for prostate cancer? (4)

Answer 15

Age
Black ethnicity
Family history
Increasing BMI

Question 16

Options for symptomless local prostate Ca?

Answer 16

Watchful waiting/active surveillance
Radical prostatectomy
Radiotherapy

Question 17

Options for symptomatic prostate Ca? (2)

Answer 17

Hormonal treatments:
LHRH analogues e.g. goserelin
Anti-androgens e.g. cyproterone acetate
Radical prostatectomy

Question 18

Three main indications for anti-androgens in prostate Ca

Answer 18

To prevent testosterone flare symptoms during initiation with LHRH analogues
As monotherapy treatment for prostate Ca
In combination with LHRH analogues for maximum blockade

Question 19

Role of bisphosphonates in prostate Ca?

Answer 19

Offer to patients treated with androgen deprivation therapy

Question 20

Management of bony mets? (3)

Answer 20

Local radiotherapy
Corticosteroids
Strontium ranelate

Question 21

First-line investigation of suspected prostate Ca?

Answer 21

Multiparametric MRI

Question 22

NICE prostate cancer referral guidelines?

Answer 22

50-69 should be referred if PSA greater than 3 or abnormal DRE