MSN 621 TEST BANK 2026 BUNDLED
QUESTIONS AND ACCURATE ANSWERS
▶ Prostate cancer management. Answer: Treatment option based on
staging:
The TNM system describes the following
-extent of the primary tumor
-whether the cancer has spread to nearby lymph nodes
-absence or presence of distant metastases
Watchful waiting
Monitoring PSA and DRE
Radiation therapy
Brachytherapy or external beam radiation therapy
Hormonal therapy
Goal of suppression of testosterone
Surgery
▶ benign prostatic hyperplasia (BPH). Answer: Ubiquitous phenomenon
among older men, is a noncancerous enlargement of the prostate gland,
specifically the smooth muscle and epithelial cells within the transition
zone, the area of the prostate that surrounds the urethra
▶ benign prostatic hyperplasia symptoms. Answer: Frequency, urgency,
and nocturnal
Bladder outlet obstruction (BOO)
-obstructive symptoms include urinary hesitancy, decreased caliber and
force of the stream, and post void dribbling
Lower urinary tract symptoms
A combination of these problems
▶ benign prostatic hyperplasia exam and diagnostics. Answer: -thorough
history, including personal, family, GU, sexual, and medications
, -DRE
- urinalysis/ culture, serum creatine, bladder ultrasound
-PVR bladder scan
-serum PSA if life expectancy >10 years
▶ benign prostatic hyperplasia management. Answer: -behavior
modifications
-watchful waiting and lifestyle modifications
- pharmacotherapy
-alpha1-adrenergic antagonist therapy
-5alpha-reductase enzyme inhibitor therapy or combination drug therapy
-Antimuscarinics
-Beta-3 agonists
-phosphodiesterase type 5 inhibitors
Mechanical and surgical treatment
-transurethral resection of the prostate (TURP, most common)
-transurethral incision of the prostate
-open prostatectomy
▶ BPH referral. Answer: Immediate referral indicated for acute urinary
retention and results of DRE suggestive of prostate cancer
▶ Proteinuria. Answer: presence of protein in urine, excretion more than
150 mg/day is the hallmark of renal disease
▶ Proteinuria diagnosis. Answer: Urinalysis/culture, Bence-Jones, serum
fasting glucose, A1C, CBC, lipid profile, 24-hour urinary protein excretion or
spot urinary protein/creatinine ratio, microscopic exam of urinary sediment,
urinary protein electrophoresis
▶ Bence-Jones proteinuria. Answer: tubular casts with foreign body giant
cell reaction
light chains are toxic to the renal tubular epithelium
▶ BPH management. Answer: Treat underlying disease
Eliminate known trigger medications
Consider ACE inhibitor
Sodium- and protein-restricted diets
QUESTIONS AND ACCURATE ANSWERS
▶ Prostate cancer management. Answer: Treatment option based on
staging:
The TNM system describes the following
-extent of the primary tumor
-whether the cancer has spread to nearby lymph nodes
-absence or presence of distant metastases
Watchful waiting
Monitoring PSA and DRE
Radiation therapy
Brachytherapy or external beam radiation therapy
Hormonal therapy
Goal of suppression of testosterone
Surgery
▶ benign prostatic hyperplasia (BPH). Answer: Ubiquitous phenomenon
among older men, is a noncancerous enlargement of the prostate gland,
specifically the smooth muscle and epithelial cells within the transition
zone, the area of the prostate that surrounds the urethra
▶ benign prostatic hyperplasia symptoms. Answer: Frequency, urgency,
and nocturnal
Bladder outlet obstruction (BOO)
-obstructive symptoms include urinary hesitancy, decreased caliber and
force of the stream, and post void dribbling
Lower urinary tract symptoms
A combination of these problems
▶ benign prostatic hyperplasia exam and diagnostics. Answer: -thorough
history, including personal, family, GU, sexual, and medications
, -DRE
- urinalysis/ culture, serum creatine, bladder ultrasound
-PVR bladder scan
-serum PSA if life expectancy >10 years
▶ benign prostatic hyperplasia management. Answer: -behavior
modifications
-watchful waiting and lifestyle modifications
- pharmacotherapy
-alpha1-adrenergic antagonist therapy
-5alpha-reductase enzyme inhibitor therapy or combination drug therapy
-Antimuscarinics
-Beta-3 agonists
-phosphodiesterase type 5 inhibitors
Mechanical and surgical treatment
-transurethral resection of the prostate (TURP, most common)
-transurethral incision of the prostate
-open prostatectomy
▶ BPH referral. Answer: Immediate referral indicated for acute urinary
retention and results of DRE suggestive of prostate cancer
▶ Proteinuria. Answer: presence of protein in urine, excretion more than
150 mg/day is the hallmark of renal disease
▶ Proteinuria diagnosis. Answer: Urinalysis/culture, Bence-Jones, serum
fasting glucose, A1C, CBC, lipid profile, 24-hour urinary protein excretion or
spot urinary protein/creatinine ratio, microscopic exam of urinary sediment,
urinary protein electrophoresis
▶ Bence-Jones proteinuria. Answer: tubular casts with foreign body giant
cell reaction
light chains are toxic to the renal tubular epithelium
▶ BPH management. Answer: Treat underlying disease
Eliminate known trigger medications
Consider ACE inhibitor
Sodium- and protein-restricted diets
