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AGNP BOARD EXAM QUESTIONS AND ANSWERS MEN'S HEALTH

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. Levofloxacin (Levaquin), used to treat acute bacterial prostatitis, is a: 2. Ciprofloxacin, used for the treatment of bacterial prostatitis, is a potent CYP1A2 inhibitor and is absolutely contraindicated with other CYP1A2 inhibitors. An example of another CYP1A2 inhibitor is: 3. A 33-year-old man has been taking sulfamethoxazole/trimethoprim for the treatment of bacterial prostatitis. Brand names of this medication do NOT include: 4. Patients with uncomplicated acute bacterial prostatitis who are NOT good candidates for treatment with a fluoroquinolone should take: 5. PDE-5 inhibitors, such as tadalafil (Cialis) for the treatment of erectile dysfunction, should be avoided in patients with: 6. The choice for initial treatment of acute bacterial prostatitis is: 7. Patients who take sildenafil (Viagra) for the treatment of erectile dysfunction, should be instructed to avoid: 8. To help with symptoms of chronic prostatitis, in addition to antibiotics, consider adjunctive therapy with an: 9. Patients taking vardenafil (Levitra) should be advised to immediately report: 10. Initial and routine monitoring for patients with benign prostatic hyperplasia (BPH) who are receiving tamsulosin (Flomax) should include: 11. The recommended pharmacological treatment for phimosis in an adult man is a(n): 12. Doxycycline (Doryx) is LEAST effective in the treatment of: 13. PDE-5 inhibitors, such as vardenafil (Levitra), are indicated in the treatment of: 14. Concomitant administration of sildenafil (Viagra) should be avoided with: 15. A 65-year-old man who is receiving finasteride (Proscar) for benign prostatic hyperplasia (BPH) is exhibiting progressive symptoms. To reduce these symptoms, prescribe: 16. 5-alpha reductase inhibitors are used in the treatment of: 17. The recommended treatment for uncomplicated acute bacterial prostatitis caused by Neisseria gonorrhea is: 18. A 20-year-old man with phimosis should be instructed to apply betamethasone (Sernivo) 0.05% cream at least twice daily for: 19. Doxycycline (Doryx) is classified as a: 20. A 58-year-old man is receiving dutasteride (Avodart) for benign prostatic hyperplasia (BPH). Avodart, a 5-alpha reductase inhibitor: 21. Initial treatment of acute prostatitis should be guided by urinalysis and culture, and antibiotic therapy should be given for at least: 22. Which of the following is NOT a fluoroquinolone used to treat prostatitis? 23. Fluoroquinolones used to treat prostatitis are NOT effective against: 24. Patients who are on prolonged fluoroquinolones (i.e. ciprofloxacin) for the treatment of chronic prostatitis should be advised to immediately report: 25. Sulfamethoxazole and trimethoprim (Bactrim), for the treatment of acute bacterial prostatitis, should NOT be prescribed for patients with: 26. Ciprofloxacin (Cipro) is a broad spectrum: 27. Due to the risk of severe hypotension, patients who are taking sildenafil (Viagra) should be advised to avoid: 28. A 27-year-old man is being treated for epididymitis with doxycycline (Doryx). The patient should be advised that doxycycline may cause: 29. Empiric antibiotic treatment of epididymitis in a 68-year-old man is: 30. Finasteride (Proscar) is an: 31. In the treatment of prostatitis, antibiotics that do NOT penetrate well into the prostate and seminal fluids include: 32. A 60-year-old man who is treated with tamsulosin (Flomax) for benign prostatic hyperplasia (BPH) should NOT be treated concomitantly with: 33. Which of the following is a PDE-5 inhibitor indicated in the treatment of erectile dysfunction and benign prostatic hypertrophy? 34. PDE-5 inhibitors, such as tadalafil (Cialis) for the treatment of erectile dysfunction, should be used with caution in patients who have: 35. A 57-year-old man has chronic prostatitis with a causative organism that is resistant to fluoroquinolones. The patient has an allergy to sulfa drugs. The next best treatment option is: 36. To avoid reducing the effectiveness of doxycycline (Doryx) for the treatment of epididymitis, it should not be taken concomitantly with: 37. Patients receiving 5-alpha-reductase inhibitors should see maximum efficacy at approximately: 38. A 65-year-old man with benign prostatic hyperplasia (BPH) is treated with tamsulosin (Flomax). Potential side effects are: 39. A 55-year-old man with benign prostatic hypertrophy has overflow incontinence. The first-line treatment is: 40. Suppressive antibiotic therapy for chronic bacterial prostatitis is: 41. To avoid esophageal irritation, patients taking doxycycline (Doryx) for the treatment of epididymitis should be advised to: 42. Which of the following is an alpha 1 adrenergic antagonist used to treat benign prostatic hyperplasia? 43. Doxazosin (Cardura) is an alpha adrenergic antagonist. Oxybutynin (Ditropan), Tolterodine (Detrol) and Solifenacin (Vesicare) are all classified as anticholinergic agents. 44. Treatment of chronic prostatitis may require prolonged antibiotic regimens, up to: 45. A 45-year-old man is receiving finasteride (Proscar) for the symptomatic treatment of benign prostatic hyperplasia. The patient should be advised that: 46. A 24-year-old man patient treated for epididymitis caused by Neisseria gonorrhoeae should be advised that: 47. A common side effect associated with sildenafil (Viagra) is: 48. Alpha-adrenergic antagonists for the treatment of benign prostatic hyperplasia (BPH): 49. The generic name for Levitra is: 50. Patients taking tamsulosin (Flomax) should be advised to seek immediate medical attention for: 51. Concomitant administration of sildenafil (Viagra) and tamsulosin (Flomax) may result in: 52. The brand name for sildenafil is: 53. Empiric treatment of epididymitis in a 28-year-old sexually active man is: 54. Trimethoprim-sulfamethoxazole (Bactrim DS) for the treatment of acute bacterial prostatitis is NOT effective against:

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AGNP BOARD EXAM QUESTIONS Men's health Prescription (Questions 53)

Question:
Levofloxacin (Levaquin), used to treat acute bacterial prostatitis, is a:
fluoroquinolone. Correct penicillin. macrolide. tetracycline.

Explanation:
Levofloxacin (Levaquin) is classified as a fluoroquinolone. An example of a penicillin is amoxicillin (Moxatag);
macrolide is azithromycin (Zithromax); and a tetracycline is doxycycline (Doryx).

Question:
Ciprofloxacin, used for the treatment of bacterial prostatitis, is a potent CYP1A2 inhibitor and is absolutely
contraindicated with other CYP1A2 inhibitors. An example of another CYP1A2 inhibitor is: ketoconazole.
tizanidine (Zanaflex). Correct fluoxetine hydrochloride (Sarafem). celecoxib (Celebrex).

Explanation:
Ciprofloxacin, a fluoroquinolone, is a strong CYP1A2 inhibitor and is absolutely contraindicated for
concomitant administration of tizanidine (Zanaflex). Concomitant use may increase the serum concentration
of tizanidine. If use with another strong inhibitor cannot be avoided, initiate tizanidine at an adult dose of 2
mg and increase in 2-4 mg increments based on response. Ketoconazole is a CYP3A4 inhibitor; celecoxib is a
CYP2D6 inhibitor; and fluoxetine is a YP2C19 inhibitor. CYP1A2 inhibitors are enzymes that catalyze many
reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids.

Question:
A 33-year-old man has been taking sulfamethoxazole/trimethoprim for the treatment of bacterial prostatitis.
Brand names of this medication do NOT include:
Azulfidine. Correct Bactrim DS.
SMX-TMP DS. Sulfatrim.

Explanation:
Brand names of sulfamethoxazole/trimethoprim does NOT include sulfasalazine ( Azulfidine ).

Question:
Patients with uncomplicated acute bacterial prostatitis who are NOT good candidates for treatment with a
fluoroquinolone should take: levofloxacin. azithromycin.
trimethoprim-sulfamethoxazole. Correct ceftriaxone.

Explanation:
Patients with uncomplicated acute bacterial prostatitis who cannot take a fluoroquinolone should take
trimethoprim-sulfamethoxazole. Trimethoprimsulfamethoxazole has good to excellent penetration into
prostatic and seminal fluids and tissues. Levofloxacin is a fluoroquinolone. Cephalosporins, such as
ceftriaxone, may not be effective unless an STD is suspected. Azithromycin is a macrolide and macrolides are
indicated for the treatment of chronic bacterial prostatitis.

Question:

, PDE-5 inhibitors, such as tadalafil (Cialis) for the treatment of erectile dysfunction, should be avoided
in patients with: infertility. a history of epididymitis. benign prostatic hyperplasia (BPH).
recent ST elevation myocardial infection (STEMI). Correct

Explanation:
PDE-5 inhibitors (ie. Levitra, Viagra, Cialis) should not be used in men with underlying cardiovascular disease
who have been advised to avoid sexual activity. These medications have systemic vasodilatory properties that
result in transient decreases in supine blood pressure. Cardiovascular status should be considered on an
individual basis, weighing the risks versus the benefits, before prescribing PDE-5 inhibitors.

Question:
The choice for initial treatment of acute bacterial prostatitis is:
doxycycline (Vibramycin). ceftriaxone
(Rocephin).
ciprofloxacin (Cipro). Correct azithromycin
(Zithromax).

Explanation:
The choice of antibiotic for treatment of acute bacterial prostatitis (ABP) is based on the results of the initial
culture and sensitivity. However, initial therapy should be directed at gram-negative enteric bacteria. Useful
agents include fluoroquinolones, trimethoprimsulfamethoxazole, and ampicillin with gentamicin. Examples of
fluoroquinolones are ciprofloxacin (Cipro) and levofloxacin (Levaquin).

Question:
Patients who take sildenafil (Viagra) for the treatment of erectile dysfunction, should be instructed to avoid:
the ingestion of grapefruit-containing products. Correct dark green, leafy vegetables. night time dosing.
omega-3 fatty acids.

Explanation:
Grapefruit and grapefruit juice may interact with sildenafil (Viagra) and lead to severe hypotension. Similar
effects may be seen with concomitant alcohol use.

Question:
To help with symptoms of chronic prostatitis, in addition to antibiotics, consider adjunctive
therapy with an: alpha adrenergic antagonist. Correct anticholinergic. antispasmodic agent.
antiandrogenic agent.

Explanation:
In addition to antibiotics, consider adding an alpha adrenergic antagonist to help with obstructive symptoms
related to chronic prostatitis including weak stream, hesitancy, straining during urination, sense of
incomplete emptying and post-void dribbling.

Question:
Patients taking vardenafil (Levitra) should be advised to immediately report: headache.
flushing.
priapism. Correct nausea.

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