Chapter·SurgeryUrology Basics

Prostate surgery basicsDownloads

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1

A 68-year-old man with hypertension comes to the physician because of fatigue and difficulty initiating urination. He wakes up several times a night to urinate. He does not take any medications. His blood pressure is 166/82 mm Hg. Digital rectal examination shows a firm, non-tender, and uniformly enlarged prostate. Which of the following is the most appropriate pharmacotherapy?

AFinasteride

Bα-Methyldopa

CPhenoxybenzamine

DTerazosin

ETamsulosin

2

A 65-year-old man is brought to the emergency department by ambulance after falling during a hiking trip. He was hiking with friends when he fell off a 3 story ledge and was not able to be rescued until 6 hours after the accident. On arrival, he is found to have multiple lacerations as well as a pelvic fracture. His past medical history is significant for diabetes and benign prostatic hyperplasia, for which he takes metformin and prazosin respectively. Furthermore, he has a family history of autoimmune diseases. Selected lab results are shown below: Serum: Na+: 135 mEq/L Creatinine: 1.5 mg/dL Blood urea nitrogen: 37 mg/dL Urine: Na+: 13.5 mEq/L Creatinine: 18 mg/dL Osmolality: 580 mOsm/kg Which of the following is the most likely cause of this patient's increased creatinine level?

AAutoimmune disease

BCompression of urethra by prostate

CBlood loss

DDiabetic nephropathy

ERhabdomyolysis

3

A 40-year-old woman was admitted to the surgical service after an uncomplicated appendectomy. She underwent surgery yesterday and had an uneventful postoperative course. However, she now complains that she is unable to completely void. She also complains of pain in the suprapubic area. You examine her and confirm the tenderness and fullness in the suprapubic region. You ask the nurse to perform a bladder scan, which reveals 450cc. What is the next appropriate step in management?

ACatheterization

BOral bethanechol chloride

CNeostigmine methylsulfate injection

DIntravenous furosemide

EIntravenous neostigmine methylsulfate

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