Self Assessment Post Test

SELF-ASSESSMENT POST-TEST There are no fees for participating and receiving CME credit for this activity. During the period December 2004 through December 31, 2005, participants must: 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the post-test by recording the best answer to each question in the answer key on the evaluation form; 4) complete the evaluation form; and 5) mail or fax the evaluation form with answer key to the Postgraduate Institute for Medicine. Treatment of LUTS and BPH 1. Men with prostate volumes >50 cm3 have a __times greater risk of having clinically moderate to severe LUTS and a __ times greater risk of having significant bladder outlet obstruction. a. 2, 4 c. 4, 2 b. 3, 5 d. 5, 3 2. ____ has become the standard for quantifying the degree of prostate enlargement. a. Uroflowmetry c. MRI b. Transrectal ultrasonography d. Digital rectal examination 3. Over the 4-year dutasteride study period, a longer duration of dutasteride therapy resulted in ____ versus a shorter duration of therapy (2 years), with no apparent plateau. a. significantly greater reductions in total prostate volume b. significantly greater improvements in symptoms c. significantly greater urinary flow d. all of the above 4. Over the 4-year dutasteride study period, there was a general trend toward a reduction in incidence of the most common sexual side effects over time with the exception of ___ , which remained low and relatively constant. a. impotence c. decreased libido b. gynecomastia d. ejaculatory disorders 5. Which of the following statements is/are true? a. 5
-reductase (5AR) exists in 2 forms, Type 1 and Type 2, both of which are found in the prostate. b. The conversion of testosterone to DHT is catalyzed by only Type 2 5AR. c. Type 1 is produced primarily in liver and skin and is carried to the prostate via the systemic circulation. d. all of the above e. a and c 6. The National Cancer Institute Prostate Cancer Prevention Trial demonstrated that finasteride compared with placebo reduced the 7-year period prevalence of prostate cancer, but there was an increased risk of high-grade tumors in the finasteride group. a. True b. False 7. Key risk factors used to develop the nomogram prediction of BPH progression include ___ . a. more severe obstructive symptoms b. lower maximal urinary flow c. greater prostate volume d. higher serum PSA level e. all of the above 8. The nomogram shown in Figure 5, page 44, has an accuracy of ___. a. 71% c. 85% b. 78% d. 90% 9. Which of the following statements is/are true? a. Long-term head-to-head studies of dutasteride and finasteride have demonstrated comparable efficacy and safety of the 2 agents. b. Although there are pharmacologic differences in DHT suppression between dutasteride and finasteride, there are not, as yet, data to indicate clinically significant differences in the treatment of BPH. c. One year is considered a long-term study of BPH. d. all of the above 10. In the long term, combination therapy with alpha-blockers can be more effective than monotherapy for symptom relief and prevention of BPH progression. a. True b. False 11. When a patient presents to a primary care provider with LUTS, ___ should be performed. a. a urinalysis b. a prostate examination c. a PSA check d. all of the above 12. The American Urological Association symptom index (AUA-SI) quantifies the LUTS referable to BPH; these symptoms include which of the following? A. nocturia and frequency B. urgency and hesitancy C. incomplete emptying and straining D. stop-start urination a. A and B c. A, B, and C b. C and D d. All of the above 13. For a patient who has a small prostate and an IPSS of less than 8, which is considered to be either no or mild symptoms and has no bother, based on the AUA guidelines the recommendation would be ___ . a. watchful waiting b. 5
-reductase inhibitor monotherapy c. alpha receptor blocker monotherapy d. combination therapy 14. The 2003 AUA Guidelines____ . a. provide evidence-based data on treatment outcomes b. were based on a review of available literature and unpublished data c. offer a number of recommended treatment options for patients with moderate to severe and bothersome LUTS associated with BPH d. all of the above EVALUATION FORM 5
-Reductase Inhibition in the Treatment of LUTS and BPH: Update and Importance of Dual Inhibition of Types 1 and 2 Project ID: 2418 ES 13 Postgraduate Institute for Medicine (PIM) respects and appreciates your opinions. To assist us in evaluating the effectiveness of this activity and to make recommendations for future educational offerings, please take a few minutes to complete this evaluation form. You must complete this evaluation form to receive acknowledgement of participation for this activity. Please Print Clearly Name: Address: City/State: Phone Number: E-mail: Specialty: Box/Suite: Zip Code: Fax Number: VOL. 6 SUPPL. 9 2004 REVIEWS IN UROLOGY S61 Please answer the following questions by circling the appropriate rating: (5 = Outstanding; 4 = Good; 3 = Satisfactory; 2 = Fair; 1 = Poor) EXTENT TO WHICH PROGRAM ACTIVITIES MET THE IDENTIFIED OBJECTIVES Upon completion of this activity, participants should be able to: • Review the natural history of LUTS and BPH as well as tools to predict the likely natural history in a given patient. • Explain the role and importance of the 5 alpha-reductase (5AR) isoenzymes in the normal male and in disease states, as well as the development of inhibitors of these enzymes. • Describe the mechanism of action of 5AR inhibitors (5ARIs), their efficacy and safety from clinical trials. • Discuss the differences and similarities between the 2 different 5ARIs available to practitioners. • Explain how to apply the AUA BPH Guidelines to the diagnosis and management of patients with LUTS and BPH. OVERALL EFFECTIVENESS OF THE ACTIVITY • Was timely and will influence how I practice • Will assist me in improving patient care • Fulfilled my educational needs • Avoided commercial bias or influence 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 5 5 5 4 4 4 4 3 3 3 3 2 2 2 2 1 1 1 1 IMPACT OF THE ACTIVITY The information presented: (check all that apply)
Reinforced my current practice/treatment habits
Will improve my practice/patient outcomes
Provided new ideas or information I expect to use
Enhanced my current knowledge base Will the information presented cause you to make any changes in your practice? Yes___ No___ If yes, please describe any change(s) you plan to make in your practice as a result of this activity: How committed are you to making these changes? (Very committed) 5 4 3 2 1 (Not at all committed) FUTURE ACTIVITIES Do you feel future activities on this subject matter are necessary and/or important to your practice?
Yes
No Please list any other topics that would be of interest to you for future educational activities: FOLLOW-UP As part of our ongoing continuous quality-improvement effort, we conduct post-activity follow-up surveys to assess the impact of our educational interventions on professional practice. Please indicate your willingness to participate in such a survey:
Yes, I would be interested in participating in a follow-up survey
No, I’m not interested in participating in a follow-up survey Additional comments about this activity: POST-TEST ANSWER KEY 1___ 2___ 3___ 4___ 5___ 6___ 7___ 8___ 9___ 10___11___ 12___ 13___ 14___ I certify my actual time spent to complete this educational activity to be:
I participated in the entire activity and claim 2.5 credits.
I participated in only part of the activity and claim _____ credits. Signature: S62 VOL. 6 SUPPL. 9 2004 REVIEWS IN UROLOGY If you wish to receive acknowledgement of participation for this activity, please complete the post-test by selecting the best answer to each question, complete this evaluation verification of participation and FAX to: 303-790-4876. Date Completed: