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General Surgery · Urology
Sample itemA 65-year-old man has hesitancy, weak stream and nocturia, with a smooth enlarged prostate of 70 grams. Which drug combination reduces the risk of progression and need for surgery?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Tamsulosin with finasteride
In benign prostatic hyperplasia, alpha-1 blockers relax smooth muscle for rapid symptom relief, and 5-alpha-reductase inhibitors shrink the gland over months. Combined therapy reduces progression, acute retention and need for surgery in men with large prostates. Finasteride lowers PSA by about half.
Option by option
A. Tadalafil with sildenafil
Two phosphodiesterase inhibitors are not used and are a hazardous combination.
B. Oxybutynin with desmopressin
Antimuscarinic with desmopressin is used for overactive bladder and nocturnal polyuria and could precipitate retention.
C. Bethanechol with finasteride
Bethanechol stimulates the bladder and does not relieve obstruction.
D. Tamsulosin with finasteride (correct)
Correct. Alpha-blocker plus 5-alpha-reductase inhibitor is the evidence-based combination.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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