CPC OE Practice 3.14 Men’s Health

Men's Health A 66-year-old with bothersome LUTS from BPH (IPSS 18) is starting tamsulosin. Which counseling is correct? A. Take 0.4 mg at bedtime on an empty stomach; capsules may be opened and sprinkled on food B. Take 0.4 mg once daily about 30 minutes after the same meal each day, swallowing the capsule whole C. Start 1 mg at bedtime and titrate weekly to 10 mg D. Start 0.8 mg daily, taken with grapefruit juice to improve absorption

B

Men's Health A man taking tamsulosin 0.8 mg daily missed 5 days of doses while hospitalized. How should therapy be resumed? A. Resume 0.8 mg daily B. Take 1.6 mg once to reload, then 0.8 mg daily C. Switch to doxazosin 8 mg daily D. Restart at 0.4 mg daily and retitrate if needed

D

Men's Health A 70-year-old with new bothersome LUTS from BPH has cataract surgery scheduled next month. Which approach is most appropriate? A. Avoid starting tamsulosin before the surgery, consider deferring alpha-blocker therapy, and make sure the ophthalmologist knows about any current or prior alpha-blocker use B. Start tamsulosin now and stop it the day before surgery to eliminate IFIS risk C. Start tamsulosin, because intraoperative floppy iris syndrome occurs only with 5-alpha reductase inhibitors D. Start doxazosin, because nonselective alpha-blockers have never been associated with IFIS

A

Men's Health A 72-year-old with LUTS from BPH has a CrCl of 40 mL/min and normal hepatic function. Which silodosin regimen is appropriate? A. 8 mg once daily with a meal B. 16 mg once daily C. 4 mg once daily with a meal D. Silodosin is contraindicated at this CrCl

C

Men's Health In which patient is silodosin contraindicated? A. A patient with a CrCl of 55 mL/min B. A patient with mild hepatic impairment C. A patient taking clarithromycin, a strong CYP3A4 inhibitor D. A patient also taking finasteride 5 mg daily

C

Men's Health A 65-year-old with Child-Pugh class B cirrhosis has bothersome LUTS from BPH. Which alpha-blocker is contraindicated? A. Alfuzosin ER B. Tamsulosin C. Silodosin D. Terazosin

A

Men's Health Which alpha-blocker for BPH carries a labeled caution about QT prolongation, so it should be used carefully in patients with congenital long-QT syndrome or on QT-prolonging drugs? A. Tamsulosin B. Silodosin C. Doxazosin D. Alfuzosin

D

Men's Health A 64-year-old who has never taken an alpha-blocker has moderate LUTS from BPH and mild baseline orthostatic lightheadedness. Per the AUA BPH guideline, which option is preferred? A. Terazosin 1 mg at bedtime, titrated to 10 mg B. A uroselective alpha-blocker such as tamsulosin, alfuzosin, or silodosin C. Doxazosin immediate-release 1 mg, titrated to 8 mg D. Prazosin 1 mg three times daily

B

Men's Health Which adverse effect is most characteristic of silodosin compared with other alpha-blockers? A. Ejaculatory dysfunction, such as retrograde ejaculation or anejaculation B. Hyperkalemia C. Gynecomastia D. Hypoglycemia

A

Men's Health A 68-year-old has taken finasteride 5 mg daily for 2 years. His PSA is 1.8 ng/mL. How should this value be interpreted? A. Halve the value, because finasteride raises PSA B. Interpret it without adjustment C. Double the value (about 3.6 ng/mL) before comparing it with reference ranges for untreated men D. Subtract 1 ng/mL to correct for the finasteride effect

C

Men's Health A man taking dutasteride for 3 years had a PSA nadir of 1.1 ng/mL. His PSA is now 1.9 ng/mL, confirmed on repeat testing. What is most appropriate? A. Reassure him, because the value is within the normal range B. Double the dutasteride dose C. Stop dutasteride and recheck the PSA in 1 year D. Evaluate for prostate cancer, because any confirmed rise from the nadir on a 5-ARI warrants evaluation

D

Men's Health Which patient is the best candidate for adding a 5-alpha reductase inhibitor? A. A man with a 20-mL prostate, a PSA of 0.6 ng/mL, and mild voiding symptoms B. A man on tamsulosin with persistent bothersome LUTS, a 55-mL prostate, and a PSA of 3.0 ng/mL C. A man with mainly storage symptoms and a small prostate D. A man who needs symptom relief within 1 week

B

Men's Health A man who started dutasteride 0.5 mg daily 4 weeks ago reports no improvement in LUTS. What is the best response? A. Treatment has failed; switch to finasteride B. Symptom improvement generally takes 3-6 months, and the prostate keeps shrinking for up to a year or more C. Add finasteride for dual 5-ARI therapy D. Take dutasteride with grapefruit juice to increase exposure

B

Men's Health The pregnant wife of a man taking dutasteride asks about handling his medication. Which counseling is correct? A. Pregnant women should not handle leaking dutasteride capsules, because the drug can be absorbed through the skin; if contact occurs, wash the area with soap and water B. Handling leaking capsules poses no risk C. Her husband must stop dutasteride for the entire pregnancy D. The couple must avoid intercourse for the entire pregnancy

A

Men's Health Which counseling point appears in dutasteride labeling? A. Do not donate blood for 1 week after starting therapy B. Blood donation is unrestricted C. Do not donate blood until at least 6 months after the last dose D. Only plasma may be donated

C

Men's Health In the 4-year CombAT trial, how much did dutasteride plus tamsulosin reduce the relative risk of acute urinary retention or BPH-related surgery, compared with tamsulosin alone? A. About 10% B. About 25% C. There was no significant difference D. About two-thirds

D

Men's Health Which statement accurately reflects the MTOPS trial? A. Doxazosin monotherapy significantly reduced the risk of acute urinary retention B. Finasteride monotherapy did not reduce the need for invasive therapy C. Combination therapy produced the smallest IPSS improvement of all arms D. Doxazosin plus finasteride reduced overall clinical progression by about 66% vs placebo, more than either drug alone

D

Men's Health A 61-year-old has both erectile dysfunction and bothersome LUTS from BPH. He would prefer a single medication. Which regimen is most appropriate? A. Tadalafil 5 mg orally once daily B. Sildenafil 50 mg as needed C. Tadalafil 20 mg as needed D. Avanafil 100 mg once daily

A

Men's Health A man taking doxazosin for BPH will start tadalafil 5 mg daily for BPH. Per tadalafil labeling, what is recommended? A. Continue both indefinitely, because the combination is recommended for BPH B. Start tadalafil at 20 mg daily C. The combination is not recommended for BPH; stop the alpha-blocker at least 1 day before starting tadalafil D. Overlap both drugs for 2 weeks, then stop doxazosin

C

Men's Health A man with LUTS from BPH and a CrCl of 25 mL/min asks about once-daily tadalafil. Which is correct? A. 5 mg once daily B. Once-daily tadalafil is not recommended at this level of renal function C. 2.5 mg once daily, increased to 5 mg after 1 week D. 10 mg once daily

B

Men's Health A man with a 60-mL prostate is starting finasteride and tadalafil together for LUTS from BPH. Per tadalafil labeling, for how long is concurrent tadalafil recommended at initiation? A. Up to 4 weeks B. Up to 12 weeks C. Up to 26 weeks D. Lifelong use is required

C

Men's Health A man on tamsulosin has persistent urgency and frequency. Before adding an antimuscarinic or beta-3 agonist, which assessment is recommended? A. Postvoid residual volume B. Serum PSA C. Morning total testosterone D. Urine cytology

A

Men's Health A man with BPH on tamsulosin has urgency and frequency, and his postvoid residual is 300 mL. What is the most appropriate next step? A. Add oxybutynin 5 mg three times daily B. Add tolterodine 4 mg daily C. Add mirabegron 50 mg daily D. Do not add an antimuscarinic or beta-3 agonist yet; evaluate for incomplete emptying or retention and refer to urology

D

Men's Health A 68-year-old man has nocturia from nocturnal polyuria, a normal serum sodium, and no contraindications. He is prescribed sublingual desmopressin (Nocdurna). Which regimen and monitoring are appropriate? A. 25 mcg sublingually at bedtime, with sodium checked annually B. 50 mcg sublingually 1 hour before bedtime, with sodium checked within about 1 week and at about 1 month C. 0.2 mg oral tablets three times daily D. 1.66 mcg intranasally in each nostril every 8 hours

B

Men's Health Which concurrent medication is a contraindication to desmopressin for nocturia (Nocdurna)? A. Tamsulosin B. Finasteride C. Amlodipine D. Furosemide

D

Men's Health Two days after starting an OTC cold product, a 72-year-old with BPH develops acute urinary retention. Which ingredient is the most likely cause? A. Guaifenesin B. Dextromethorphan C. Pseudoephedrine D. Acetaminophen

C

Men's Health A man with acute urinary retention from BPH has an indwelling catheter. Which medication improves the chance of a successful trial without catheter? A. An alpha-blocker (e.g., alfuzosin or tamsulosin), started before catheter removal B. Finasteride, with the catheter removed the next day C. Oxybutynin D. Bethanechol

A

Men's Health A 52-year-old with fatigue and low libido has a single afternoon total testosterone of 260 ng/dL. Per the AUA, what is the next step? A. Start testosterone gel B. Repeat total testosterone in the early morning on a separate occasion C. Check free PSA D. Start clomiphene citrate

B

Men's Health A symptomatic man has two early-morning total testosterone levels of 210 and 230 ng/dL. Per the AUA, which test should come next? A. LH, followed by prolactin if LH is low or low-normal B. Estradiol in all patients C. Karyotype D. DHEA-S

A

Men's Health Per the AUA testosterone deficiency guideline, what is a reasonable total testosterone cutoff for diagnosing low testosterone? A. Below 150 ng/dL B. Below 200 ng/dL C. Below 450 ng/dL D. Below 300 ng/dL

D

Men's Health A man with confirmed symptomatic testosterone deficiency has a baseline hematocrit of 52%. Per the AUA, what is most appropriate? A. Start testosterone at full dose B. Start an injectable testosterone ester C. Withhold testosterone until the cause of the elevated hematocrit (e.g., sleep apnea, smoking) is investigated D. Start testosterone together with routine monthly phlebotomy

C

Men's Health A man receiving testosterone cypionate 200 mg IM every 2 weeks has a hematocrit of 55%. What is most appropriate? A. Continue the current regimen B. Add aspirin and continue the current dose C. Hold or reduce the testosterone dose (consider a formulation with steadier levels), refer for phlebotomy if needed, and recheck the hematocrit D. Switch to a higher-dose topical gel

C

Men's Health A 32-year-old has symptomatic low testosterone (240 and 250 ng/dL) with low-normal LH. He and his partner hope to conceive within the next year. Which therapy is most appropriate? A. Testosterone gel 1.62% B. Clomiphene citrate (off-label) or hCG C. Testosterone cypionate 100 mg IM weekly D. Testosterone pellets

B

Men's Health A 28-year-old who received testosterone cypionate from a men's health clinic is now azoospermic. How does exogenous testosterone impair spermatogenesis? A. It directly damages sperm DNA B. It raises estradiol, which destroys mature sperm C. It causes obstruction of the vas deferens D. It suppresses LH and FSH through negative feedback, lowering intratesticular testosterone

D

Men's Health Which agent used for male hypogonadotropic hypogonadism is FDA-approved for use in men? A. Human chorionic gonadotropin (hCG) B. Clomiphene citrate C. Anastrozole D. Letrozole

A

Men's Health A man using testosterone gel learns that his 3-year-old has enlarged genitalia and new pubic hair. Which counseling addresses the boxed warning? A. Switch to a higher-concentration gel so less is applied B. Wash hands after applying, cover the site with clothing once dry, and wash the site before skin-to-skin contact with others C. Apply the gel to the scrotum to reduce transfer D. No action is needed, because transfer does not occur

B

Men's Health Which requirement applies to testosterone undecanoate injection (Aveed)? A. Give it only in a REMS-certified setting and observe the patient for 30 minutes after each injection for pulmonary oil microembolism and anaphylaxis B. Patients may self-inject at home after training C. It is given once weekly subcutaneously D. It is given by IV infusion

A

Men's Health What is the labeled dosing schedule for testosterone undecanoate injection (Aveed)? A. 750 mg IM every 4 weeks B. 1,000 mg IM every 12 weeks from the first dose C. 75 mg SC weekly D. 750 mg IM at initiation and at 4 weeks, then every 10 weeks

D

Men's Health A man is starting testosterone enanthate subcutaneous autoinjector (Xyosted). Which regimen and monitoring are correct? A. 200 mg IM every 2 weeks, with peak levels checked 24 hours after the dose B. 75 mg SC once weekly in the abdomen, with a trough total testosterone drawn 7 days after a dose at about 6 weeks C. 50 mg SC daily into the thigh D. 750 mg SC every 10 weeks

B

Men's Health How should oral testosterone undecanoate (Tlando or Kyzatrex) be taken? A. On an empty stomach, 1 hour before breakfast B. At bedtime after an overnight fast C. Twice daily with food D. Once weekly with a high-protein meal

C

Men's Health Which testosterone product is given as 11 mg intranasally three times daily, avoiding the skin-transfer risk of topical gels? A. Testopel B. AndroGel C. Jatenzo D. Natesto

D

Men's Health Which patient should not use nasal testosterone (Natesto)? A. A man with controlled hypertension B. A man with a chronic nasal condition or prior nasal or sinus surgery C. A man taking atorvastatin D. A man with mild BPH

B

Men's Health Which class-wide testosterone labeling change did the FDA require in 2025 after the TRAVERSE trial? A. A new boxed warning for myocardial infarction and stroke B. Withdrawal of all oral testosterone undecanoate products C. Removal of language describing increased MACE risk (including boxed CV warnings where present), addition of TRAVERSE results, and a class warning about blood pressure increases D. Approval of testosterone for age-related hypogonadism without other limitations

C

Men's Health In TRAVERSE (men aged 45-80 with hypogonadism and elevated CV risk), what did testosterone gel show compared with placebo? A. Noninferiority for MACE, with higher incidences of atrial fibrillation, pulmonary embolism, and acute kidney injury B. A 30% reduction in MACE C. A significant increase in myocardial infarction D. A significant reduction in clinical fractures

A

Men's Health Per the AUA, which on-treatment total testosterone range should therapy target? A. Middle tertile of the normal range, about 450-600 ng/dL B. 1,000-1,500 ng/dL C. 200-300 ng/dL D. Above 1,200 ng/dL

A

Men's Health Which condition is a labeled contraindication to testosterone therapy? A. Controlled hypertension B. Mild BPH without significant LUTS C. Age older than 65 years D. Known male breast cancer

D

Men's Health A man on warfarin for atrial fibrillation is starting testosterone therapy. Which statement reflects labeling? A. There is no interaction B. Androgens can change anticoagulant activity, so monitor the INR more often, especially when starting and stopping testosterone C. Testosterone lowers the INR, so the warfarin dose should be doubled D. The combination is contraindicated

B

Men's Health A man with type 2 diabetes on insulin glargine is starting testosterone. Which effect does testosterone labeling describe? A. Androgens raise blood glucose, so the insulin dose should be increased B. Testosterone does not affect glycemic control C. Androgens may lower blood glucose and insulin requirements D. Testosterone commonly causes diabetic ketoacidosis

C

Men's Health Per the AUA, in which men should PSA be measured before starting testosterone therapy? A. All men older than 18 years B. Only men older than 70 years C. Never; PSA is irrelevant to testosterone therapy D. Men older than 40 years

D

Men's Health Which counseling point is correct for testosterone pellets (Testopel)? A. Each 75-mg pellet is implanted subcutaneously, usually every 3-6 months; the dose cannot be adjusted after insertion, and the pellets can extrude or the site can become infected B. They are swallowed daily with food C. They are placed intranasally three times daily D. They are easily removed at home if levels are too high

A

Men's Health A man reports that sildenafil works poorly when he takes it after a large steak dinner. What is the best counseling? A. Take it with a high-fat meal to increase absorption B. A high-fat meal delays absorption and reduces effect; take it on an empty stomach about 1 hour before sex, or consider tadalafil, whose absorption is not affected by food C. Increase the dose to 200 mg D. Take it daily at bedtime

B

Men's Health A man says sildenafil 25 mg "failed" after two attempts, both without sexual stimulation. What is most appropriate? A. Switch to intracavernosal alprostadil B. Conclude that PDE5 inhibitors are ineffective for him C. Explain that sexual stimulation is required, titrate to 50-100 mg as tolerated, and make several attempts before judging response D. Start testosterone empirically

C

Men's Health A man who took tadalafil 20 mg 30 hours ago presents with chest pain. When may nitroglycerin be given? A. Immediately B. 12 hours after the last tadalafil dose C. 24 hours after the last tadalafil dose D. At least 48 hours after the last tadalafil dose

D

Men's Health Per the 2025 ACC/AHA ACS guideline, what is the minimum interval between the last avanafil dose and nitrate administration? A. 6 hours B. 24 hours C. 12 hours D. 48 hours

C

Men's Health Which PDE5 inhibitor can work within about 15 minutes and is contraindicated with strong CYP3A4 inhibitors? A. Avanafil B. Tadalafil C. Vardenafil D. Sildenafil

A

Men's Health A man with HIV taking darunavir/ritonavir asks for sildenafil for erectile dysfunction. Which regimen is appropriate? A. 50 mg as needed, up to once daily B. 25 mg, with no more than one dose in 48 hours C. 100 mg once daily D. Sildenafil is contraindicated

B

Men's Health A man taking itraconazole wants as-needed tadalafil for erectile dysfunction. What is the maximum dose? A. 20 mg once daily B. 10 mg, no more than once every 72 hours C. 5 mg twice daily D. No dose limit is needed

B

Men's Health Apart from nitrates, which medication is contraindicated with PDE5 inhibitors? A. Amlodipine B. Tamsulosin C. Atorvastatin D. Riociguat

D

Men's Health The morning after taking sildenafil, a 62-year-old notices sudden painless vision loss in one eye. Which counseling is correct? A. Stop the PDE5 inhibitor and seek medical care immediately for possible NAION; prior NAION raises the risk of recurrence B. Continue sildenafil at a lower dose C. Switch to vardenafil D. Use lubricating eye drops and continue therapy

A

Men's Health A man stable on doxazosin 4 mg daily for BPH wants sildenafil for erectile dysfunction. What is the labeled starting dose? A. 100 mg B. 50 mg C. 25 mg D. Sildenafil is contraindicated with doxazosin

C

Men's Health Which warning appears in the labeling of all PDE5 inhibitors? A. Sudden decrease or loss of hearing; stop the drug and seek prompt care B. A boxed warning for hepatotoxicity C. Agranulocytosis D. Hyperkalemia

A

Men's Health A 55-year-old with hypertension controlled on hydrochlorothiazide and atenolol reports new erectile dysfunction. Which antihypertensive change is most likely to help sexual function? A. Add clonidine B. Switch atenolol to propranolol C. Switch to an ARB (e.g., losartan), or to nebivolol if a beta-blocker is needed D. Increase hydrochlorothiazide

C

Men's Health A man with vasculogenic erectile dysfunction who failed PDE5 inhibitors is starting intracavernosal alprostadil. Which initial approach is appropriate? A. Start at 40 mcg at home B. Start at 2.5 mcg with in-office titration C. Start at 500 mcg D. Start at 1.25 mg

B

Men's Health What is the maximum labeled frequency of intracavernosal alprostadil use? A. Twice daily B. Every 4 hours as needed C. Once weekly D. No more than 3 times weekly, at least 24 hours apart

D

Men's Health A man is starting intraurethral alprostadil (MUSE). Which practice is recommended? A. Take the first dose at home without supervision B. Give the first dose in the office under supervision because of the risk of hypotension or syncope C. Give it intravenously before intercourse D. Use it daily regardless of sexual activity

B

Men's Health Six hours after an intracavernosal trimix injection, a man has a painful, fully rigid erection, and corporal blood gas confirms ischemic priapism. What is first-line management? A. Corporal aspiration with or without irrigation, plus intracavernosal phenylephrine 100-500 mcg repeated every few minutes as needed, with BP and heart rate monitoring B. Oral pseudoephedrine and observation C. Ice packs and observation for 24 hours D. An IV phenylephrine infusion

A

Men's Health Which antidepressant is most often associated with priapism? A. Bupropion B. Fluoxetine C. Trazodone D. Mirtazapine

C

Men's Health During intracavernosal phenylephrine for ischemic priapism, which monitoring is most important? A. Blood glucose B. Serum potassium C. INR D. Blood pressure and heart rate, watching for hypertension and reflex bradycardia

D

Men's Health A 30-year-old has lifelong premature ejaculation (IELT about 40 seconds) causing distress and prefers daily oral therapy. Per the AUA/SMSNA guideline, which is a first-line option? A. Tramadol 50 mg daily B. Dapoxetine 30 mg on demand C. Paroxetine 10-40 mg daily D. Bupropion SR 150 mg daily

C

Men's Health Which statement about dapoxetine for premature ejaculation is correct? A. It is FDA-approved in the US for premature ejaculation B. It is a short-acting on-demand SSRI approved in other countries but not by the FDA C. It is a daily tricyclic antidepressant D. It is a topical anesthetic

B

Men's Health A man with premature ejaculation wants an on-demand option without systemic effects. Which is most appropriate? A. Topical lidocaine-prilocaine applied to the penis before intercourse, with a condom or washing beforehand to avoid numbing the partner B. Sertraline 50 mg daily C. Clomipramine 25 mg daily D. Tadalafil 5 mg daily

A

Men's Health A man's premature ejaculation has not improved with daily SSRIs or topical anesthetics. Which second-line option does the AUA/SMSNA guideline conditionally support? A. Dapoxetine B. Testosterone C. Finasteride D. On-demand tramadol, with counseling about dependence and serotonin syndrome

D

Men's Health When SSRIs or clomipramine are used on demand for premature ejaculation, about how long before intercourse are they taken? A. 3-6 hours B. 5 minutes C. 24 hours D. 1 week

A

Men's Health A man with stable Peyronie disease asks about oral vitamin E, tamoxifen, carnitine, or omega-3 fatty acids. Per the AUA guideline, what is correct? A. Oral vitamin E is first-line therapy B. Oral pentoxifylline is FDA-approved for Peyronie disease C. These oral therapies should not be offered because they lack proven efficacy D. Colchicine is the preferred first-line oral therapy

C

Men's Health For which patient with Peyronie disease is intralesional collagenase clostridium histolyticum appropriate? A. Acute painful phase with 20° curvature B. 100° curvature with severe ED C. A plaque involving the penile urethra D. Stable disease with a palpable plaque, curvature of 30-90°, and intact erectile function

D

Men's Health What is the labeled collagenase clostridium histolyticum regimen for Peyronie disease? A. A single 0.58-mg intralesional injection B. 0.58 mg intralesionally twice, 1-3 days apart, with penile modeling 1-3 days after the second injection; up to 4 cycles about 6 weeks apart C. Weekly injections for 8 weeks without modeling D. IV infusion every 2 weeks

B

Men's Health Which serious risk is the subject of the boxed warning and REMS for collagenase clostridium histolyticum in Peyronie disease? A. Hepatotoxicity B. Tendon rupture C. Anaphylaxis only D. Corporal rupture (penile fracture) or other serious penile injury

D

Men's Health A 26-year-old has male-pattern hair loss. Which oral therapy is FDA-approved for this indication? A. Finasteride 5 mg daily B. Dutasteride 0.5 mg daily C. Finasteride 1 mg daily D. Spironolactone 100 mg daily

C

Men's Health A 51-year-old taking finasteride 1 mg daily for hair loss is about to have PSA screening. Which counseling is correct? A. The 1-mg dose has no effect on PSA B. Low-dose finasteride also lowers PSA substantially; the clinician should be told so the result can be adjusted (e.g., doubled) C. Finasteride raises PSA D. Stop finasteride 1 week before the test to normalize PSA

B

Men's Health A man is starting topical minoxidil 5% for androgenetic alopecia. Which counseling is correct? A. Apply to the dry scalp as directed (solution twice daily); temporary shedding may occur early, and gains are lost if it is stopped B. Use it for 1 week and then stop C. Results are permanent after 6 months of use D. Apply to a wet scalp and rinse off immediately

A

Men's Health Which adverse effect is most common with off-label low-dose oral minoxidil (e.g., 2.5 mg daily) for male-pattern hair loss? A. Hyperkalemia B. Hepatotoxicity C. Hypertrichosis D. Gynecomastia

C

Men's Health Which patient should avoid low-dose oral minoxidil for hair loss? A. A man with well-controlled hypertension on losartan B. A man also taking finasteride 1 mg C. A man with mild acne D. A man with a history of pericardial effusion or pericarditis

D

Men's Health A 64-year-old at average risk asks about PSA screening. What does the 2018 USPSTF recommendation state? A. Annual PSA screening for all men (Grade A) B. An individual decision after shared decision-making about benefits and harms (Grade C) C. Recommends against screening (Grade D) D. Digital rectal exam alone is preferred

B

Men's Health A 41-year-old Black man asks when to begin prostate cancer screening. What does the AUA/SUO guideline recommend? A. Offer baseline PSA screening at ages 40-45 B. Begin at age 55 C. Begin at age 70 D. Screening is not recommended

A

Men's Health A healthy 75-year-old asks for PSA screening. What does the 2018 USPSTF recommendation state? A. Individualized decision (Grade C) B. Recommended (Grade A) C. Recommended (Grade B) D. Recommends against PSA-based screening (Grade D)

D

Men's Health At what age does the AUA/SUO guideline suggest offering baseline PSA testing to men at average risk? A. 40 B. 45-50 C. 55 D. 60

B

Men's Health A 58-year-old outpatient has fever, dysuria, and a tender, boggy prostate. Urine culture grows E. coli susceptible to fluoroquinolones. Which regimen is most appropriate? A. Nitrofurantoin for 5 days B. Fosfomycin 3 g as a single dose C. Ciprofloxacin 500 mg twice daily (or levofloxacin) for at least 2 weeks, commonly 2-4 weeks D. Cephalexin for 3 days

C

Men's Health Which practice should be avoided in acute bacterial prostatitis? A. Vigorous prostatic massage B. Urine culture before antibiotics C. Blood cultures in febrile patients D. Analgesics and antipyretics

A

Men's Health A man has recurrent E. coli UTIs from chronic bacterial prostatitis, and the isolate is fluoroquinolone-susceptible. What treatment duration is typical? A. 3 days B. 4-6 weeks of a fluoroquinolone C. A single dose D. 6 months of nitrofurantoin

B

Men's Health A man has culture-negative chronic prostatitis/chronic pelvic pain syndrome with voiding LUTS. Per the 2025 AUA guideline, which therapy should be offered? A. Repeated fluoroquinolone courses B. Testosterone therapy C. An alpha-blocker (e.g., tamsulosin) D. Long-term nitrofurantoin

C

Men's Health A 24-year-old has acute epididymitis most likely caused by chlamydia or gonorrhea. Which CDC regimen is recommended? A. Ceftriaxone 500 mg IM once plus doxycycline 100 mg orally twice daily for 10 days B. Levofloxacin 500 mg daily for 5 days C. Azithromycin 1 g orally once D. Cephalexin 500 mg four times daily for 7 days

A

Men's Health A 30-year-old who practices insertive anal intercourse has acute epididymitis, with enteric organisms and gonorrhea or chlamydia both possible. Which CDC regimen is recommended? A. Doxycycline 100 mg twice daily for 10 days alone B. Ceftriaxone 500 mg IM once alone C. Levofloxacin 500 mg daily for 10 days alone D. Ceftriaxone 500 mg IM once plus levofloxacin 500 mg daily for 10 days

D

Men's Health A 70-year-old man has osteoporosis (femoral neck T-score −2.8), normal renal function, and no GI contraindications. Which therapy is first-line? A. Romosozumab B. Raloxifene C. Alendronate 70 mg weekly D. Calcitonin nasal spray

C

Men's Health Which osteoporosis agent is not FDA-approved for use in men? A. Romosozumab B. Zoledronic acid C. Denosumab D. Teriparatide

A

Men's Health A man on long-term ADT for nonmetastatic prostate cancer is at high fracture risk. Which agent is FDA-approved to increase bone mass in this setting? A. Raloxifene B. Denosumab 60 mg SC every 6 months C. Calcitonin D. Teriparatide 80 mcg daily

B

Men's Health A man with HFrEF develops painful gynecomastia on spironolactone 50 mg daily. Which change is most appropriate? A. Switch to amiloride B. Increase spironolactone to 100 mg daily C. Stop the mineralocorticoid receptor antagonist permanently D. Switch to eplerenone

D

Men's Health Which acid-suppressing drug is associated with gynecomastia because of its antiandrogenic effects? A. Famotidine B. Nizatidine C. Cimetidine D. Pantoprazole

C

Men's Health A 48-year-old transgender woman who smokes is starting feminizing hormone therapy. Which estrogen regimen is most appropriate? A. Ethinyl estradiol 50 mcg daily B. Conjugated equine estrogens 2.5 mg daily C. Oral estradiol 6 mg daily D. Transdermal 17β-estradiol, with an antiandrogen such as spironolactone and smoking-cessation counseling

D

Men's Health A transgender woman is taking estradiol and spironolactone. Which monitoring targets match Endocrine Society guidance? A. Estradiol 100-200 pg/mL and testosterone below 50 ng/dL, with potassium and creatinine checked during spironolactone therapy B. Estradiol above 500 pg/mL and testosterone below 300 ng/dL C. No laboratory monitoring is needed D. Estradiol 20-40 pg/mL with testosterone in the normal male range

A

Men's Health A 35-year-old has infertility, a palpable left varicocele, and oligospermia, and his partner's fertility evaluation is normal. Per the AUA/ASRM guideline, what is recommended? A. Observation only B. Surgical varicocelectomy, preferably microsurgical subinguinal C. Testosterone therapy to improve semen parameters D. Repair of any varicocele, even if found only on imaging

B