CME QUESTIONS FOR AUGUST 2003 ISSUE OFTHE JOURNAL OF UROLOGY

1. EFFECT OF ASCORBIC ACID CONSUMPTION ON URINARY STONE RISK FACTORS (vol. 170, pp. 397–401)

In stone formers the following changes in urinary biochemical parameters occur with consumption of 2 gm ascorbicacid daily:

a) Decrease in pH, increase in oxalateb) Decrease in pH, no change in oxalatec) Increase in pH, increase in oxalated) No change in pH, increase in oxalatee) No change in pH, no change in oxalate

2. EXPECTANT MANAGEMENT OF SMALL, RECURRENT, NONINVASIVE PAPILLARY BLADDER TUMORS (vol.170, pp. 438–441)

There are several possible approaches to treating a patient with a history of low grade Ta (noninvasive) papillarybladder tumor who now has a small (0.5 cm) papillary low grade appearing tumor on the right wall of the bladder.Which choice is not appropriate?

a) In office fulgurationb) Observe for 3 monthsc) In office laser therapyd) Transurethral methode) Partial cystectomy

3. PROSPECTIVE RANDOMIZED COMPARATIVE STUDY OF THE EFFECTIVENESS AND SAFETY OFELECTROHYDRAULIC AND ELECTROMAGNETIC EXTRACORPOREAL SHOCK WAVE LITHOTRIPTORS (vol.170, pp. 389–392)

The focal zone size of the electromagnetic lithotriptor that uses the acoustic lens for focusing varies as a result ofincreasing the:

a) Rate of shock wavesb) Energy levelc) Treatment timed) Number of shockse) Water cushion inflation

4. COMPARISON OF AMINOLEVULINIC ACID AND HEXYLESTER AMINOLEVULINATE INDUCEDPROTOPORPHYRIN IX DISTRIBUTION IN HUMAN BLADDER CANCER (vol. 170, pp. 428–432)

Bladder instillation with hexylester aminolevulinate:

a) Induces protoporphyrin IX fluorescence in the bladder smooth muscleb) Causes chemical cystitisc) Produces the highest level of protoporphyrin IX accumulation after 6 hoursd) Permits a highly significant discrimination between normal and malignant urothelial cellse) Needs to obtain higher fluorescence ratios and higher concentration of the instillation solution in comparison withaminolevulinic acid

5. CORRELATION OF MINUTE (0.5 MM OR LESS) FOCUS OF PROSTATE ADENOCARCINOMA ON NEEDLEBIOPSY WITH RADICAL PROSTATECTOMY SPECIMEN: ROLE OF PROSTATE SPECIFIC ANTIGEN DENSITY(vol. 170, pp. 370–372)

In a man with a minute focus of adenocarcinoma of the prostate and Gleason score 3 � 3 � 6 on needle biopsy, whichparameter best predicts potentially significant cancer within the prostate?

a) Abnormal digital rectal examinationb) Young agec) High prostate specific antigen densityd) High grade prostatic intraepithelial neoplasia in another core

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