TiSBU Urologia Practice Questions - TiSBU - Título de Especialista em Urologia (Sociedade Brasileira de Urologia AMB) Exam - TiSBU Urologia Practice Questions - TiSBU - Título de Especialista em Urologia (Sociedade Brasileira de Urologia AMB) Exam

Question 1

A 54-year-old man presents for a routine urological evaluation. His serum prostate-specific antigen (PSA) is 5.8 ng/mL, and digital rectal examination (DRE / toque retal) reveals a benign, smooth, non-nodular prostate. Transrectal ultrasound (TRUS) calculates a total prostate volume of 32 mL. When assessing the patient's risk of harboring clinically significant prostate cancer to determine the need for multiparametric MRI or prostate biopsy, what is the widely accepted cutoff for Prostate-Specific Antigen Density (PSAD)?

PSAD > 0.05 ng/mL/cm³ PSAD > 0.15 ng/mL/cm³ PSAD > 0.35 ng/mL/cm³ PSAD > 0.50 ng/mL/cm³

Correct Answer:

PSAD > 0.15 ng/mL/cm³

Question 2

According to the Prostate Imaging–Reporting and Data System version 2.1 (PI-RADS v2.1) guidelines for multiparametric magnetic resonance imaging (mpMRI) of the prostate, which imaging sequences serve as the primary determining sequence (dominant sequence) for evaluating lesions located in the Peripheral Zone (PZ) and Transition Zone (TZ), respectively?

Diffusion-Weighted Imaging (DWI/ADC) for the Peripheral Zone, and T2-Weighted Imaging (T2W) for the Transition Zone. T2-Weighted Imaging (T2W) for the Peripheral Zone, and Dynamic Contrast-Enhanced (DCE) imaging for the Transition Zone. Dynamic Contrast-Enhanced (DCE) imaging for the Peripheral Zone, and Diffusion-Weighted Imaging (DWI/ADC) for the Transition Zone. T1-Weighted Imaging (T1W) for the Peripheral Zone, and MR Spectroscopy for the Transition Zone.

Correct Answer:

Diffusion-Weighted Imaging (DWI/ADC) for the Peripheral Zone, and T2-Weighted Imaging (T2W) for the Transition Zone.

Question 3

A 62-year-old man undergoes transperineal targeted prostate biopsy for a PI-RADS 4 lesion. Histopathology reveals adenocarcinoma with predominantly well-formed glands (Gleason pattern 3, 60%) alongside poorly formed/fused cribriform glands (Gleason pattern 4, 40%). According to the 2014/2019 International Society of Urological Pathology (ISUP) consensus, what is the corresponding ISUP Grade Group, and what is the clinical significance of the cribriform architectural pattern?

ISUP Grade Group 1; cribriform pattern indicates indolent behavior suitable for unmonitored observation. ISUP Grade Group 2; presence of cribriform pattern independently predicts adverse pathology, higher recurrence rates, and is considered an unfavorable feature for active surveillance. ISUP Grade Group 3; cribriform pattern mandates immediate systemic chemotherapy prior to any local therapy. ISUP Grade Group 4; cribriform pattern is classified as Gleason pattern 5 and confers a uniformly poor survival.

Correct Answer:

ISUP Grade Group 2; presence of cribriform pattern independently predicts adverse pathology, higher recurrence rates, and is considered an unfavorable feature for active surveillance.

Question 4

According to the D'Amico and European Association of Urology (EAU) risk stratification systems for localized prostate cancer, which of the following combinations of clinical parameters defines the Low-Risk category?

PSA < 10 ng/mL, ISUP Grade Group 1 (Gleason score ≤ 6), and clinical stage cT1c to cT2a. PSA 10–20 ng/mL, ISUP Grade Group 2 (Gleason 3+4=7), and clinical stage cT2b. PSA < 15 ng/mL, ISUP Grade Group 2 (Gleason 3+4=7), and clinical stage cT2c. PSA < 20 ng/mL, ISUP Grade Group 3 (Gleason 4+3=7), and clinical stage cT3a.

Correct Answer:

PSA < 10 ng/mL, ISUP Grade Group 1 (Gleason score ≤ 6), and clinical stage cT1c to cT2a.

Question 5

A 58-year-old asymptomatic man with a life expectancy >15 years is diagnosed with localized prostate cancer following an elevated PSA of 4.6 ng/mL. A 12-core systematic biopsy reveals ISUP Grade Group 1 (Gleason 3+3=6) adenocarcinoma in 1 core (involving 15% of the core). Pre-biopsy mpMRI showed a 7 mm PI-RADS 3 lesion in the left peripheral zone, and DRE is normal (cT1c). According to major consensus guidelines (such as PRIAS and SBU guidelines), what is the most appropriate initial management strategy?

Immediate radical prostatectomy with bilateral extended pelvic lymphadenectomy. Active surveillance with serial PSA monitoring, periodic clinical/mpMRI evaluation, and confirmatory/surveillance biopsies. External beam radiation therapy with 24 months of androgen deprivation therapy (ADT). Immediate bilateral subcapsular orchiectomy.

Correct Answer:

Active surveillance with serial PSA monitoring, periodic clinical/mpMRI evaluation, and confirmatory/surveillance biopsies.

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Prepare with the TiSBU Urologia Practice Questions - TiSBU - Título de Especialista em Urologia (Sociedade Brasileira de Urologia AMB) Exam practice quiz. This question bank includes 100 questions covering year-old, renal, prostate, cancer, and guidelines. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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TiSBU Urologia Practice Questions - TiSBU - Título de Especialista em Urologia (Sociedade Brasileira de Urologia AMB) Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, renal, prostate, cancer, and guidelines. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

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TiSBU Urologia Practice Questions - TiSBU - Título de Especialista em Urologia (Sociedade Brasileira de Urologia AMB) Exam

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