Professional and Linguistic Assessments Board (PLAB) Practice Exam

Which class of medication is considered a first-line treatment for benign prostatic hyperplasia (BPH)?

1. Alpha 1 antagonist

2. 5-alpha reductase inhibitor

3. Anticholinergic

4. Beta blocker

The correct answer is: Alpha 1 antagonist

Alpha 1 antagonists are considered a first-line treatment for benign prostatic hyperplasia (BPH) because they work by relaxing the smooth muscles in the prostate and bladder neck, leading to improved urinary flow and reduced symptoms associated with BPH. This class of medication targets the alpha-1 adrenergic receptors, which are present in the prostate and the bladder, thereby alleviating symptoms such as difficulty in urination, urgency, and frequency. While 5-alpha reductase inhibitors can also be used to treat BPH, particularly in patients with enlarged prostates, they primarily work by decreasing the size of the prostate over time and may take several months to show effects. Therefore, they are typically used in conjunction with alpha 1 antagonists for patients with significant symptoms or larger prostates. Anticholinergics are generally not preferred for BPH as they can further exacerbate urinary retention issues, especially in older males. Beta blockers do not have a role in treating BPH directly and are mainly used for other conditions such as hypertension or heart disease. The effectiveness and rapid symptom relief provided by alpha 1 antagonists make them the preferred initial treatment choice for managing BPH.