Not sure if this is an oversight or not, but feel free to move this to Wishlist if it's intended.
I set up a hotkey for "Sync Play Count from Last.fm." I'd expect a default option to be selected at this point (I'd prefer "Yes" if it matters) so the user could just hit "Enter" or "Tab->Enter" to select one of the options on the keyboard, but there's no default option set there so you have to go to the mouse and click one of them, which kind of defeats the purpose of a hotkey. The only keyboard input accepted on that dialog box is escape to get rid of it.