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Old 03-19-2015
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Default repeated usmle question 22

A 51 year-old man visits his physician for a routine physical examination. He has no health complains. He smokes 1 pack of cigarettes and drinks a cup of wine daily for 30 years. He has no significant past history and takes no medications. He has no significant family history and both his parents are healthy. Physical examination and blood tests are normal.

What is the test recommended to be done next?

A- Chest x-ray
B- Liver function tests
C- Kidney function tests
D- Colonoscopy
E- Prostate-specific antigen (PSA) test
http://medical-usmle.com/?p=890
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Old 03-19-2015
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Default kindly guide me for step 1

Kindly guide me for step 1.
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Old 03-19-2015
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Default guide to step 1

Are you medical student or you already practicing medicine in a different country.
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Old 03-19-2015
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D- Colonoscopy, BUT i'm not sure when we're supposed to start screening for it, after 50 or 60. BUT it's the only one in the choices.
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Old 03-19-2015
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Default screening for colonoscopy

There is a quote by my professor ....Send invitation for colonoscopy inside the 50th birthday card to your clients. Yes you suppose to start colonoscopy at 50.
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Old 03-21-2015
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Why not PSA? The incidence of prostatic carcionoma is higher than colorectal CA. The incidence is as follows:
1. Prostate
2. Lung
3. Colorectal
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Old 03-22-2015
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Quote:
Originally Posted by Hassan8 View Post
Why not PSA? The incidence of prostatic carcionoma is higher than colorectal CA. The incidence is as follows:
1. Prostate
2. Lung
3. Colorectal
First, prostate cancer usually has a symptomatic presentation unlike colorectal cancer which is very subtle in the beginning as occult blood in the stool.
Second, PSA isn't specific!!! even a value of more than 4 can be benign prostatic hyperplasia! That's why PSA isn't recommended by the US guidelines but colonoscopy is indicated in the US guidelines at ages later than 50 years

Lung cancer is the number one killer malignancy in total (male and female) elderlies , why don't we do CXR? that's because it's non-specific and also not very sensitive early on (unlike colonoscopy which has decreased the death rate in colon cancer patients due to early recognition)

hope that made it clear.
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