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  #1  
Old 07-07-2013
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Question Prostatits versus BPH

A 72 year old man has difficulty initiating urination. Digital rectal examination shows an enlarged, firm prostate. An assay for serum prostate specific antigen is 3.5 (reference range is 0-5). Examination of tissue obtained on biopsy of the prostate is most likely to show:

a) adenocarcinoma
b) chronic prostatitis
c) epithelial dysplasia
d) glandular hyperplasia
e) leiomyoma


I picked B as my answer. Not entirely sure though....please explain your answer
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Old 07-07-2013
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PSA is in reference, so wouldn't be A. I would also rule out B, because that would present with more symptoms...rather than just obstruction...with chronic prostatitis, you also get discomfort, low back pain, stuff like that.

I don't think epithelial dysplasia can produce obstruction (as this patient has). correct me if i'm wrong though!!!!! So rule out C.

I think the answer is D. because that can be large enough to cause obstruction, it's FIRM (as oppose to boggy - as would be seen in acute prostatitis).

As for E, I suppose that could also cause it, but i suppose a pure Benign Smooth Muscle tumor of the Prostate would not be that common?????



So I'd go with D. Do you have the correct answer for this question, and where it came from?
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Old 07-07-2013
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D, since there one symptom is mentioned , a patient can have both b & d
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Old 07-07-2013
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i say D
do you have the correct answer?
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Old 07-08-2013
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The answer is D, glandular hyperplasia.

The explanation tells us about his age, 72 years old. DRE showed enlarged firm prostate. PSA is not always a confirmatory test, it may be elevated or it may be in range (like this patient).

BPH is hyperplasia (NOT hypertrophy) of the prostate gland. FA 2013, page 535

Thanks guys
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Old 07-08-2013
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i ll go with d but in kaplan q bank they say that if palpation is nodular and firmmmmm so its adenocarcinoma
and if its rubbery(boggy) so its bph
so i think the true answer will be adenocarcinoma and for the psa in adenocarcinoma there is decrease free psa and increased bounded portion of psa
is there anyone had an opinion?

Last edited by cage92; 07-08-2013 at 02:55 AM. Reason: clarification
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