next step in management ?

[K06100]

A 60-year-old man presents to the urologist
complaining of diffi culty urinating. He states
he frequently gets out of bed in the middle of
the night to go to the bathroom. Once he gets
to the bathroom he can’t urinate easily and
must “bear down” to do so. He denies any history
of sexually transmitted disease, trauma to
the genitourinary tract, or prior genitourinary
instrumentation. On rectal examination the
patient has an enlarged prostate and one 1-cm
area of induration located on the middle posterior
aspect of the prostate. He has a prostatespecifi
c antigen level of 6 ng/mL (normal: 0–4
ng/mL), BUN of 20 mg/L, and creatinine of
1.6 mg/L. The patient undergoes a transrectal
prostate biopsy, and no dysplasia or atypia is
present. Which of the following is the most appropriate
treatment?

(A) Brachytherapy
(B) Finasteride
(C) Radical retropubic prostatectomy
(D) Transurethral resection of the prostate
(E) Watchful waiting

[cingulate.gyrus]

(B) Finasteride

[sandhu 001]

B) waht do u think it is?

[Dr.faraz]

BPH finesteride

[K06100]

B is wrong answer guys ...i made the same mistake...read the ques carefully.......

[Anders]

Originally Posted by K06100

A 60-year-old man presents to the urologist
complaining of diffi culty urinating. He states
he frequently gets out of bed in the middle of
the night to go to the bathroom. Once he gets
to the bathroom he can’t urinate easily and
must “bear down” to do so. He denies any history
of sexually transmitted disease, trauma to
the genitourinary tract, or prior genitourinary
instrumentation. On rectal examination the
patient has an enlarged prostate and one 1-cm
area of induration located on the middle posterior
aspect of the prostate. He has a prostatespecifi
c antigen level of 6 ng/mL (normal: 0–4
ng/mL), BUN of 20 mg/L, and creatinine of
1.6 mg/L. The patient undergoes a transrectal
prostate biopsy, and no dysplasia or atypia is
present. Which of the following is the most appropriate
treatment?

(A) Brachytherapy
(B) Finasteride
(C) Radical retropubic prostatectomy
(D) Transurethral resection of the prostate
(E) Watchful waiting

I was confused btw B and E but since you marked B as wrong answer, i would go with E

[XpaezX]

Patient has BPH and no signs of cancer....

I dont know wtf is brachytherapy and that means is not the answer HAHA

the other options are for Prostatic Carcinoma

Ill pick E eventho what you do is A1 blockers but whatever


I will assume this is Kaplan Q bank because the questions and options are way wtf and unreal

[K06100]

Originally Posted by XpaezX

I will assume this is Kaplan Q bank because the questions and options are way wtf and unreal

no man ...ths is FA Q & A CK....It also has many WTF questions .

while doing them , i was like

[absolutjag9]

why not B? this is BPH!

[K06100]

The correct answer is D. The patient has
BPH, which may produce obstructive (hesitancy,
weakened and intermittent urinary
stream, urinary retention) or irritative (urge
incontinence, nocturia) symptoms. While
biopsy is not usually warranted in cases of
BPH, DRE in this patient revealed a suspicious
nodule requiring further evaluation. In
most cases of BPH, DRE reveals a uniformly
enlarged, rubbery prostate without areas of induration.
The patient in this case had an area
of induration, suggestive of cancer. Additionally,
while BPH may cause mildly elevated
levels of PSA, prostate cancer can also result
in elevated PSA levels. Therefore, biopsy is
warranted to distinguish between benign and
malignant disease. This patient’s biopsy revealed
a benign process. BPH can be managed
expectantly with medication, or with surgery,
depending on the severity of symptoms
and associated fi ndings. This patient reported
moderate to severe symptoms. Additionally,
his elevated creatinine level suggests that he
is in renal failure secondary to obstruction of
the prostatic urethra. Therefore, transurethral
resection of the prostate is the best treatment.
Answer A is incorrect. Brachytherapy would
be a reasonable option had the biopsy shown
more dysplasia and irregularity consistent with
carcinoma. Brachytherapy involves placing radioactive
seeds within the tumor, allowing for
localized radiation therapy.
Answer B is incorrect. Finasteride is a
5α-reductase inhibitor that can be used to treat
BPH. The presence of renal disease (i.e., elevated
creatinine level) would encourage more
aggressive steps to prevent further renal damage.
Answer C is incorrect. Radical retropubic
prostatectomy would be a reasonable choice
if the biopsy had shown prostatic carcinoma.
However, this procedure is much too aggressive
an approach for BPH.
Answer E is incorrect. Watchful waiting would
be acceptable if the man were less symptomatic
and did not have an elevated creatinine
level.

[jameshodge]

That is a long answer but I guess it does make sense. I've read similar cases in Super Beta Prostate Supplement reviews that were really helped by that supplement.

[jameshodge]

I'm trying to educate myself on prostate issues. So far I've read Super Beta Prostate testimonials and those seem great but I have a long way to go in really understanding the numbers.