QuestionSBA
QuestionChoice
This patient's symptoms and DRE findings are more suggestive of prostate cancer than prostatitis. Prostatitis symptoms include fever, pelvic pain or discomfort, urinary symptoms (frequency, urgency, dysuria, haematuria, hesitancy) and flu-like symptoms.
10028137
b
Prescribe antibiotics for prostatitis
QuestionChoice
5-alpha reductase inhibitors are typically used to treat benign prostatic hyperplasia, not prostate cancer. Initiating treatment without a confirmed diagnosis would not be appropriate.
10028139
d
Initiate treatment with a 5-alpha reductase inhibitor
QuestionChoice
These findings are concerning for prostate cancer. To get a definitive diagnosis or rule out prostate cancer, a transrectal ultrasound-guided prostate biopsy is needed. This procedure involves taking small samples of prostate tissue to determine if cancer cells are present. This is the most appropriate next step in the evaluation of a patient with suspected prostate cancer.
10028136
a
Perform a transrectal ultrasound-guided prostate biopsy
QuestionChoice
Radiotherapy is a treatment option for prostate cancer but would not be attempted before a confirmed diagnosis and discussion of appropriate treatment options.
10028138
c
Refer the patient for radiotherapy
QuestionChoice
Bone scans are important for staging cancers but are typically done after a confirmed diagnosis. The initial step is to obtain a tissue diagnosis through a biopsy.
10028140
e
Order a bone scan to evaluate for metastatic disease
Concept
Chapter
2693
3755
Prostate cancer
Topic
143
Urology
18025
A 70-year-old male presents to the urology clinic with lower urinary tract symptoms of increased frequency, nocturia and a weak urinary stream.

On digital rectal examination (DRE), his prostate feels firm and nodular. His prostate-specific antigen (PSA) level is found to be elevated at 7.5 ng/mL.

Which of the following is the most appropriate next step?
a