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Benign prostatic hyperplasia
9%
1/11
Normal physical exam
0%
0/11
Prostate abscess
Prostate cancer
64%
7/11
Prostatitis
18%
2/11
Select Answer to see Preferred Response
This patient is presenting with an incidentally discovered firm and nodular prostate which is concerning for prostate cancer. Prostate cancer screening with a digital rectal exam and a PSA is no longer routinely performed; however, it is performed occasionally in elderly patients per patient request. If a rock-hard, nodular prostate is discovered incidentally on physical exam, it is possible that the patient may have prostate cancer and should undergo further workup for their malignancy including a biopsy followed by either surgery or external radiation. If there is metastatic disease, then androgen blockade is often indicated with treatment including flutamide followed by leuprolide/goserelin. Incorrect Answers: Answer 1: Benign prostatic hyperplasia would present with a firm/smooth, enlarged prostate and may present with urinary retention. Treatment includes tamsulosin and finasteride. Answer 2: Normal physical exam would present with a normal-sized, smooth prostate that is nontender. Answer 3: Prostate abscess would present with a fever, pyuria, and a fluctuant/tender mass in the prostate. Drainage and IV antibiotics are indicated in this condition. Answer 5: Prostatitis would present with a fever, pyuria, and a soft/boggy/tender prostate. IV antibiotics are indicated in this condition. Bullet Summary: Prostate cancer presents with a firm, nodular prostate.
3.8
(6)
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