Author Question: A 65-year-old male patient complains of frequency, urgency, hesitancy, and weak urine stream. ... (Read 92 times)

melina_rosy · **on:** Jun 25, 2018

A 65-year-old male patient complains of frequency, urgency, hesitancy, and weak urine stream. Physical examination is unremarkable except DRE reveals an enlarged, firm, non-tender prostate gland. Urine culture reveals 100 bacteria CFU/mL.

The clinician should suspect:
A. Lower urinary tract infection due to benign prostatic hyperplasia
B. Bacteriuria due to prostatitis
C. Obstructive uropathy due to prostate cancer
D. Upper urinary tract infection due to benign prostatic hyperplasia

Question 2

A 27-year-old male comes in to the clinic for symptoms of dysuria, urinary frequency, as well as urgency and perineal pain. Transrectal palpation of the prostate reveals a very tender, boggy, swollen prostate.

The clinician should recognize these as signs of:
A. Prostatitis
B. Prostate cancer
C. Urethritis
D. Benign prostatic hyperplasia

upturnedfurball · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
Urinary tract infection is uncommon in males and when UTI is diagnosed in the male the etiology should be determined. Benign prostatic hyperplasia presents as an enlarged, firm, non-tender prostate on DRE. An enlarged prostate is commonly diagnosed when a male presents with a lower urinary tract infection. The enlarged prostate causes urine retention in the bladder, and stagnant urine in the bladder is a medium for bacterial growth causing lower UTI.

Answer to Question 2

ANS: A
Prostatitis is an acute or chronic infection of the prostate gland. Acute bacterial prostatitis is usually the result of infection by aerobic gram-negative rods (coliform bacteria or Pseudomonas). Enterococcus faecalis, an aerobic gram-positive bacteria, can also cause prostatitis. Routes of infection are ascent from the urethra, reflux of infected urine into the prostatic ducts, direct extension of bacteria, and migration via the lymphatic and vascular system. Acute symptoms commonly include fever, low back and perineal pain, possible penis pain, urinary urgency and frequency, nocturia, dysuria, and muscle and joint aches. Transrectal palpation of the prostate reveals a very tender, boggy, swollen prostate.