Your 77-year-old patient complains of frequent urination, ...

[silviawilliams41]

Your 77-year-old patient complains of frequent urination, hesitation in getting the stream started, and nocturnal frequency of urination that is bothersome. On DRE, there is an enlarged, firm, non-tender, smooth prostate.
 
  The clinician should recognize these as symptoms of:
  A. Prostatitis
  B. Prostate cancer
  C. Urethritis
  D. Benign prostatic hyperplasia

Question 2

Your 66-year-old patient complains of frequency of urination and hesitancy of the urine stream. On DRE, there is a hard, nodular, enlarged, non-tender prostate. The clinician should recognize these as symptoms of:
 
  A. Prostatitis
  B. Prostate cancer
  C. Urethritis
  D. Benign prostatic hyperplasia

[stallen]

Answer to Question 1

ANS: D
BPH is an enlargement of the transition zone of the prostate gland which occurs as men age. An enlarged prostate causes symptoms that include urinary urgency, frequency, hesitation in getting the stream started, decreased caliber and force of stream, and nocturnal frequency of urination that is bothersome. This collection of symptoms has also been termed prostatism. A patient with BPH shows symmetric or asymmetric enlargement and a firm, smooth, non-tender gland.

Answer to Question 2

ANS: B
A prostate suspicious for malignancy will demonstrate nodular areas and/or overall hardness. Definitive diagnosis is made via prostate biopsy. Routine or urgent referral to a urologist is indicated, depending on the degree of PSA elevation and/or the degree to which it has risen since the previous value in conjunction with any suspicious findings on the rectal examination. A patient with prostate cancer often has no symptoms. Alternatively, an enlarged prostate can cause obstructive symptoms that include urinary urgency, frequency, hesitation in getting the stream started, decreased caliber and force of stream, and nocturnal frequency of urination that is bothersome.