1. Question:
When palpating the prostate gland during the rectal exam, the prostate feels tender,
swollen, “boggy,” and warm. This finding is consistent with:
a normal prostate gland.
acute bacterial prostatitis. Correct
benign prostatic hyperplasia.
carcinoma of the prostate.
Explanation:
The prostate gland feels tender, swollen, “boggy,” and warm in patients who have
acute bacterial prostatitis. As palpated through the anterior rectal wall, the normal
prostate is a rounded, heart-shaped structure, somewhat rubbery and nontender. It
measures approximately 2.5 cm long. In a patient with benign prostatic hyperplasia
(BPH), the gland feels enlarged and increases with age. BPH is present in more than
50% of men by 50 years of age. Carcinoma of the prostate gland is suggested by an area
of hardness in the gland. A distinct hard nodule that alters the contour of the gland may
or may not be palpable. However, as the cancer enlarges, the prostate feels irregular
and may extend beyond the confines of the gland.
2. Question:
A 31-year-old man with human immunodeficiency virus (HIV) infection states that he
has been having urinary frequency, hesitancy, fever, and nocturia. Considering his
medical history, he should be evaluated for:
a varicocele.
benign prostatic hypertrophy (BPH).
prostatitis. Correct
urolithiasis.
Explanation:
Human immunodeficiency virus (HIV) infection is an autoimmune deficiency virus that
predisposes men to bacterial infections such as prostatitis. Symptoms include urinary
frequency, hesitancy, burning, nocturia, and fevers. Most men with varicocele have no
symptoms. Benign prostatic hypertrophy (BPH) is age-associated prostate enlargement
without signs of initial infection or fever symptoms. Urolithiasis involves a sharp pain
during urination, along with nausea, hematuria, and acute abdominal pain.
3. Question:
A 30-year-old man who has a history of heart disease will present with which symptom
related to the development of arteriosclerosis?
Hypogonadism
, Erectile dysfunction Correct
Enlarged prostate
Urinary incontinence
Explanation:
Erectile dysfunction is commonly caused by atherosclerosis in older men and is
frequently considered a manifestation of vascular disease. Hypogonadism is caused by
changes in testosterone. Prostate enlargement occurs in most older men and is not
specifically related to heart disease. Urinary incontinence is a symptom associated with
enlarged prostate and is not specific to atherosclerotic changes.
4. Question:
At what age should a practitioner suggest a colonoscopy for a male patient as part of
primary care screening?
40 years
45 years
50 years Correct
55 years
Explanation:
The American Cancer Society recommends that a colonoscopy for colorectal cancer
screening be performed at age 50 and every 10 years afterward, as long as screening is
negative. Testing prior to age 50 depends on risk factors such as family history or
history of inflammatory bowel disease.
5. Question:
When the scrotum is transilluminated in a 4-month-old boy, it lights up brightly. This
finding may be consistent with:
normal scrotal findings.
an inguinal hernia.
cryptorchidism.
a hydrocele. Correct
Explanation:
A hydrocele is defined as swelling in the scrotum that lights up on transillumination.
Inguinal hernia and cryptorchidism are diagnosed using palpation of the scrotum and
testicle and are not associated with fluid collection. Swelling of the scrotum and
collection of serous fluid are not normal findings.
6. Question:
When examining the prostate gland the examiner should inform the patient that this
procedure may:
cause him to urinate.