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Question:
What is the recommendation of American Cancer Society for initial
screening of an African-American male for prostate cancer?
Digital rectal exam starting at age 40 yearsPSA starting at age 45
yearsDiscussions starting at age 40-45 years CorrectHe should be
screened starting at age 50 years.
Explanation:
American Cancer Society guidelines recommend beginning screening
discussion at age 40-45 years for males at high risk for developing prostate
cancer (e.g. a first degree relative with prostate cancer before age 65 or
African American race). The reason for “screening discussions” is to keep
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males involved in individual decision making. The PSA threshold is 4.0
ng/mL. Testing is discouraged for males with less than a 10 year expected
survival. US Preventive Services Task Force does not recommend
screening.
Question:
What is American Cancer Society’s recommendation for prostate screening in a 70 year-ol
male?
He should be screened annually with PSA only.He should be screened
annually with PSA and DRE.He should be screened until he has a life
expectancy of less than 10 years. CorrectScreening can stop at age 75 years.
Explanation:
Prostate cancer screening at age 70 years includes both prostate specific
antigen measurement (PSA) and digital rectal exam (DRE). Prostate cancer
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is typically a slow growing tumor, thus if life expectancy is < 10 years,
screening is not cost-effective.
Question:
A 70 year-old male presents to your clinic with a lump in his breast. How
should this be evaluated? Palpation and ultrasound IncorrectMammogram
and ultrasound CorrectUltrasound onlyMammogram only
Explanation:
This patient has a lump identified in the breast. Since males can develop
breast cancer, it must be evaluated in the same means that a female breast
lump would be evaluated. He should have a clinical breast exam to identify
the position of the lump, and any other abnormal findings such as nodes or
other lumps. Then, he should have mammogram and ultrasound to help
evaluate the lump. If the findings were suspicious for a malignancy, the
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patient would be referred to a surgeon.
Question:
A 22 year-old male who is otherwise healthy complains of scrotal pain. His
pain has developed over the past 4 days. He is diagnosed with epididymitis.
What is the most likely reason?
His ageInfection with Chlamydia CorrectUnderlying hydroceleUrinary tract infection
Explanation:
Several factors predispose males to epididymitis. In men under age 35, the
most common cause of epididymitis is infection with Chlamydia
trachomatis. In older men, urinary tract pathogens are more typical. In pre-
pubertal boys, bicycle riding and heavy physical exertion are most
common. In pre-pubertal boys, consideration should be given to congenital
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