A 52 year-old male presents complaining of urinary frequency, with hesitancy, and nocturia for the past few months. During his physical examination, you note a nontender, non-enlarged prostate with ... an isolated right posterior lobe nodule. Which of the following options is most appropriate? *A.* order a serum acid phosphatase level *B.* initiate prazosin and schedule a follow-up appointment in 6 weeks *C.* refer the patient for an ultrasound of the prostate and order a PSA level *D.* reassure the patient and schedule a follow-up appointment in six months *E.* initiate norfloxacin therapy for 7 days and schedule follow-up in two weeks - ANS - *Answer: C* This patient has an isolated nodule of the prostate gland — cancer until proven otherwise. You should order an ultrasound and a PSA. BPH will present as diffuse enlargement, and not a discrete nodule. You are educating a patient that has just been advised that he has "polyps" in his colon. Which of the following statements is FALSE? A. The larger the colonic polyp, the greater the risk of malignant transformation B. Villous adenomas have a 30-70% risk of malignant transformation. C. The greater the number of concomitant colonic polyps, the greater the risk of malignant transformatio D. The majority of colonic polyps are hyperplastic in origin E. The majority of colonic polyps are > 3 cm in size. - ANS - Answer: E, The majority of colonic polyps are > 3 cm in size. Most polyps are, in fact, quite small. All the rest of these statements are true [Show More]
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