Question

question 41
1 pts
moussa is a 75 y/o african american male who presents to the clinic with the following
symptoms: perianal pain, low back pain, night time urination, and weak urinary stream. labs
taken one week ago show a psa of 6.0 ng/ml. the most likely diagnosis is:
prostate cancer
testicular torsion
prostatitis
epididymitis
previous

Explanation:

• Prostate Cancer: Common in older African - American men. Symptoms like perianal pain, low back pain (due to metastasis in some cases), urinary symptoms (nocturia, weak stream) are typical. PSA (prostate - specific antigen) of 6.0 ng/ml (elevated, normal is usually < 4 ng/ml in many references, though some consider up to 4 - 10 ng/ml as a gray zone where further testing is needed) is also a clue as PSA can be elevated in prostate cancer.
• Testicular Torsion: Usually presents with sudden - onset severe testicular pain, nausea, vomiting. There is no mention of testicular pain here, so this is unlikely.
• Prostatitis: Can cause perianal pain and urinary symptoms. But it is more likely to have fever, chills (in acute cases) and a more rapid onset. Also, while PSA can be elevated in prostatitis (due to inflammation), the overall clinical picture in an older man with these symptoms leans more towards cancer.
• Epididymitis: Presents with scrotal pain (epididymal swelling and tenderness), urinary frequency, dysuria. No scrotal symptoms are described here.

Answer:

Prostate Cancer