07-31-2010, 08:45 PM
A 55-year-old black man presents for an annual examination. His medical history includes sickle cell trait and hypertension. His medications include hydrochlorothiazide, diltiazem, and atenolol. He has stable nocturia, urinating once each night. Digital rectal examination discloses an asymmetric prostate gland. The right lobe is slightly larger, and the anterior portion feels firmer than the rest of the gland but no discrete nodule is noted. Serum prostate-specific antigen (PSA) concentration is 3.2 ng/mL and has been 2.8 to 3.2 ng/mL for the previous 4 years.
What do you recommend for this patient?
A. Continued annual PSA monitoring
B. Follow-up PSA measurement in 3 to 6 months
C. Determination of free/total PSA ratio
D. Biopsy of the prostate gland
E. Transrectal ultrasonography of the prostate gland
What do you recommend for this patient?
A. Continued annual PSA monitoring
B. Follow-up PSA measurement in 3 to 6 months
C. Determination of free/total PSA ratio
D. Biopsy of the prostate gland
E. Transrectal ultrasonography of the prostate gland