American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

The MKSAP Challenge

From the March ACP Observer, copyright © 2005 by the American College of Physicians.

A 52-year-old man presents as a new patient requesting an annual examination and a serum prostate-specific antigen (PSA) measurement. He exercises, does not smoke and drinks alcohol infrequently. His medical records disclose well-controlled hypertension, a negative exercise tolerance test four years ago, and various laboratory evaluations, all of which were normal. His only medication is atenolol.

Previous health maintenance included a colonoscopy two years ago, and serum PSA values of 4.2 ng/mL one year ago and 3.8 ng/mL two years ago. The patient recalls his prior physician telling him the value was borderline and recommending a repeat measurement in one year.

Physical examination, including digital rectal examination, is unremarkable. Serum PSA value is 5.0 ng/mL.

Which of the following is the most appropriate next step in the management of this patient?

A. Prescribe tamsulosin therapy
B. Perform serial PSA measurements
C. Order free PSA assay
D. Refer for urologic evaluation
E. Prescribe finasteride

Answer

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Share

 
 

Internist Archives Quick Links

What will you learn from your Annals Virtual Patient?

Reviews of the World's Top Medical Journals—FREE to ACP Members! Annals Virtual Patients is a unique patient care simulator that mirrors real patient care decisions and consequences. CME Credit and MOC Points are available. Start off with a FREE sample case. Start your journey now.

Products and Resources for Patients

Products and Resources for PatientsACP has developed easy- to-use materials designed to help educate your patients on self-management of a wide variety of common health conditions. Order yours today!