The MKSAP Challenge
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
Internist Archives Quick Links
What will you learn from your Annals Virtual Patient?
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
ACP 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!