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Elevation of prostate-specific antigen
| Clinical Discipline(s)/Organ System(s) Genitourinary System, Urology, Epidemiology | Progress Test Topic(s) Renal |
Description
A 65 year old Dutch male, a retired plumber, has a history of a slow stream of urine and needing to get up to void once or twice in the night. He has been referred to the Urology Outpatient Clinic after a blood test showed an elevated prostate-specific antigen.
Progress Test-Type Questions: Question 1 | Question 2Applied Science for Medicine
- Anatomy and physiology of micturition and its disturbance with outflow obstruction
- Genetic, molecular and cellular differences between normal prostate gland, benign and neoplastic growth
- Hormonal control of prostate growth and its role in benign prostatic enlargement and cancer
- Pathological basis of tumour markers
- The evolution of cancer: pre-cancerous to cancer to metastatic disease
- Pharmacology of alpha adrenoceptor blocking drugs and hormonal treatments including 5-alpha-reductase inhibitors for benign prostatic hyperplasia
- Anatomy and physiology of micturition and its disturbance with outflow obstruction
- Genetic, molecular and cellular differences between normal prostate gland, benign and neoplastic growth
- Hormonal control of prostate growth and its role in benign prostatic enlargement and cancer
- Pathological basis of tumour markers
- The evolution of cancer: pre-cancerous to cancer to metastatic disease
- Pharmacology of alpha adrenoceptor blocking drugs and hormonal treatments including 5-alpha-reductase inhibitors for benign prostatic hyperplasia
Clinical and Communication Skills
- Elicit a relevant genitourinary history relating to lower urinary tract
- Communication regarding potentially embarrassing symptoms
- Perform a focused examination relating to lower urinary tract and prostatic symptoms
- Perform, with sensitivity, a digital rectal examination
- Interpret full blood count, renal function tests, prostate specific antigen (PSA), midstream urine, ultrasound, pathology report of transrectal/prostatic biopsy
- Causes of an elevated PSA
- Common organisms that cause prostatitis and suggest appropriate antibiotic treatment
- Management of benign prostatic hyperplasia
- Stage prostate cancer using the TNM system, incorporating the Gleason score
- Outline the management of prostate cancer: active surveillance, radical prostatectomy, radiotherapy, hormonal and chemotherapy, palliative
- Outline the potential complications and management of patients following prostatic surgery
- Management of long-term catheters in the community
- Elicit a relevant genitourinary history relating to lower urinary tract
- Communication regarding potentially embarrassing symptoms
- Perform a focused examination relating to lower urinary tract and prostatic symptoms
- Perform, with sensitivity, a digital rectal examination
- Interpret full blood count, renal function tests, prostate specific antigen (PSA), midstream urine, ultrasound, pathology report of transrectal/prostatic biopsy
- Causes of an elevated PSA
- Common organisms that cause prostatitis and suggest appropriate antibiotic treatment
- Management of benign prostatic hyperplasia
- Stage prostate cancer using the TNM system, incorporating the Gleason score
- Outline the management of prostate cancer: active surveillance, radical prostatectomy, radiotherapy, hormonal and chemotherapy, palliative
- Outline the potential complications and management of patients following prostatic surgery
- Management of long-term catheters in the community
Personal and Professional Skills
- Self-awareness regarding managing diagnosic uncertainty
- Social stigma around urinary tract conditions
- Influence of patient's health status and opinions on choice of therapy
- Intimate examination and use of a chaperone
- Self-awareness regarding managing diagnosic uncertainty
- Social stigma around urinary tract conditions
- Influence of patient's health status and opinions on choice of therapy
- Intimate examination and use of a chaperone
Hauora Māori
- Inequities in prostate cancer rates and mortality between Māori and non-Māori
- Inequities in access to timely cancer care for Māori, and application of this to clinical decision making and management
- Understanding of the role of kaupapa Māori cancer services and research in reducing inequalities
- Inequities in prostate cancer rates and mortality between Māori and non-Māori
- Inequities in access to timely cancer care for Māori, and application of this to clinical decision making and management
- Understanding of the role of kaupapa Māori cancer services and research in reducing inequalities
Population Health
- Epidemiology of prostatism
- Costs and benefits of PSA tests
- Effectiveness and cost-effectiveness of PSA screening in the general population
- Communicating risk - sensitivity, specificity, predictive values and likelihood ratios
- Epidemiology of prostatism
- Costs and benefits of PSA tests
- Effectiveness and cost-effectiveness of PSA screening in the general population
- Communicating risk - sensitivity, specificity, predictive values and likelihood ratios
Conditions to be considered relating to this scenario
Common
benign prostatic hypertrophy, prostate adenocarcinoma, prostatitis, perineal trauma (post catheter insertion, post-procedure including rectal examination, sexual activity), urinary tract infection
benign prostatic hypertrophy, prostate adenocarcinoma, prostatitis, perineal trauma (post catheter insertion, post-procedure including rectal examination, sexual activity), urinary tract infection
Uncommon
salivary gland tumours (as cause of raised PSA)
salivary gland tumours (as cause of raised PSA)
