A 59-Year-Old Man Is Being Evaluated for Markedly Elevated Prostate-Specific

question 570

Multiple Choice

A 59-year-old man is being evaluated for markedly elevated prostate-specific antigen levels.  He has no bone pain or urinary symptoms.  The patient has no chronic medical conditions or surgical history.  His father died of prostate cancer.  Vital signs are normal.  Digital rectal examination reveals an indurated prostate with no palpable nodules.  The remainder of the examination is normal.  Prostate biopsy is planned.  Which of the following is the best way to obtain a diagnosis in this patient?

• A)Cystoscopy guided; multiple random biopsies of the prostate
• B)Cystoscopy guided; single biopsy of the central portion of the prostate
• C)Transperineal approach; fine-needle aspiration of the prostate
• D)Transrectal route; multiple random biopsies of the prostate
• E)Transrectal route; single biopsy from the center of the gland

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Definitions:

Cocktail Party Effect

The brain's ability to focus one's auditory attention on a particular stimulus while filtering out a range of other stimuli, as when one hears their name in a noisy room.

Driving

The act of controlling and operating a vehicle, typically an automobile, as a means of transportation from one location to another.

Inattentional Blindness

A psychological phenomenon whereby an individual fails to perceive an unexpected stimulus in plain sight, due to the focus of attention elsewhere.

Selective Attention

The cognitive process of focusing on one particular object or task in the environment while ignoring other irrelevant stimuli.