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A 65-Year-Old Man Comes to the Office for a Follow-Up

question 523

Multiple Choice

A 65-year-old man comes to the office for a follow-up evaluation of hematuria. He underwent evaluation for an insurance policy and was told that he had blood in his urine. He has never observed any blood in his urine; however, he has noticed a progressively weaker urinary stream over the past several years and often gets up to urinate at least twice each night. He has no history of flank or abdominal pain, and has never passed a kidney stone or had urinary tract infection. He has smoked more than one pack of cigarettes daily for 40 years. He recently retired from many years of employment in the dye industry.
He has been diagnosed with moderate chronic obstructive lung disease, benign prostatic hypertrophy, degenerative joint disease, and hypertension. His current medications consist of an inhaler containing a beta adrenergic agonist, several over-the-counter NSAIDs, and lisinopril.
His blood pressure is 140/90 mm Hg, pulse is 84/min, and respirations are 20/min. Physical examination findings are compatible with moderate chronic obstructive lung disease. A urinalysis performed in the office shows a positive dipstick and 3-5/hpf RBCs. Subsequently, 2 additional urinalyses are performed; RBCs are 1-2/hpf on the first and 5-10/hpf on the second urinalysis. Urine cytology is negative for malignant cells on 3 occasions. A CT scan of the kidneys is within normal limits. A urine culture is negative.
The patient's laboratory studies reveal:

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

Recognize the empirical nature of psychology and how it relies on direct observation and systematic observation.

Appreciate the role of natural selection in evolutionary psychology and its impact on behavior.

Understand the concept of positive psychology and its focus on positive individual traits and institutions.

Recognize the importance of diverse theoretical perspectives in explaining psychological phenomena.

Definitions:

Intuitive-Type

A person who relies more on intuition and subjective impressions than on rational analysis and objective evidence.

Reason

The power of the mind to think, understand, and form judgments by a process of logic.

Dogmatism

The tendency to lay down principles as incontrovertibly true, without consideration of evidence or the opinions of others.

Authoritarianism

A leadership style marked by strict adherence to authority and control, often at the expense of individual freedom and creativity.