A 65-year-old patient is referred to the Outpatient Clinic with raised prostate-specific antigen (PSA), but a normal prostate on physical examination. He is later diagnosed with prostate cancer on biopsy.
What is the most common area of the prostate where this disease develops?
A 28-year-old man comes to the Emergency Department complaining of pain in his left testicle that has been gradually increasing over the past 72 hours. He appears to be in discomfort but is able to walk. Upon examination, his left testicle is tender to firm palpation. His vital signs are normal, and there is no redness or swelling. His abdominal examination is unremarkable. He reports dysuria and has recently started a new sexual relationship.
What is the most suitable course of action?
A 58-year-old man comes to his General Practitioner complaining of erectile dysfunction that has been going on for 6 months. He has a BMI of 30 kg/m², a history of hypertension, and has been smoking for 35 years. He reports no other symptoms and feels generally healthy.
What is the primary initial test that should be done for this patient’s erectile dysfunction?
A 53-year-old woman presents with left loin pain and haematuria. Upon examination, she displays tenderness in her left loin. A CT-KUB is conducted, revealing the presence of a renal tract calculus in her left kidney. Where is the most frequent location for this condition?
A 4-year-old boy undergoes a biopsy for a painless testicular tumour. Microscopy reveals tissue that resembles glomeruli. What is the most probable diagnosis?
A 27-year-old trans female patient contacts her GP for a telephone consultation to discuss contraception options. She was assigned male at birth and is currently receiving treatment from the gender identity clinic, taking oestradiol and goserelin. Although she plans to undergo surgery in the future, she has not done so yet. She is currently in a relationship with a female partner and engages in penetrative sexual intercourse. She has no significant medical history and is not taking any regular medications apart from those prescribed by the GIC. What advice should she receive regarding contraception?
Lila is a 38-year-old woman who presents to you with heavy menstrual bleeding that has been progressively worsening over the past year. She also complains of severe period pain that typically starts a few days before each menstrual cycle. Her menstrual cycles are regular, occurring every 28 days. Lila states she has not been sexually active for the past year and is not taking any regular medications. She has two children, both born via vaginal delivery without any complications. Upon abdominal examination, no abnormalities are noted, and a speculum examination reveals a normal cervix.
You decide to order a full blood count. What is the most appropriate next step?
You have organized a semen analysis for a 37-year-old man who has been experiencing difficulty in conceiving with his partner for the past year. The results are as follows:
– Semen volume 1.8 ml (1.5ml or more)
– pH 7.4 (7.2 or more)
– Sperm concentration 12 million per ml (15 million per ml or more)
– Total sperm number 21 million (39 million or more)
– Total motility 40% progressively motile (32% or more)
– Vitality 68% live spermatozoa (58% or more)
– Normal forms 5% (4% or more)
His partner is also undergoing investigations, and you plan on referring him to fertility services. What steps should be taken based on these semen analysis results?
A 67-year-old woman visits her GP complaining of urinary incontinence. She experiences this symptom throughout the day and has noticed that her urine flow is weak when she does manage to go voluntarily. During the examination, the GP detects a distended bladder despite the patient having just urinated before the appointment. What is the probable diagnosis for this woman’s condition?
A 79-year-old woman complains of difficulty urinating, weak stream, feeling of incomplete bladder emptying, and urinary leakage. Urodynamic testing reveals a detrusor pressure of 90 cm H2O during voiding (normal range < 70 cm H2O) and a peak flow rate of 5 mL/second (normal range > 15 mL/second). What is the probable diagnosis?