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 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?
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 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 30-year-old man comes to the clinic with a testicular lump that has been present for a few weeks and is gradually getting bigger. He has no history of trauma and is not experiencing any other symptoms. He has no significant medical history or regular medications. During the examination, a solid 3 cm mass is found in the left testicle, along with widespread lymphadenopathy. The following are his blood test results:
Alpha-fetoprotein (αFP): 0.1 ng/ml (0-10 ng/ml)
Beta-human chorionic gonadotrophin (βHCG): 4,500 IU/l
Lactate dehydrogenase (LDH): 375 IU/l
What is the most probable diagnosis?
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?
A 28-year-old man and his 26-year-old wife visit their GP for a follow-up appointment regarding their difficulty in conceiving. The couple has been trying to conceive for the past year without success. The wife has a regular menstrual cycle and no previous gynaecological issues. An ovulation test measuring her progesterone level showed normal ovulation. The GP advises the couple that the husband needs to undergo tests to determine if there is any cause on his side contributing to the infertility. Both the man and the woman have no history of sexually transmitted infections. The man has been smoking one to two cigarettes a day since he was 16 years old. What is the best next investigation for this patient?
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?
A 15-year-old presents with a tender, pea-sized lump in the upper pole of his left testis. He says it has developed gradually over the last 24 hours. His mum states that his grandfather died of testicular cancer at just 45 years of age. Other than pain from the lump, he says he feels generally well in himself. On examination, the lump does not transilluminate and feels regular. There is no associated oedema or erythema.
What is the most likely diagnosis?
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?