Prostate cancer Quiz: Ace Your Exams
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A 71-year-old man comes to the office because of progressive lower back pain for the past 4 months. The pain is relatively constant, non-radiating, aching and interferes with his sleep at night. It is not relieved by rest or change in position. He also reports feeling tired all day and not being able to get out of bed without help. He has smoked a pack of cigarettes daily for 35 years. Vitals are within normal limits. Physical examination shows point tenderness at the level of L4-L5 vertebrae. Forward flexion does not alleviate the pain. A hard lump is palpated on digital rectal examination. Hemoglobin is 9.8 g/dL, and leukocyte count is 10,000/mm3. Serum chemistry is shown below:
Serum prostate specific antigen is 15 ng/mL. Further evaluation of this patient will show which of the following?
| Laboratory value | Result |
| Serum chemistry | |
| Sodium | 139 mEq/L |
| Potassium | 3.5 mEq/L |
| Chloride | 95 mEq/L |
| Calcium, serum | 9.2 mg/dL |
| Erythrocyte sedimentation rate (ESR) | 7 mm/hr |
| Creatinine | 1.1 g/dL |
| Alkaline phosphatase | 157 U/L |
Serum prostate specific antigen is 15 ng/mL. Further evaluation of this patient will show which of the following?
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