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Internal Medicine · USMLE Step 2 CK

USMLE Step 2 CK Men's Health in Primary Care

Primary care men's health topics including prostate screening and hypogonadism, as tested on USMLE Step 2 CK.

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What is the most common cause of lower urinary tract symptoms in older men?
Benign prostatic hyperplasia (BPH)
What is the first-line medication class for symptomatic relief of BPH?
Alpha-1 blockers (e.g., tamsulosin)
What is the mechanism of action of 5-alpha-reductase inhibitors in BPH?
They block conversion of testosterone to dihydrotestosterone (DHT), shrinking the prostate
How does finasteride affect PSA levels?
It lowers PSA by about 50 percent
What is the surgical gold standard for BPH refractory to medical therapy?
Transurethral resection of the prostate (TURP)
What is a common side effect of alpha-1 blockers used for BPH?
Orthostatic hypotension
Acute urinary retention is a recognized complication of ____.
benign prostatic hyperplasia
What does the USPSTF recommend for PSA screening in men aged 55 to 69?
An individualized decision after shared decision-making with a clinician
What does the USPSTF recommend for PSA screening in men 70 and older?
Recommends against routine screening
What PSA level has historically been used as a cutoff to prompt further prostate cancer workup?
4.0 ng/mL
What digital rectal exam finding is suggestive of prostate cancer?
A firm, irregular nodule or area of induration
What is the definitive method to diagnose prostate cancer?
Transrectal ultrasound-guided prostate biopsy
What does the Gleason score grade?
The architectural pattern, or differentiation, of prostate cancer cells seen on biopsy
How is the Gleason score calculated?
By summing the grades of the two most prevalent tumor patterns on biopsy
How does a lower free PSA percentage affect prostate cancer risk?
A lower free PSA percentage is associated with a higher likelihood of prostate cancer

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