What is the significance of the PSA result?Discuss the aetiological factors relevant to this case.

A 70-year old man visits his GP complaining of feeling fatigued. During the consultation he mentions he has lost weight over the past 6 months despite having a relatively normal appetite.On further questioning the patient describes increasingly frequent urination, particularly at night, with some difficulty starting to urinate. He denies any pain at urination and has not noticed any sign of blood in his urine.He has no significant previous medical history.
Examination: GP requests urinalysis with culture and sensitivity, a blood test for PSA, and performs a digital rectal examination (DRE), which reveals firmness in one lobe of the prostate. PSA result is received several days later and is increased at 12 ng/ml, urinalysis reveals trace amounts of blood and protein, urine culture is negative.
The patient is referred to the urology clinic for transrectal prostate biopsies for histological examination.

Questions for discussion:
1). What is the significance of the PSA result?Discuss the aetiological factors relevant to this case.
2). Why are transrectal prostate biopsies the preferred method of tissue sampling prostate tissue? What regions of the prostate are most likely to be sampled and why?
3). What fixatives are most suitable for this tissue type? How long is required for adequate fixation of this tissue?
4). What histological features by Haematoxylin and Eosin (H and E) staining would suggest the presence of prostate cancer? How are these findings graded?

IN-TEXT AND HAVARD REFERENING
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Added on 18.11.2015 06:40
case study essay.
A 70-year old man visits his GP complaining of feeling fatigued. During the consultation he mentions he has lost weight over the past 6 months despite having a relatively normal appetite.On further questioning the patient describes increasingly frequent urination, particularly at night, with some difficulty starting to urinate. He denies any pain at urination and has not noticed any sign of blood in his urine.He has no significant previous medical history.
Examination: GP requests urinalysis with culture and sensitivity, a blood test for PSA, and performs a digital rectal examination (DRE), which reveals firmness in one lobe of the prostate. PSA result is received several days later and is increased at 12 ng/ml, urinalysis reveals trace amounts of blood and protein, urine culture is negative.
The patient is referred to the urology clinic for transrectal prostate biopsies for histological examination.

Questions for discussion:
1). What is the significance of the PSA result?Discuss the aetiological factors relevant to this case.
2). Why are transrectal prostate biopsies the preferred method of tissue sampling prostate tissue? What regions of the prostate are most likely to be sampled and why?
3). What fixatives are most suitable for this tissue type? How long is required for adequate fixation of this tissue?
4). What histological features by Haematoxylin and Eosin (H and E) staining would suggest the presence of prostate cancer? How are these findings graded?

IN-TEXT AND HAVARD REFERENING
sources can be up to 10 pls

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