Check out today’s Step 2 CK Qmax Question Challenge.
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A 56-year-old man with erectile dysfunction and hypertension presents to his doctor with aching low back pain. He says that the back pain has grown in intensity over the past 2 months and is now a 7 of 10 in intensity. The patient denies any back trauma or recent heavy lifting. He says the back pain does not radiate and is relatively constant in nature. His temperature is 37.2°C (98.9°F), heart rate is 100/min, respiratory rate is 14/min, and blood pressure is 140/80 mm Hg. On physical examination his back is atraumatic, and the pain does not increase in intensity with percussion or palpation of the lower back. There is no costovertebral angle tenderness. The patient’s laboratory values are significant for alkaline phosphatase of 800 U/L and prostate-specific antigen of 12 ng/mL (normal: 0-4 ng/mL).
Which of the following is the most likely location of the primary lesion?
A. Immature prostatic muscle cells
B. Lumbar vertebral body
C. Peripheral zone of the prostate
D. Seminal vesicle
E. Transition (periurethral) zone of the prostate
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