SAQ 928 – Urology – isolated ALP elevation and prostate bone metastases

A 67-year-old man with a urethral catheter in situ for 2 months, awaiting TURP, presents with a blocked catheter that has been changed. Routine pathology is shown below.

Result	Value	Reference range
Na	137	135-145
K	4.3	3.5-5.2
Cl	104	95-110
Bicarbonate	22	22-32
Urea	5.2	3-8
Creatinine	67	45-90
eGFR	94	>60
Bilirubin	5	3-20
Protein	68	60-80
Albumin	38	32-46
ALP	585	30-110
GGT	47	9-36
ALT	13	<55
AST	39	12-36

List two possible causes of the abnormal pathology result.

(Marked out of 2.0)

/ 2

List three further pathology tests you would perform and give the reasoning for each.

(Marked out of 6.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Test</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Clinical reasoning</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Test 1</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Test 2</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Test 3</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 6

List five malignancies that metastasise to bone.

(Marked out of 5.0)

/ 5

What type of bony metastases occurs in prostatic malignancy?

(Marked out of 1.0)

/ 1

Total Score: 0 / 14

Percentage: 0%