Step II Prostatitis Urine Sample: Mid vs Late?

[StrangerX]

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Did a UWORLD question where for prostatitis the answer was to culture midstream fluid rather than look at post-prostatic massage stuff. For the prostate wouldn't you want a late-stream as opposed to midstream sample though?

 

[evilbooyaa]

I remember that question. I don't know that there is a significant difference between middle and late-strem urine. I think as long as you remember that in prostatitis you're not supposed to 1) Massage the prostate and 2) Don't get an early catch urine, you know how much you need to.

That being said, a mid-stream sample is the best possible answer out of those 5 choices.

 

[StrangerX]

The midstream sample reflects the bladder environment while the late stream sample reflects the prostate environment. But yes out of the answers it was probably the best one.

 

[evilbooyaa]

The midstream sample reflects the bladder environment while the late stream sample reflects the prostate environment. But yes out of the answers it was probably the best one.

Did a quick google search and the only thing that came up was this thread. Never heard that tidbit of information. Would you mind citing your source?

 

[StrangerX]

I can't remember the exact source as I read it a long time ago but here is one source which discusses hematuria in different parts of the the urinary stream as it pertains to the parts of the urinary tract they reflect:

"When the blood in the urine is at the beginning of urination, it most likely comes from the urethra, (the tube from the bladder to the outside). Blood throughout urination is most likely from the bladder or kidneys or ureters (the tubes connecting the kidneys and the bladder). Blood at the end of your stream may be from the bladder or prostate (in men)."

http://www.uihealthcare.org/content.aspx?id=16040

 

[Omizzle]

I remember that question. I don't know that there is a significant difference between middle and late-strem urine. I think as long as you remember that in prostatitis you're not supposed to 1) Massage the prostate and 2) Don't get an early catch urine, you know how much you need to.

That being said, a mid-stream sample is the best possible answer out of those 5 choices.

I have also read that prostate massage should not be done. But in Kaplan highyield prep, Conrad says that it increases the yield of the urine culture. Do we have a definite answer?

 

[link2swim06]

I have also read that prostate massage should not be done. But in Kaplan highyield prep, Conrad says that it increases the yield of the urine culture. Do we have a definite answer?

Honestly we search for 'the correct answer' but honestly who knows what the nbme's opinion is on it. We have no idea how often their questions are updated. I doubt they check every question every week. That would not be feasible. Some questions/answers on step 2 are bound to be outdated and possible wrong.

 

[evilbooyaa]

I think the UWorld question's explanation of "Don't do a prostate massage as that may cause bacteremia" is a reasonable one.

If I had to pick between Fisher and UWorld, I'd probably go w/ UWorld.