Rosh Internal Medicine Boost Practice Exam

Which physical exam finding might indicate an obstructive pattern in a male patient with lower urinary symptoms?

1. Raised prostate

2. Indurated prostate

3. Rubber consistency

4. Soft boggy prostate

The correct answer is: Rubber consistency

The presence of a rubber consistency in the prostate is indicative of an obstructive pattern in a male patient experiencing lower urinary symptoms. This finding is suggestive of benign prostatic hyperplasia (BPH), which is a common condition that can lead to urinary obstruction as the enlarged prostate compresses the urethra. When palpating the prostate during a physical examination, a prostate with a rubber-like consistency often reflects the firm, smooth enlargement typical of BPH, which can obstruct urinary flow and lead to symptoms such as hesitancy, weak stream, or frequency. Other prostate characteristics can provide different diagnostic insights. For instance, a raised prostate may indicate potential malignancy or tophaceous deposits but isn’t specifically characteristic of obstructive symptoms. An indurated prostate often raises suspicion for prostatic cancer, where hard lesions may be felt, and that does not typically suggest an obstructive pattern associated with benign conditions. A soft boggy prostate usually indicates prostatitis or inflammation, which presents differently on examination and may not correlate directly with a mechanical obstruction of urinary flow. Thus, the rubber consistency as a finding in the prostate aligns strongly with an obstructive pattern in patients suffering from lower urinary tract symptoms.