Patient Note — 221619

4/14/26, 11:03 AM Print Preview [PATIENT_NAME] DOB: [DOB] (76 yo M) Acc No. [ACCOUNT_ID] DOS: 04/14/2026 Progress Notes Patient: [PATIENT_NAME] Provider: Pratik S. Desai, MD Account: [ACCOUNT_ID]: [ACCOUNT_ID] DOB: [DOB] Age: 76 Y Sex: Male Date: 04/14/2026 Phone: [PHONE] Address: [ADDRESS], ALEXANDRIA, VA-[ZIP] Pcp: [PATIENT_NAME] Structured Data: How did you hear about us? : Other; Patient's temperature : 0 Subjective: Chief Complaints: 1. 7 WK F/U PSA/PET SCAN. HPI: Prostate Cancer: 76yM with hx of prostate cancer s/p cryotherapy in 2021 (Dr Jeff Pan) presents for PSA and PET scan review. ----------------------------------------------- PSA: 12.7 (March 2026), 12.3 (Feb 2026), 96.4 (2018) PET CT: An enlarged L internal iliac lymph node shows moderate increased radiotracer accumulation and is highly suspicious for metastatic prostate carcinoma. (April 2026) He had biopsy in 2018 at Kaiser that was neg. Daughter believes in had a biopsy with Dr. Jeff Pan in 2021. MRI Pelvis: 5/26/25 which showed stable small bone lesions in right medial iliac bone and left femoral intertrochanteric region compatible with benign fibro-osseous lesions which have been stable for 2 yrs. MRI of prostate(5/20/25) showed no evidence of clinically significant/high risk prostate cancer. Prostate vol was 19 cc. Indeterminate 0.9 cm short axis node in left obturator region. Unchanged since prior CT scan. BPH: also with hx of BPH and urinary retention. He is stabilized on tamsulosin. . Frequency associated with fluid intake. Nocturia x1, Flow is good. No urgency, leakage, dysuria or GH -------------------------------------- Urocuff : Pcuffint 76 and Qmax 7.6 PVR; 28 and voided volume 80. Erectile Dysfunction screening: also w/ ED, on Tadalfil 20MG with poor efficacy. Medical History: Hypertension, High Cholesterol. Hospitalization/Major Diagnostic Procedure: fever 04/02/2023. Family History: Father: unknown. Mother: unknown. Screening: Social History: Smoking: no Are you a: nonsmoker Provider: Pratik S. Desai, MD Date: 04/14/2026 1/3 4/14/26, 11:03 AM Print Preview [PATIENT_NAME] DOB: [DOB] (76 yo M) Acc No. [ACCOUNT_ID] DOS: 04/14/2026 Recreational drug use: no. Caffeine: no. Medications: Taking Vitamin D , Taking Olmesartan Medoxomil 5 MG Tablet 1 tablet Orally Once a day , Taking Metoprolol Succinate 25 MG Capsule ER 24 Hour Sprinkle 1 capsule Orally Once a day , Taking Tamsulosin HCl 0.4 MG Capsule 1 cap(s) orally once a day , Taking Atorvastatin Calcium 10 MG Tablet 1 tablet Orally Once a day , Taking NIFEdipine ER Osmotic Release 60 MG Tablet Extended Release 24 Hour Oral , Taking Dapagliflozin Propanediol 10 MG Tablet Oral , Medication List reviewed and reconciled with the patient Allergies: N.K.D.A. Objective: Vitals: Assessment: Assessment: 1. Prostate cancer - C61 (Primary) 2. Benign prostatic hyperplasia with lower urinary tract symptoms - N40.1 3. Erectile dysfunction due to diseases classified elsewhere - N52.1 4. Urinary retention - R33.9 Plan: Treatment: 1. P