Lesson 4A (Part 2)

Question 1

What is needed for a transabdominal US scan of the prostate?

Answer 1

A distended urinary bladder

Question 2

What is the frequency for a transabdominal US scan of the prostate?

Answer 2

3-5 MHz

• curved linear array
• vector array

Question 3

When is an endorectal scan of the prostate needed?

Answer 3

When high resolution is required

Question 4

What is the frequency for a endorectal US scan of the prostate?

Answer 4

5-9 MHz

- intracavity

Question 5

What are the clinical indications for a prostate gland? (12)

Answer 5

1. Urinary symptoms
2. Nocturia
3. Dysuria
4. Decrease force of urinary stream
5. Terminal dribble
6. Hematuria
   - infertility work-up
7. Hematospermia
8. Oligospermia
9. Abnormal biochemistry 10. Elevated PSA
10. Abnormal digital rectal exam
    - DRE
11. Pain
    - lower back
    - pelvis
    - upper thighs
    - perineum

Question 6

What is the normal appearance of the prostate?

Answer 6

Homogeneous

- uniform echo pattern

Question 7

What is the normal appearance of the seminal vesicles?

Answer 7

Hypoechoic compared to rest of prostate

Question 8

What is the normal appearance of the central and peripheral zone? (2)

Answer 8

1. Homogeneous
2. Hypoechoic
   - area in posterior prostate

Question 9

What is the normal appearance of the transition zone?

Answer 9

Moderately hypoechoic

Question 10

What are 5 endorectal indications for a prostate scan?

Answer 10

1. Elevated PSA levels
2. Palpable nodules
3. Biopsy guidance
4. Prostate abscess
5. Male infertility

Question 11

TRUS

Answer 11

Transrectal Ultrasound

Question 12

DRE

Answer 12

Digital rectal examination

Question 13

Digital rectal examination

Answer 13

A doctor inserts a lubricated, gloved finger into the rectum and feels the prostate`

Question 14

What can a DRE sometimes detect? (3)

Answer 14

1. An enlarged prostate
2. Lumps or nodules of prostate cancer
3. Tenderness from prostatitis

Question 15

PSA

Answer 15

Prostate specific antigen

Question 16

Prostate specific antigen

Answer 16

The prostate makes a protein called PSA, which can be measured by a blood test

Question 17

What does it mean if PSA is elevated?

Answer 17

Prostate cancer is more likely

- not confirmed though

Question 18

What does an enlarged prostate potentially indicate?

Answer 18

High PSA

Question 19

Prostate US (transrectal US)

Answer 19

An ultrasound probe is inserted into the rectum, bringing it close to the prostate

Question 20

What is often done with US to conform prostate cancer?

Answer 20

Biopsy

Question 21

Prostate biopsy

Answer 21

A needle is inserted into the prostate to take tissue out to check for prostate cancer
- this is usually done through the rectum

Question 22

What kind of test is done to rule out prostate cancer?

Answer 22

PSA

Question 23

What PSA levels are considered normal?

Answer 23

0-4

Question 24

What PSA levels are considered suspicious?

Answer 24

4-10

Question 25

What PSA levels are considered a possible indicator of prostate cancer?

Answer 25

Higher than 10

Question 26

What shape do the seminal vesicles demonstrate on US?

Answer 26

Bowtie sign

Question 27

What are other possible conditions the can cause a rise in PSA? (5)

Answer 27

1. A larger prostate
2. Prostate infection
   - prostatitis
3. Urinary tract infection
4. Recent tests on your bladder (cystoscopy) or prostate (biopsy)
5. Catheter tube recently placed into your bladder to drain urine

Question 28

What is seen in aging male prostates? (2)

Answer 28

1. Calcification

2. Chronic inflammation

Question 29

What can calcification be confused with on US?

Answer 29

The urethra