Prostate

Question 0

Rectum is ____ to the prostate

Answer 0

Posterior

Question 1

What 4 factors assoc with inc PSA (prostate specific antigen)

Answer 1

Patient age
Prostate volume inc
Benign prostatic hyperplasia
Prostate cancer

Question 2

Zone most likely involved with cancer

Answer 2

Peripheral zone

70%, Cancer is hypo peripherally oriented lesion

Question 3

BPH is in what zone

Answer 3

Transitional zone

Question 4

Trans rectal US image patient position

Answer 4

LLD

Question 5

Lab test for prostate cancer

Answer 5

PSA prostate specific antigen

Question 6

MC symptoms of Prostatism

Answer 6

Difficult initiation of voiding
Nocturia
Small stream

Question 7

Indication for transrectal

Answer 7

Abnl digital rectal exam
Abnl lab indicating prostate cancer
Guidance for biopsy
Monitor prostate cancer treatment

Question 8

Color Doppler in transrectal exam

Answer 8

Allows improved perception of pathologic vessels assoc with cancer

Question 9

US appearance of prostate cancer

Answer 9

Hypo, hyper, Iso lesions

Question 10

Patient prep for transrectal biopsy

Answer 10

A cleansing enema immediately prior to exam and antibiotics given before and after exam.

Question 11

Prostate gland anatomic classification used

Answer 11

Zonal anatomy

Question 12

The prostaticovesical arteries that supply prostate are branches off the

Answer 12

Internal iliac arteries

Question 13

Display of prostate with transrectal US

Answer 13

The rectum is shown at the bottom of the screen

Question 14

Transrectal prostate sag plane. The most lateral images of the gland show

Answer 14

The peripheral zone

Question 15

Frequency for transrectal imaging

Answer 15

7-8MHz

Question 16

Seminal vesicles in transrectal US looks

Answer 16

Hypoechoic, symmetrical, irregular shape

Question 17

US appearance of BPH

Answer 17

Enlarged prostate gland, focal or diffuse

Question 18

Cyst associated with infertility

Answer 18

Ejaculatory duct cyst

Question 19

Acute prostatitis with an anechoic mass

Answer 19

abscess

Question 20

4 zones of Prostate

Answer 20

Peripheral zone (prostate cancer)
Transitional zone (BPH)
Central zone
Fibromuscular stroma (nonglandular region)

Question 21

What area in the prostate Is not affected by cancer

Answer 21

Fibromuscular stroma

Not affected by cancer, prostatitis, or hyperplasia

Question 22

Fibromuscular Stroma

Answer 22

Non glandular anterior part of prostate. Not affected by cancer, prostatitis, or hyperplasia.

Question 23

Benign Prostatic Hyperplasia (BPH)

Answer 23

Enlargement of inner prostate gland. Hypo to peripheral zone.
95% in transitional zone
Originates from inner gland

Question 24

Ejaculatory ducts pass through ___ and empty into urethra

Answer 24

The central zone

Question 25

Seminal vesicles are 2 sac-like out pouchings of the vas deferans situated adj to the ____ aspect of the prostate between the urinary bladder and rectum

Answer 25

Superior / posterior

Question 26

The base of the prostate is the ____ part of the gland

Answer 26

Superior

Question 27

The apex of the prostate is the __ part of the gland

Answer 27

Inferior

Question 28

The demarcation between the inner gland and the outer gland is called the

Answer 28

Surgical capsule

Question 29

The prostate is situated in the retroperitoneum and is bordered ant by _____, post by _____, sup by _____, and inf by ______

Answer 29

Ant by the pubic bone Post by the rectum Sup by the urinary bladder Inf by the urogenital diaphragm

Question 30

Prostate-Specific Antigen PSA

Answer 30

Produced by prostate acinar cells. Rises in relationship to the amount of tissue (benign or malignant) Rises with patient age, prostate volume, BPH, and prostate cancer PSA rises 10 times more in cancer than BPH 1.5-4 ng/mL inc risk cancer Black, old men, fam hx, prior disease, prior prostate bx

Question 31

Fibromuscular stroma is ___ to prostate

Answer 31

Anterior

Question 32

Denovilliers fascia is located ___ to the prostate

Answer 32

Posterior

Question 33

When see a solid testicular mass evaluate

Answer 33

Periaortic region for lymphadenopathy

Question 34

Function

Answer 34

Fluid transport for sperm mobility

Question 35

Prostate size

Answer 35

Oval/cone shape Walnut size 4 x 3.8 x 3 cm Base (sup) Apex (inf)

Question 36

Prostate Cancer

Answer 36

MC cancer in men | 2nd cancer death after lung

Question 37

Vasectomy

Answer 37

Remove vas deferens

Question 38

Blood supply

Answer 38

Internal iliacs art and vein

Question 39

Surgical capsule

Answer 39

Boundary between central and peripheral zones

Question 40

Patient prep

Answer 40

Cleansing enema | Urethra is in center of prostate

Question 41

Cysts

Answer 41

Müllerian duct cysts: MC pelvic cyst, above base of gland. Connect to prostate by stalk. May have cancer. Utricle cysts: midline close to verumontanum. Assoc with hypospadias (urethra under penis). May have cancer. Seminal vesicle cyst: assoc with ipsilateral renal agenesis. Sup to prostate. Prostatic cyst: congenital/acquired. Lat to prostate. Ejaculatory Duct cyst

Question 42

BPH

Answer 42

MC prostate disease 90% of males over 80 yrs 95% in transition zone Bladder outlet obstruction, hesitancy, dribbling, urine retention, nocturia Hypo/hyper hetero/homo well defined. May compress central and peripheral zone.

Question 43

Calculi

Answer 43

2nd to prostatitis, BPH, urine, ca+ of corpora amylacea Incidental finding Ejaculatory duct Ca+ Periuretheral duct Ca+

Question 44

Prostatitis

Answer 44

Inflammation of prostate forms in acinar prostate primarily in peripheral zone Fever chills discomfort when void. Low back pain. Painful perineum/rectum Hard swollen tender prostate Acute: hypo rim surrounding periuretheral tissue. Hetero. Chronic: diffuse/focal hetero, focal hypo, abscess, ca+ Granulomatous prostatitis

Question 45

Prostate Cancer

Answer 45

``` Most common cancer in men. MC adenocarcinoma > 50 yrs Develops in acinar tissue 80% in peripheral gland. ``` 2nd MC cause of cancer death besides lungs Fam hx, hormone, age, environmental Micrurition, uremia, weak stream, bone pain, weak, obstruction, urgency, change in bowel habits, wt loss. Hypo peripheral lesion with poor margins. Hyper-Iso. Asymmetry. Ca+. Inc color. Hypervascular Prostatectomy

Question 46

Prostatic acid phosphatase PAP

Answer 46

Not 100% specific for cancer | Dx with biopsy/excision/surgery

Question 47

Largest zone

Answer 47

Peripheral