On Digital Rectal Exam, You Note That a 45-Year-Old Patient

Multiple Choice

On digital rectal exam, you note that a 45-year-old patient has a firm, smooth, nontender but asymmetrically shaped prostate. The patient has no symptoms and a normal urinalysis. The patient's prostate specific antigen is within normal limits for the patient's age. The clinician should:

A) Refer the patient for transrectal ultrasound-guided prostate biopsy
B) Obtain an abdominal x-ray of kidneys, ureter, and bladder
C) Recognize this as a normal finding that requires periodic follow-up
D) Obtain urine culture and sensitivity for prostatitis