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Flashcards in Clin Assess Deck (58):
1

What is the dx: 18yo female wiyh breast lump. It is a round mass that is well-delineated and very mobile and non tender.

fibroadenoma

2

What is the dx: A 40yo female presents with a beast lump. It is soft and elastic and mobile. It is slightly tender.

breast cyst

3

What is the dx: Patient presents with breast lump. The mass is irregular and fixed and not clearly delineated.

Breast Cancer

4

What are common signs of breast cancer (7)

1. retraction signs
2. skin dimpliing
3. nipple retraction, deviation
4. edema of the skin (orange peel appearing)
5. Paget's disease
6. breast pain/discomfort
7. nipple discharge (galacorhhea)

5

What is a female patients lifetime risk of developing breast CA?

12% (1 in 8)

6

What are high risks for breast CA?

1. female
2. 65+
3. BRCA1/BRCA2
4. high breast tissue denisty
5. biopsy-confirmed atypical hyperlplsia

7

What are medium risks for breast CA?

1. 1+ first-degree relative with breast CA
2. high-dose radiation to chest
3. high bone density (post menopausal)

8

What are lower risks for breast CA?

1. late age first pregnancy (>30)
2. early menarche (55yp_
4. no full-term pregnancies
5. never breast fed
6. recent OCP use
7. recent long-term use of HRT
8. obesity (postmenopausal)

9

What are some breast cancer risk assessment tools? (3 models)

1. Gail model: best for infividuas over 50yo who have no family hx
2. Claus model: best used for indivuduals with no more than 2 first-degree relatives
3. BRCAPRO model: used for high risk womrn

10

Mammogram screening recommendations

1. 40-50yo: "individual decision"
2. 50-74yo: biennial
3. 75yo+: controversial

11

How often/when to do breast self-exams?

monthly, 5-7 days after onset of menses

12

Who should get a breast MRI?

young women at high risk for breast CA

13

What age do people generally get indirect hernias?

young people (but can be seen at any age)

14

What are clinical features of indirect hernias?

1. internal inguinal ring
2. often in scrotum (can hear bowel sounds)
3. cannot get finger above mass

15

Patient presents with hernia after lifting/straining. What is the most likely type of hernia?

Direct hernia

16

What are clinical features of direct hernias?

1. external inguinal ring
2. bulges anteriorly and pushes side of finger forward

17

What type of hernia is more associated with bowel movements?

femoral hernias

18

Male patient presents with YELLOW penile discharge. What is the most likely dx?

Gonorrhea

19

What color penile discharge is associated with chlamydia?

WHITE discharge

20

Male patient presents with palpable, nontender, hard plaques are found just beneath the skin. The patient complains of a crooked painful erection. What is the most likely?

Peyronie's disease

21

Male patient presents with indurated nodule or ulcer that is nontender?

carcinoma of the penis

22

Who is most at risk for developing penile CA?

UNCIRCUMCISED MEN!

23

Patient presents with scrotal swelling. The scrotum has pitting edema and the scrotal skin is taut (pulled tight)

scrotal edema

24

Patient presents with nontender, fluid-filled testicular mass. The scrotum transilluminates and you are able to palpate above the mass

Hydrocele

25

What is cryptochidism?

No palpable testies, unfilled scortum due to atrophied testis.

26

What are people with cryptochidim at high risk for?

testicular CA

27

A non-immunized male presents with an acutely inflamed, painful, tender swollen testicle. What is the most likely dx?

orchitis from UMPS!

28

Patient presents with a painless, movable cytic mass just above the testis. It transilluminates. What are the most likely dx?

Spermatocele and cyst of epididymis

29

Patient presents with tender, swollen testicle that is difficult to distinguish from the testis.

Acute epididymitis

30

What is the most common cause of epididmytiis?

chlamydia!

31

Patient presents with scrotum that feels like a "bag of worms"

varicocele

32

What side is varicoele usually found on?

left side

33

When is a self-testicular exam best performed?

after a warm bath or shower

34

What are causes of primary dysmenorrhea?

Increased prostaglandin production during luteal phase

35

What are secondary causes of dysmenorrhea?

1. endometriosis
2. adenomyosis
3. PID
4. endometrial polyps

36

How do you define polymenorrhea?

less than 21-day intercal between menses

37

What labs should you order to determine the cause of amenorrhea?

1. hcg
2. prolactin/FSH/LH
3. TSH

38

What does the G stand for (in gravida para)?

total number of pregnancies

39

What does the P stand for?

number of delivered pregnancies

40

What does the F stand for?

number of full-term pregnancies

41

What does the P stand for?

premature deliveries

42

What does the A stand for?

abortions

43

What does the L stand for?

number of living children

44

What are the 3 signs of ovarian CA?

1. abdominal distention
2. abdominal bloating
3. urinary frequency

45

What are risk factors for ovarian CA?

1. family history
2. BRCA1/2

46

Elderly woman with ulcerated or raised red vulvular lesion

vulvular CA

47

Patient with yellow/green FROTHY vaginal discharge

trichomoniasis

48

What presents as a cauliflower like growth on cervix?

cervical CA

49

On exam you feel a firm, irregular nodule in continuity with uterine surface

uterine fibroid

50

What frequency should prenatal visits be?

1. 1st visit at 8 weeks
2. 8-28 weeks: every 4 weeks
3. 28-36 weeks: every 2 weeks
4. 36wks-delivery: weekly

51

When can the FHR first be heard?

10 weeks

52

What is chadwicks sign?

bluish discoloration of cervix due to increased blood flow

53

What labs should be ordered at first prenatal visit?

1. STI (gonorrhea, chlamydia, HIV, syphilis, Hep B)
2. PAP (only if indicated)
3. genetic screening
4. CBC
5. blood type, Rh
6. Rubella, varicella immunity
7. UC
8. TSH
9. TRANSVAGINAL US

54

What labs do you do at second trimester prenatal visit?

1. 1hr glucose (24-28 weeks)
2. CBC (hbg, platelets)
3. Rhogam if Rh negative
4. US (check anatomy

55

What labs do you want to order during the third trimester?

1. group B strep (36 weeks)
2. Hbg (36 weeks)

56

When should you start feeling fetal movement?

1. quickening 18-22 weeks
2. external palpation: 24 weeks

57

How do you estimate a womens due date?

1. crown to rump via transvaginal US
2. count back 3 months from LMP and add 7 days

58

What are the 4 cervical changes?

1. dilation
2. effacement
3. position
4. consistency