Exam 1 Flashcards
(97 cards)
1
Q
Puberty age
A
8-13
2
Q
Lactating engorgement
A
First 24-48 hours
3
Q
4 positions for inspecting breasts seated
A
Arms at side
Arms overhead
Arms on hips with shoulders forward
Leaning forward at waist
4
Q
Areolae changes in pregnancy
A
Darker brown
5
Q
Best time for palpation of breasts
A
A week after their menstrual cycle
6
Q
Do you routinely check for nipple discharge?
A
No
7
Q
Tenderness on palpation of breasts
A
Cyst, inflammation, infection
8
Q
Cords on breast palpation
A
Mammary duct ectasia
Tender cords may have mass as well
9
Q
Describe mastectomy exam
A
2 fingers palpate scar
2-3 finger chest wall sweep
Lymph node exam
10
Q
Age of breast cancer
A
80% of breast cancers are over the age of 50
11
Q
Fibrocystic changes
A
Bilateral Multiple or single Round Soft-firm Mobile No retraction Tender Varies with menses Well delineated
12
Q
Fibroadenoma
A
Usually bilateral Usually single Firm and rubbery Mobile Non tender Well delineated No variation with menses
13
Q
Breast cancer characteristics
A
Single Irregular, stellate Hard, stone Fixed Retraction Non tender Irregular Peau d'orange
14
Q
Breast cancer risk factors
A
>50 age Female Hx of breast CA and family hx Early menarche or late menopause Alcohol, obesity Nulliparity First child after 30 years old Dense breast tissue Caucasian
15
Q
Galactorrhea
A
Increased prolactin, multiductal, serous or milky discharge
16
Q
Mammary duct ectasia
A
Subareolar ducts dilated or blocked, common in menopausal women, green/brown/sticky discharge
May or may not have a mass behind the nipple or. Retraction of nipple
17
Q
Intraductal papillomas
A
Wartlike tumor, unilateral, single duct, serous or bloody discharge
18
Q
Pagets disease
A
Ductal carcinoma manifested with malignant epithelial cells
Crusted nipple, watery discharge
Unilateral or bilateral
Red, scaling, does not respond to steroids
19
Q
Mastitis
A
Staph aureus
MCC lactating women 2-3 weeks post partum
Swelling, tenderness, erythema, warm to touch, hard mass, purulent discharge
Sudden onset, fever/chills, could form an abscess
20
Q
Gynecomastia
A
Imbalance of estrogens and androgens in male breast, unilateral or bilateral, usually nontender
21
Q
Menarche begins
A
11-14 years of age
22
Q
Size of uterus at 20 week pregnancy
A
Umbilicus
23
Q
12 week pregnancy size of uterus
A
At symphysis pubis
24
Q
GTPAL
A
Gravida Term birth Pre term births Abortion/miscarriage Living children
25
Clitoris size
2 cm x .5 cm
26
Car uncle
Buldge in the urethra
27
Skene glands
Outward on either side of the urethra at the top of the vagina
28
Bartholin glands
Bilaterally palpate entire labial area with focus on posterolateral portion
29
Which patients do you assess muscle tone in for females?
Women who have had children, concerned about weak muscles or urinary incontinence
30
Lubricant for speculum
Usually water or only a scant amount because it could interfere with a sample
31
Inserting speculum
Oblique or downward slope
Insert length of canal along posterior wall, then rotate horizontal
THEN open blades and move speculum upward to visualize cervi
32
Cervix color
Pink, possible blue hue with pregnancy
33
Symmetrical red area around so
Exposed columnar epithelium
34
Anterior cervic
Retroverted uterus
35
Posterior cervix
Anteverted uterus
36
Horizontal cervix
Midposition uterus
37
Normal nulliparous cervix
Round or oval
38
Normal parous cervix
Slit like
39
Nabothian cysts
Within expected findings on cervix, can become infected
40
Papsmere best results
Not mentruating
Avoid intercourse or douching 24-48 hours before
41
Performing papsmere
Insert into os, circular clock and counterclockwise to include squamocolumnar junction
42
Wet mount
Sample of vaginal discharge, place on slide and add saline
Look under microscope for trichomoniasis or clue cells
43
KOH/whiff test
Add drop of 10% KOH to vaginal discharge sample then cover slip, looking for hyphae or budding yeast cells
Whiff- positive with fishy odor for bacterial vaginosis
44
Rugated vaginal walls
Premenopausal
45
Smooth vaginal walls
Postmenopausal
46
Cystocele
Protrusion of the bladder into the vaginal wall
47
Bimanual exam
Index and middle finger in the vagina, locate cervix, CMT
48
Anteverted or anteflexed bimanual palpation
Internal hand push inward and upward, and downward on cervix
49
Retroverted or retroflexed exam
Internal hand in posterior fornix push inward on cervix
50
Uterus size
5.5 to 8 cm long, nulliparous, pear shaped
Should be mobile
51
Ovaries on exam
3x2x1 cm, slight tenderness, firm and smooth
52
Rectovaginal exam
Index finger in vagina and middle finger in rectum, can re evaluate adnexa and uterus and perform stool eval
53
Infant exam
Hymen, .5 cm opening
Mucoid discharge up to 4 weeks after birth
Swelling of labia
Adhesions of labia minors
54
Hysterectomy exam
Vaginal cuff scar as white or pink line, may Pap smear here if needed
55
PMS
Bloating, weight gain, headache, breast swelling, mood swings, cravings all 5-7 days prior to mensstruation
56
Ectopic pregnancy
Can be life threatening
Classic triad: vaginal bleeding, amenorrhea, abdominal pain
Pain on one side, could rupture
CMT, if abdominal can feel fetal movements
57
Sites for ectopic pregnancy
80% ampullary, 12% isthmic
Both in the Fallopian tube, amupllary is closer to the ovary and isthmic is a little farther away
58
Ovarian cysts
Could be asymptomatic
Hx of irregular menses, pain with intercourse
Sudden acute sharp pain could be rupture, peritoneal signs
Could cause torsion
59
Polycystic ovarian syndrome
Hirsutism, infertility, oligomenorrhea, obesity, late onset acne with polycystic ovaries
60
Endometriosis
Painfula nd heavy periods, pain with sex, associated with infertility in 30-40% of patients
Laparoscopic diagnosis
61
Uterine prolapse
Three degrees, complains of heaviness in pelvis or tissue protruding through vagina
62
Myomas
Can effect bowel and urination patters if large enough
Heavy menses
Pelvic discomfort
Irregular nodules on uterus
63
Ovarian cancer
40 years old, nulliparous, endometriosis, white
64
Ovarian cancer signs and symptoms
Abnormal vaginal bleeding, back pain, bloating, vague GI concerns over 40, enlarged ovary
65
Endometrial/uterine carcinoma
Adenocarcinoma
Post menopausal 75%
Bleeding post menopausal #1 symptom, need endometrial biopsy
66
Cervical cancer
Squamous cell carcinoma
HPV associated! 80% of women HPV infected by age 50
Multiple sexual partners, OCP for >5 years
Abnormal bleeding and ulcerations on cervix
67
Medications that make it difficult to maintain erection
Opioids, benzo's, beta blockers, h2 inhibitors
68
5 p's
Partners, practices, protection from STIs, past history of STIs, prevention of pregnancy
69
Beginning sign of sexual development for a male
2.5cm teste and pubic hair stage 2
70
Phimosis
Unable to retract the foreskin
71
Paraphimosis
Cannot replace the foreskin after retracting it
72
Smegma
Dead skin cells, will be around the foreskin and under the penis, this is a normal finding
73
Balantitis
Inflammation of the penis
74
Balanoposthitis
Inflammation including the glans penis
75
Hypospadias
Congenital ventral discplacement of the urethral meatus
76
Urethral meatus stenosis
Narrowing of urethral opening, appearing more rounded than slit
Upward stream, difficulty with aim
77
Priapism
Sustained erection that cannot go away
Consider leukemia or sickle cell, possible medication use
78
Peyronia disease
Shaft that is curved, typically from trauma
79
Chordee
Curved shaft that is congenital
Associated with hypospadias
80
Penile carcinoma
Unsealing ulcerations, more common in uncircumcised
Glans or foreskin, most often squamous cell
81
Which testicle is typically lower hanging?
Left
82
Hydrocele
Usually anteriolateral testicle
Trans illuminates
83
Spermatocele
Painless fluid filled benign cyst
Smooth firm lump felt on top of testicle (head of epididymis)
84
Varicocele
Enlargement of papminiform venous plexus, heavy achy pain
Bag of worms
85
Scrotal hernia
Large mass that reduces when patient lies down
86
Cryptorchidism
Undescended testicle
87
Where is the epididymis
Posterolateral surface of testes
88
Epididymitis
Pain and swelling, erythema and warm to touch
Bacterial infection MCC
89
Testicular carcinoma
Painless mass, possible enlargement of testicle or inguinal LAD
Maybe hydrocele
90
Testicular torsion
Painful, acute swelling or discoloration
Adolescents commonly
NO cremasteric reflex noted
91
Orchitis
Swelling of testicle, heavy and painful
Associated with epididymitis
92
Indirect hernia
Most common, maybe bilateral and may progress to scrotum
Feel buldge at the tip of the finger in examination, pain with straining
Less likely to reoccur
93
Direct hernia
Less common
Enters through hesselbach triangle and pushes on side of finger on exam
Painless, rarely enters scrotum
More likely to reoccur, buldge appears the same after reduction
94
Femoral hernia
More common in females but overall uncommon
Through femoral ring
May have significant pain and strangulation
95
Incarcertaed hernia
Cannot be reduced
96
Strangulated hernia
Blood supply is compromised secondary to incarceration
Urgent!
97
Foreskin retraction age
Partial to urinate but not fully until 3-4 years old
