Exam 4

Question 1

this type of breast discharge may be bloody, unilateral, spontaneous, and associated with a mass

Answer 1

pathologic

Question 2

this type of breast discharge may be normal or exhibited after chest wall stimulation

Answer 2

physiologic

Question 3

list mammography recommendations

Answer 3

50-74- every 2 years
<50- individualized
>74- no evidence of benefits

Question 4

list 4 views of the breast examination

Answer 4

1- arms up
2- arms down
3- arms on hips
4- leaning forward

Question 5

this term refers to extra nipples

Answer 5

extranumerary/ supernumerary nipples

Question 6

what quadrant is breast cancer MC in?

Answer 6

upper outer quadrant

Question 7

what lymph nodes are most likely to be palpable on exam?

Answer 7

central nodes

Question 8

what 3 structures make up the pelvic floor?

Answer 8

levator ani
coccygeus muscles
perineal membrane

Question 9

this type of amenorrhea is absence of periods, including menarche

Answer 9

primary

Question 10

this type of amenorrhea is absence of periods after menarche

Answer 10

secondary

may be due to- pregnancy, lactation, low body weight, ovarian dysfunction

Question 11

this is pain with menses

Answer 11

dysmenorrhea

Question 12

this type of dysmenorrhea is due to increased prostaglandin production during the luteal phase

Answer 12

primary

Question 13

this type of dysmenorrhea is due to endometriosis, adenomyosis, PID or endometrial polyps

Answer 13

secondary

Question 13

what are 3 diagnostic features of PMS?

Answer 13

1- s/s in 5 days prior to menses for at least 3 consecutive cycles
2- cessation of s/s within 4 days after onset of menses
3- interference with ADL

Question 14

this refers to less than 21 days between menses

Answer 14

polymenorrhea

Question 15

this refers to infrequent bleeding

Answer 15

oligomenorrhea

Question 16

this refers to excessive flow of bleeding

Answer 16

menorrhagia

Question 17

this refers to intermenstural bleeding

Answer 17

metrorrhagia

Question 18

this is bleeding after sex and may indicate cervical polyps or cancer

Answer 18

postcoital bleeding

Question 19

classification of menopause

Answer 19

absence of menses for 12 consecutive months

Question 20

true or false- postmenopausal bleeding is cancer until proven otherwise

Answer 20

true

Question 21

tanner scale stage 1

Answer 21

no breast tissue
no pubic hair

Question 22

tanner scale stage 2

Answer 22

breast buds
long pigmented hair along labia majora

Question 23

tanner scale stage 3

Answer 23

enlargement of breast and areola w/o separation
darkening and coarsening of hair which extends up and laterally

Question 24

tanner scale stage 4

Answer 24

areola and nipple form mound atop breast tissue hair of adult consistency limited to mons

Question 25

tanner scale stage 5

Answer 25

adult configuration with smooth contour hair spreads to medial aspect of thigh

Question 26

number of times woman has been pregnant

Answer 26

gravida

Question 27

this refers to a woman who has never been pregnant

Answer 27

nulligravida

Question 28

this refers to a woman who is pregnant for the first time or has been pregnant once

Answer 28

primigravida

Question 29

this refers to a woman who has been pregnant more than 1 time

Answer 29

multigravida

Question 30

what are 4 further things to inquire about in a gravida woman?

Answer 30

term, premature, abortions, and living children

Question 31

if a fetus is aborted after 20 wks, it's counted as a ______ birth

Answer 31

premature

Question 32

this refers to the number of pregnancies reaching a viable gestational age, live and stillbirths included

Answer 32

para

Question 33

this is the number of pregnancies lost for any reason

Answer 33

abortus

Question 34

are stillbirths counted in abortus or para?

Answer 34

para

Question 35

this type of pelvic pain elicits immediate attention in menstruating women

Answer 35

acute

Question 36

this type of pelvic pain lasts more than 6 mo and doesn't respond to treatment

Answer 36

chronic

Question 37

what type of pelvic pain may be indicative of ectopic pregnancy, ovarian torsion, PID or appendicitis

Answer 37

acute

Question 38

what type of pelvic pain may indicate sexual abuse, adenomyosis or fibroids?

Answer 38

chronic

Question 39

tenderness upon palpation of the fornices may indicate what?

Answer 39

endometriosis

Question 40

tenderness upon palpation and movement of the cervix may indicate what?

Answer 40

PID, ectopic pregnancy, appendicits

Question 41

list at least 3 RFs for HPV

Answer 41

multiple sexual partners inadequate pap smears long term use of oral contraceptives more than 3 full term pregnancies coinfection with chlamydia tobacco use

Question 42

what 2 types of HPV are associated with genital warts?

Answer 42

6 and 11

Question 43

what 2 types of HPV are found in almost all cervical cancers?

Answer 43

16 and 18

Question 44

list HPV vaccine recommendations

Answer 44

<15- 2 doses within 6-12 mo 15-26 and immunocompromised 9-26- 0, 1, 2, 6 mo 27-45- discuss with pts who were not adequately vaccinated

Question 45

list 3 factors for women at average risk of cervical cancer

Answer 45

no hx of high-grade precancerous cervical lesion not immunocompromised no in utero exposure to DES

Question 46

list cervical screening guidelines

Answer 46

21-29- screen q 3 yrs with cytology 30-60 * q 3 yrs with cytology * q 5 yrs w/ HPV testing for high risk types * q 5 yrs with both tests

Question 47

list 3 contraindications to cervical cancer screening

Answer 47

<21 >65 w/ adequate previous screening hysterectomy with removal of cervix

Question 48

list 3 s/s of ovarian cancer

Answer 48

1- abd distension 2- abd bloating 3- urinary frequency

Question 49

this may accumulate under foreskin

Answer 49

smegma

Question 50

this is a tight prepuce that can't be retracted over the glans

Answer 50

phimosis

Question 51

this is a tight prepuce that can't be returned once retracted

Answer 51

paraphimosis

Question 52

this is inflammation of the glans

Answer 52

balantitis

Question 53

what is hypospadias?

Answer 53

congenital ventral (inferior surface of penis) displacement of urethral meatus

Question 54

what is epispadias?

Answer 54

congenital dorsal displacement of the urethral meatus

Question 55

this disease occurs when fibrous scar tissue develops on penis and causes curved, painful erections

Answer 55

Peyronie's disease

Question 56

suspect this condition with acute pain and swelling of the testis/ scrotum and loss of cremasteric reflex

Answer 56

testicular torsion

Question 57

this occurs when fluid collects in the tunica vaginalis in the scrotum--> transillumination

Answer 57

hydrocele

Question 58

this is enlargment of the veins within the scrotum

Answer 58

varicocele

Question 59

this is a painless moveable mass above the testis that transilluminates

Answer 59

spermatocele and cyst of the epididymis

Question 60

this type of hernia typically occurs in men and presents as a bulge near the external ring

Answer 60

direct inguinal hernia

Question 61

this type of hernia presents as a bulge near the internal ring and may go down through the inguinal canal

Answer 61

indirect inguinal hernia

Question 62

this type of hernia occurs below the inguinal ligament

Answer 62

femoral hernia

Question 63

scrotal hernias are typically a result of ________ hernias

Answer 63

indirect

Question 64

this is an undescended testis

Answer 64

cryptochidism

Question 65

what factors are investigated in BPH score?

Answer 65

incomplete urinary emptying frequency intermittency urgency weak stream straining nocturia

Question 66

this type of hemorrhoid originates below the pectinate line and is covered with skin

Answer 66

external

Question 67

this type of hemorrhoid is enlargement of normal vascular cushions above the pectinate line

Answer 67

internal