Examination

Question 1

What is the first thing you need to do in a vaginal examination

Answer 1

What’s your hands introduce yourself explain what you’re going to do ask for permission

Question 2

As part of wiper what extra questions do you need to include

Answer 2

Is there a possibility you could be pregnant would you like to you empty your bladder before we start

Question 3

You have just put your gloves on and the patient is in the correct position you are inspecting the outside of the vagina what do you need to comment on

Answer 3

Are there any scars erythema masses discharge bleeding rash or vesicles

Question 4

You have finished inspection no scars erythema massive discharge or bleeding how would you test for vaginal prolapse

Answer 4

Ask the patient to cough

Question 5

You have completed inspection and are about to insert a gloved finger into the vagina what should you do first

Answer 5

Insure a small amount of lubricant is on the finger to be inserted

Question 6

How should your hands be positioned for correct entry

Answer 6

Use your left hand to spread the labia majora and use your right hand to insert two fingers in a vertical orientation

Question 7

What are you feeling for

Answer 7

Masses

Question 8

How do you correctly perform a bimanual examination

Answer 8

Two fingers in inserted in the vertical orientation palpate the uterus then move your left hand which is palpating the uterus both left and right to check the ovaries whilst mirroring with your right hand

Question 9

When you have finished palpating for masses and palpated the adnexa see the uterus and the ovaries how should you withdraw your fingers

Answer 9

Slowly checking for blood or any abnormal discharge

Question 10

What is the end statement to make on to complete the vaginal examination you are presenting to a more senior doctor

Answer 10

To complete my examination I would go on to do a urine dip a pregnancy test a speculum exam swab and further imaging if required