Female GU abnormals

Question 1

_______ areas can have epidermoid cysts, are these infectious?

Answer 1

glandular areas can have epidermoid cysts, not infectious

Question 2

what are the Bartholin’s glands? what if there is a cyst there?

Answer 2

located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina
- more likely an abscess there.

Question 3

HPV leads to _____ ________

secondary syphilis leads to _______ _______

Answer 3

HPV leads to condyloma acuminatum

Secondary syphilis leads to condyloma latum

Question 4

what is the vaginal introitus?

Answer 4

The vaginal introitus is the opening that leads to the vaginal canal

Question 5

types of sores: Herpes lesion is….

Syphilitic chancre is …..

Answer 5

Herpes lesion is painful, shallow, small, with red base

Syphilitic chancre is painless, firm

Question 6

vaginal cancer: Can be _______ or ______.

Answer 6

Can be ulcerated or raised; skin “looks different”. maybe outgrowths of irregular, cauliflower-like growths

Question 7

what should the cervix look like? what about the cells around the os ?

Answer 7

Color should be shiny pink; may still have columnar cells around os which will be darker red

Question 8

abnormal finding of cervix: cervicitis (caused by gonorrhea)

Answer 8

Look for mucopurulent yellow drainage from the os in cervicitis

Question 9

3 types of vaginitis discharge

Answer 9

Trichomonal vaginitis
Candidal vaginitis
Bacterial vaginitis

Question 10

if someone has a strawberry cervix and lots of frothy discharge?

Answer 10

trichomonas

Question 11

what will DM patients likely get?

Answer 11

candidiasis

Question 12

5 things to note about the cervix on bimanual exam

Answer 12

Position, Shape, Consistency, Regularity,

mobility- (should be mobile and nontender)

Question 13

two abnormal positions of the uterus

Answer 13

retroverted: angle between cervix and uterus is normal ( but TOGETHER is abnormal)
retroflexed: angle BETWEEN cervix and uterus is abnormal (wider) - uterus tipped back
- no problems with these, just congenital differences

Question 14

what does pedunculated mean?

Answer 14

pedunculated = has a stalk its hanging off of

Question 15

ovary, Hard to palpate so if you find one in a postmenopausal woman think _____

Answer 15

cancer

Question 16

May be able to palpate one in _____ ______ _____

Answer 16

thin relaxed women

Question 17

Palpate the adnexa for ______ or ______
Tenderness may be______, ______ or ______
often described as _____ in the adnexa

Answer 17

Palpate the adnexa for tenderness or masses
Tenderness may be infectious, ectopic pregnancy, or ovarian cyst
Oftentimes described as “fullness” in the adnexa

Question 18

what does adnexa mean?

Answer 18

the parts adjoining an organ.

Question 19

pelvic muscle strength: Weakness can be from….

Can also have tightening from ….

Answer 19

Weakness can be from aging, vaginal deliveries, neurologic conditions,
Can also have tightening from spasm of muscles

Question 20

rectovaginal exam to assess the posterior uterine wall for … (4)

Answer 20

To assess the posterior uterine wall…
Retroverted uterus
Cul-de-sac
Adnexa
Colorectal cancer in women 50 years or older
also endometriosis … (Airey didnt specifically say.. but talked about it when we talked about this exam)

Question 21

what is endometriosis?

Answer 21

can grow between uterus and anus: uterine tissue comes out of uterus and implants around abdominal cavity - reacts to hormones throughout menstrual cycle= painful , sex is painful, blood into abdomen with every period

Question 22

what is the most common type of hernia?

Answer 22

Indirect inguinal hernia : At or through the internal inguinal ring , Located above the inguinal ligament

Question 23

what is the second most common type of hernia? what it is hard to differentiate from?

Answer 23

femoral hernia: Hernia appears below the inguinal ligament, Hard to differentiate from lymph nodes

Question 24

inspection for a hernia: what two things do you look for? what do you ask the pt to do?

Answer 24

look for any asymmetry or bulges. Ask patient to bear down and look for any changes

Question 25

palpation for a hernia: Have patient stand in front of you ______ the index finger into the scrotum and palpate ... Ask patient to bear down checking for ... Palpate for femoral hernia by ...

Answer 25

Invaginate the index finger into the scrotum and palpate the external inguinal ring just lateral to the pubic tubercle Ask patient to bear down checking for any bulges or masses that are appreciated against the side of the finger or at the finger pad. Same with left side Palpate for femoral hernia by asking patient to bear down while palpating the femoral canal.

Question 26

possible scrotal hernia? what do you do? what do you look and listen for?

Answer 26

Ask patient to lay down look to see if mass retracts Listen for bowel sounds

Question 27

what is balanitis? what could this indicate that the patient has?

Answer 27

inflammation of the glans penis, pt might have DM

Question 28

phimosis vs paraphimosis

Answer 28

phimosis is when you can't retract the foreskin, paraphimosis is when the foreskin can't be replaced back over the glans (gets stuck behind it)

Question 29

hypospadias

Answer 29

urethra meatus is displaced

Question 30

Starts as a small red papule and becomes a painless erosion up to 2 cm in diameter; base is clean, red, smooth, and glistening with raised indurated borders. what is this?

Answer 30

sphylitic chancre

Question 31

Small scattered grouped vesicles 1-3 mm in size on glans or shaft; may appear as an erosion of vesicle opens; usually caused by what?

Answer 31

HSV 2

Question 32

single or multiple papules or plaques of variable shapes; raised, flat, cauliflower-like (verrucous). what is this?

Answer 32

venereal wart

Question 33

Palpable, nontender, hard plaques just below skin usually along dorsum of penis; complaints of crooked, painful erections. what is this?

Answer 33

peyroine's disease

Question 34

spontaneous descent of undescended testes usually occur by __ months old.

Answer 34

3, rarely occurs after 4 months

Question 35

if you still have undescended testes (cryptochordism) after __ months, need for fix unless what?. how do you count this?

Answer 35

if still have after 6 months, need to fix (unless they were born early… start counting from the time they were SUPPOSED to be born)

Question 36

what is this? | Dome-shaped white or yellow papules/nodules on the scrotum

Answer 36

epidermoid cyst | follicles clogged with keratin debris of desquamated follicular epithelium; common; frequently multiple; benign

Question 37

what is a hydrocele and how do you test for it?

Answer 37

Abnormal collection of fluid between the tunical layers and is congenital or acquired Dx: transillumination ( "glows like a pumpkin")

Question 38

"bag of worms" appearance of the scrotum, likely on the left side. Slowly collapses when scrotum is elevated in supine patient. what is this?

Answer 38

varicocele. Spermatic cord or scrotal enlargement caused by dilation of pampiniform venous plexus

Question 39

what is a spermatocele? how do you diagnose it? how it is different from an epidermoid cyst?

Answer 39

Cystic dilation of epididymis involving upper or epididymal head. Usually small and painless following an episode of epididymitis Dx. Transilluminating cystic mass above and separate from testis - similar to EC but Fluid contains dead spermatozoa

Question 40

acute epididymitis presentation

Answer 40

tender, swollen, may be difficult to distinguish from testis. Scrotum may be red and vas deferens inflamed; usually in adults

Question 41

tuberculous epididymitis presentation

Answer 41

chronic inflammation of tuberculosis produces a firm enlargement of epididymis; sometimes tender; thickened/beaded vas

Question 42

who does epididymitis present more commonly in? bilateral or uni?

Answer 42

young men, unilateral usually

Question 43

what is "sterile" epididymitis?

Answer 43

no infectious cause found, associated with vigorous physical activity

Question 44

testical giant red and inflamed, VERY tender. what is this?

Answer 44

epididymitis