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PCM Spring 2015 Exam 1 > Female GU and Breast Exam - King > Flashcards

Female GU and Breast Exam - King Flashcards

1
Q

female GU and breast exam

A

talk before touch
touch neutral area first

have patient empty bladder**

be gentle and prepared

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2
Q

female hair distribution

A

tanner stages

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3
Q

inspection of female external genital

A 
large clitoris - endocrine
labia major and major
urethral orifice
vaginal introitus
bartholin gland
skene gland
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4
Q

labia trauma

A

sexual abuse

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5
Q

hypertrophic clitoris

A

looks like penis

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6
Q

herpes

A

painful vesicles to ulcerations

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7
Q

HPV

A

cauliflower warts

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8
Q

primary syphilis

A

painless chancre

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9
Q

condyloma lata

A

syphilis

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10
Q

vulvar carcinoma

A

epidermoid squamous cell

slow growing

rare

ulcerated flat lesion

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11
Q

lichen planus

A

white plaques and ulcerations

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12
Q

cottage cheese

A

candida infection

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13
Q

ulcerations and inflammation of labia

A

trichomonas infection

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14
Q

bartholin glands

A

4 and 8 oclock

secretory glands - can become clogged with bacteria

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15
Q

labial pain and swelling

A

inspect and palpate the bartholin glands

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16
Q

causes of bartholin gland abscess

A

gonococcus and chlamydia

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17
Q

skene gland issue

A

more rare infection

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18
Q

inadequate pelvic support

A

cystocele
rectocele
uterine prolapse

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19
Q

first degree uterine prolapse

A

cervix droops into vagina

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20
Q

second degree uterine prolapse

A

cervix comes down to opening of vagina

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21
Q

third degree uterine prolapse

A

cervix outside the vagina

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22
Q

fourth degree uterine prolapse

A

entire uterus outside vagina

procidentia

weakness all supporting muscles

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23
Q

insertion of speculum

A

pressure to posterior wall of vagina

anterior wall - sensitive

45 degrees*

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24
Q

90% cervical cancers

A

transformation zone

area of squamous metaplasia

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25
Q

nabothian cyst

A

inclusion of cyst of endocervical glands

normal variant - completely b9 - mistaken for carcinoma of cervix

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26
Q

pap smear

A

papanicolaou test

for screening malignant processes of cervix

cells from transformation zone

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27
Q

cervicitis

A

infection

  • chlamydia
  • gonnococcus
  • trichomonas
  • HSV
  • HPV
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28
Q

inspection of vagina

A

as withdraw speculum**

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29
Q

bimanual exam

A

uterus and ovary info

also cervix and strength of pelvic floor

30
Q

version

A

relationship of fundus of uterus and vagina

31
Q

flexion

A

relationship between fundus of uterus and cervix

32
Q

rectovaginal exam

A

examine pouch of douglas - rectovaginal pouch

retroverted/retroflexed uterus

rectum exam

33
Q

most common hernia in women

A

indirect

34
Q

femoral hernia

A

more in women than in men

35
Q

top cancer killer in women

A

lung

2nd is colon

36
Q

anatomy of breast

A

15 to 20 lobes each with several lobules

suspensory ligaments of cooper - structural support

37
Q

ducts of breasts

A

dilated portion - lactiferous sinus
-lined by stratified squamous epithelium

major ducts - lined by two layers of cuboidal cells
-minor ducts - single layer of columnar or cuboidal cells

38
Q

extent of breast

A

2-3 rib to inframammary fold at 6-7 rib

lateral border of sternum to anterior axillary line**

39
Q

greatest volume of breast

A

upper outer quadrant

40
Q

posterior surface of breast

A

rests on fascia of pectoralis major, serratus anterior, and external abdominal obliques and upper extent of rectus sheath

41
Q

blood supply to breast

A

internal mammary artery
posterior intercostal arteries
axillary artery

arborize as medial mammary arteries

42
Q

axillary lymph nodes

A

breast drainage

43
Q

drainage across sternum

A

can occur with lymph from breasts

44
Q

optimal time for breast exam

A

5-7 days following last menstrual period

45
Q

erythema

A

mastitis

inflammatory carcinoma

46
Q

bloody nipple discharge

A

cancer

47
Q

non-bloody nipple discharge

A

endocrine

48
Q

nipple ulceration

A

pagets disease

or mechanical causes

49
Q

breast inspection

A
  • seated arms at side
  • arms over head
  • hands against hips
  • palms together
  • arms extended and bent forward at waist
50
Q

paget disease of breast

A

epidermal cancer
of areola or breast ca
grows slowly

presentation - scaly ulcerating change to nipple**

51
Q

scaly ulcerating change to nipple

A

paget

diagnosis - biopsy

52
Q

nipple retraction

A

not good

cancer sucks things to center

53
Q

mastitis

A

confused with inflammatory breast cancer

often have coexisting lactation**

infection of breast tissue

54
Q

peau d’orange

A

inflammatory breast cancer

55
Q

palpation of breast

A

cover ENTIRE breast**

56
Q

breast cancer

A

women over 50

single

irregular or stellate shape

firm or hard

not clearly demarcated

fixed to skin or underlying tissue

nontender

retractions present

57
Q

fibroadenoma

A

single, may be multiple

round, disclike

soft

well demarcated

very mobile

nontender

58
Q

cyst

A

single or multiple

round

soft to firm

well delineated

mobile

often tender

absent

59
Q

breast ca risk fx

A 
previous hx breast ca #1
fam hx #2
increased age
nulliparous
first child after age 30
early menarche
estrogen and HRT
radiotherapy of chest
smoking
60
Q

presentation of breast ca

A

90% lump painless
20% painful lump
10% nipple discharge

61
Q

stage 1 breast ca

A

no more than 2m in diamter
no nodes and no mets

98% 5 yr survival

62
Q

stage 2 breast ca

A

2-5cm

small with less than 4 nodes
big tumor with no nodes

no mets

63
Q

stage 3 breast ca

A

tumor to nodes

64
Q

stage 4 breast ca

A

tumor mets

65
Q

inflammatoy breast cancer

A

stage 3

cancer spread to breast skin - swelling and redness

50% 5 yr survival

66
Q

primary dysmenorrhea

A

results from increased prostaglandin produc- tion during the luteal phase of the menstrual cycle, when estrogen and progesterone levels decline

67
Q

Causes of secondary dysmenorrhea

A

include endometriosis, adenomyosis (endometriosis in the muscular layers of the uterus), pelvic inflammatory disease, and endometrial polyps

68
Q

pain from ovulation at midcycle

A

mittelschmerz

69
Q

most common STI in women

A

chlamydia trachomatis

70
Q

pediculosis pubis

A

lice or crabs

PCM Spring 2015 Exam 1 (6 decks)

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