Female GU and Breast Exams - King

Question 1

Define menarche

Answer 1

age at onset of menses

Question 2

Define menopause

Answer 2

absence of menses for 12 consecutive months (usually 48 – 55 years old)

Question 3

Define post-menopausal bleeding

Answer 3

bleeding occurring 6 months or more after cessation of bleeding

Question 4

Define amenorrhea

Answer 4

absence of menses

Question 5

Define dysmenorrhea

Answer 5

pain with menses

Question 6

Define polymenorrhea

Answer 6

menses at abnormally frequent intervals

Question 7

Define oligomenorrhea

Answer 7

abnormally scant or infrequent menses

Question 8

Define menorrhagia

Answer 8

excessive bleeding

Question 9

Define metrorrhagia

Answer 9

bleeding between periods

Question 10

Define post-coital bleeding

Answer 10

bleeding after sexual intercourse

Question 11

Things to include in a gynecologic history:

Answer 11

Last menstrual period
Regularity of periods
Usual time between periods
Number of days of flow
Amount of flow
Pain with periods
Bleeding between periods
Age of menarche

Question 12

Ask about ________ (4) in sexual history taking:

Answer 12

Current sexual status
Number of partners
Gender of partners
Any sexually transmitted diseases

Question 13

G5P2032 means what?

Answer 13

5 pregnancies, 2 term deliveries, (0 pre-term deliveries), 3 abortions, 2 living offspring

Question 14

G4P3105 means what?

Answer 14

4 pregnancies, 3 term deliveries, 1 preterm deliveries, 5 living

Question 15

G3P3002?

Answer 15

3 pregnancies, 3 term deliveries, 2 living

Question 16

The GU exam is performed best (better exam and pt comfort) after the pt has _______?

Answer 16

Voided their bladder

Question 17

Skene’s glands are located where in the vaginal opening?

Answer 17

10 and 2 o’clock

Question 18

Location of Bartholin’s glands?

Answer 18

4 and 8 o’clock

Question 19

When doing a pap smear, the physician “scrapes” cells from this portion of the cervix:

Answer 19

The transformation zone (TZ)

Question 20

What occurs at the TZ?

Answer 20

premalignant changes and neoplasia occur (Encompasses immature and mature squamous metaplasia)

Question 21

What is the true squamocolumnar junction (SCJ) and where is it located?

Answer 21

It is the proximal limit of squamous metaplasia

It usually not visualized because it is located within the endocervical canal, approximately 3 cm from observed SCJ

Question 22

Define flexion of the uterus

Answer 22

the relationship between the fundus of the uterus and the cervix

Question 23

Define version of the uterus

Answer 23

the relationship between the fundus of the uterus and the vagina

Question 24

When doing a rectovaginal exam, what are you trying to palpate and assess?

Answer 24

A retroverted and retroflexed uterus and the uterosacral ligaments; assess pelvic pathology in the posterior rectovaginal pouch (Pouch of Douglas)

Question 25

If you can palpate an ovary during a bimanual exam...

Answer 25

"something is wrong".... if bimanual is normal, document "ovaries are non palpable"

Question 26

Bimanual examination can reveal pelvic floor....

Answer 26

strength

Question 27

Which quadrant of breast contains the most breast tissue? What is this area called?

Answer 27

The upper outer quadrant does compared to the other three quadrants... it contains the axillary tail "of Spence" which extends laterally across the anterior axillary fold

Question 28

Axillary tails drains into...

Answer 28

the subscapular group of axillary nodes

Question 29

Upper portion of breast drains into...

Answer 29

the infraclavicular nodes

Question 30

Most of the lymph from the subareolar and submammary plexus is drained to...

Answer 30

the anterior or pectoral group of axillary nodes

Question 31

Medial part of the breast is drained by...

Answer 31

the submammary plexus of the opposite breast, the lymph nodes along the internal thoracic artery and then to mediastinal nodes

Question 32

The inferior portion of the breast is drained by the...

Answer 32

lymphatics of the abdominal wall and to the extra peritoneal lymphatic plexus

Question 33

When is the best time to do a breast exam?

Answer 33

Around 5-7 days post-menses (5-7 days following the end of the LMP)... this is when the secretory tissue are at their lowest size

Question 34

Things to look for during inspection of the breasts:

Answer 34

``` Development Size and symmetry Contours ***Retractions or dimpling (of skin) Skin color and texture Venous engorgement ```

Question 35

Where else should you palpate for enlarged nodes during a breast exam?

Answer 35

The axilla