Male/Female genitals, breast, anus, rectum

Question 1

What is the most common site for breast cancers?

Answer 1

Upper outer quadrant

Question 2

What are the breast lymphatics?

Answer 2

Central, pectoral (anterior), subscapular (posterior), lateral

Question 3

What is gynecomastia?

Answer 3

Increased mass of the breast

Question 4

Which lymph nodes drain the breast?

Answer 4

Sentinel/central lymph nodes

Will likely be biopsied if cancer is in question

Question 5

What is the Tail of Spence?

Answer 5

Piece of breast tissue that goes into axillary region

Question 6

What are breast exam techniques?

Answer 6

Pt sitting, disrobed to waist, arms at side

Also have pt with hands on hips bending forward slightly for inspection

Question 7

What should one look for when examining for breast cancer?

Answer 7

Dimpling/concavities
Redness
Inflammation
Size and symmetry
Size, shape, direction, rashes,, ulceration, discharge of nipples

Question 8

What is Peau d’Orange?

Answer 8

When the skin of the breast looks like an orange peel - sign of cancer

Question 9

How does one palpate during the breast exams

Answer 9

With pt arms behind head, use pads of first 3 fingers, compress tissue gently, concentric circles
Palpate each nipple and gently compress to check for discharge

Question 10

What characteristics are important if one finds a nodule?

Answer 10

Location
Size
Shape
Consistency
Movable
Distinctness
Nipple
Lymphadenopathy

Question 11

When should a clinical breast exam be given?

Answer 11

Age 20-39 every 3 years

>40 - yearly along with mammography

Question 12

What is the cumulative lifetime risk factor for developing breast cancer?

Answer 12

1 in 7

Question 13

What is leukorrhea?

Answer 13

Normal discharge from vagina

Question 14

What are the 3 reasons for a female rectal exam?

Answer 14

Check the posterior portion of the uterus
Check the sphincter tone of the rectum
Guaiac testing (testing of stool for blood)

Question 15

What is a rectocele?

Answer 15

When the rectal wall pushes against the vagina
Can cause a fistula
Increases the risk of infection

Question 16

What to ask for in the ROS?

Answer 16

Menstrual History
Sexual History
Medical/Surgical History
Medication
Any complaints
Last CBE, SBE Compliance, Mammography, Pap smear, digital rectal exam

Question 17

What is amenorrhea?

Answer 17

Lack of a period

Question 18

What is dysmenorrhea?

Answer 18

Painful periods

Question 19

What is polymenorrhea?

Answer 19

Many periods

Question 20

What is the lithotomy position?

Answer 20

Both legs in stirrups and shifted down on the table

Question 21

What happens during the internal exam?

Answer 21

Locate the cervix
Assess support of the vaginal wall
Check for cystocele
Check for uterine Prolapse
Check for rectocele
Inspect cervix and os
Pap Smear
Palpate the cervix
Palpate the uterus
Retroversion of the uterus
Palpate each ovary

Question 22

What is smegma?

Answer 22

Given off by glans penis - must be washes, or it can develop an infection

Question 23

Which side of the scrotum hangs lower and why?

Answer 23

Left because sperm is sensitive to temperature and stays cooler in the environment

Question 24

What is cryptorchidism?

Answer 24

When one testicle doesn’t descend and it’s not in the sac

Can self-correct or requires surgery

Question 25

What is hypospadia?

Answer 25

When the urethra is on the underside of the penis

Question 26

What are symptoms of BPH?

Answer 26

Increased urination, nocturia, ejaculation problems

Question 27

What are 3 reasons for a male prostate exam?

Answer 27

BPH Guaiac testing Sphincter tone

Question 28

Which type of hernia is more common in men?

Answer 28

Inguinal hernias

Question 29

Which type of hernia is more common in women?

Answer 29

Femoral hernias

Question 30

How does one check for a hernia?

Answer 30

Put hands in the area and have the pt cough

Question 31

What should one look for during the ROS?

Answer 31

``` Sexual History Medical/Surgical History Medications Any complaints Last DRE, PSA blood test Clinical testicular and breast exam Self testicular and breast exam Compliance ```

Question 32

What age is at the highest risk of testicular cancer?

Answer 32

15-40

Question 33

What are signs of testicular cancer?

Answer 33

Lump Rapid enlargement/swelling (hydrocele) Painless mass, but aching in lower abdomen Shriveling of testicle

Question 34

What is a hydrocele?

Answer 34

Build up of fluid in the scrotum

Question 35

What should you inspect during the male genital exam?

Answer 35

``` Penis Foreskin Smegma Phimosis Paraphimosis Glans; hypospadias Palpate shaft between thumb and first 2 fingers; feel for induration along ventral surface. Scrotum Testicular Cancer ```

Question 36

What is phimosis?

Answer 36

Retraction of the foreskin

Question 37

What is paraphimosis?

Answer 37

Putting foreskin back

Question 38

How do you check for a hydrocele?

Answer 38

Transillumination

Question 39

How far should the prostate protrude into the rectum?

Answer 39

No more than 1 cm

Question 40

What should you look for during a rectal exam?

Answer 40

``` Lumps Ulcers Inflammation Rashes Excoriation Venereal warts Herpes Hemorrhoids, lesions, signs of trauma Sphincter for tone Nodules Irregularities ```

Question 41

Does gynecomastia increase the risk of breast cancer?

Answer 41

No

Question 42

What do you do if you suspect urethritis or inflammation of the Skene's glands (paraurethral)?

Answer 42

Insert index finger into vagina, milk urethra gently from inside outward