Pelvic Exam/ PTHD findings

Question 1

Pelvic exam normal findings in context in dysmenorrhea?

Answer 1

External genitalia, vaginal walls, and cervix appear normal on inspection; the uterus is non-tender, smooth, mobile, and of normal size, with no asymmetry, adnexal masses, nodules or tenderness on bimanual exam.

Question 2

Pelvic exam abnormal findings in the context of secondary dysmenorrhea?

Answer 2

• Endometriosis: cervical motion tenderness, adnexal masses, palpable nodules
• Adenomyosis: uterine enlargement or asymmetry
• PID: mucopurulent cervical discharge
• Ovarian cysts

Question 3

Pelvic Exam normal findings in the context of vaginitis?

Answer 3

The external genitalia are normal with no lesions, swelling, or redness. The vaginal mucosa is healthy, with no signs of irritation or abnormal discharge. On speculum exam, the cervix is pink and smooth with no visible discharge or lesions. The bimanual exam reveals a non-tender, mobile uterus and normal-sized ovaries with no palpable masses.

Question 4

Pelvic exam abnormal findings in the context of vaginitis?

Answer 4

Inspection: erythema or irritation of vaginal mucosa/ vulva, abnormal discharge, edema, lesions

Speculum: abnormal discharge, cervical erythema, strawberry cervix (trichomoniasis)
- if atrophic vaginitis: dryness, loss of rugae

Question 5

Pelvic exam abnormal findings (menopause)

Answer 5

Inspection:
- vaginal atrophy (dryness, thinning of labia, irritation)
- vaginal prolapse

Speculum:
- vaginal atrophy (vaginal wall appear thin + dry, loss of rugae)
- vaginal prolapse

Bimanual:
- uterus smaller + firmer, cervix more firm and less mobile, ovaries may be difficult to palpate (atrophy post menopause)

Question 6

Normal findings for pelvic exam in the context of menopause

Answer 6

External genitalia, vaginal mucosa, and cervix appear normal; no atrophy or lesions observed. The bimanual exam reveals a small, mobile, non-tender uterus with no adnexal masses or tenderness

Question 7

PTHD normal findings.

Answer 7

Penis is normal in appearance with no lesions, discharge, or structural abnormalities.

scrotum, testes, epididymis, and spermatic cord are normal in size, non-tender, smooth, and without masses or swelling

Prostate is smooth, firm, non-tender, and of normal size. No nodules or asymmetry. Rectal tone is normal, no masses or tenderness.

Question 8

PTHD abnormal findins in context of LUTS + ED?

Answer 8

Penis: Visible lesions, scarring, or abnormal curvaturemay suggest structural issues, which can contribute to both LUTS and ED

Testes:
Testicular masses or tenderness may suggest conditions like epididymitis, or testicular cancer, which can contribute to both LUTS and ED

DRE:
Enlarged, nodular, or tender prostate may indicate BPH, prostatitis, or other prostate pathologies, which can contribute to both LUTS and ED

• BPH: enlarged, non-tender, sulcus non-palpable, uniformly hard/ dense