Fall Exam 1 Flashcards Preview

PD > Fall Exam 1 > Flashcards

Flashcards in Fall Exam 1 Deck (196)
Loading flashcards...
1
Q

Good draping method for a women pelvic exam

A

cover her knees and symphysis dress the drape between her knees

2
Q

Labial swelling, redness, or tenderness, particularly unilateral may indicate

A

Bartholin gland infection

3
Q

Excoriation, rashes, or lesions of the labial suggest

A

infectious or inflammatory process

4
Q

palpate what parts of the external female genitalia?

A

labia minora, clitoris, urethral orifice, vaginal introitus, and perineum

5
Q

discoloration or tenderness of the labia minora may be a result from

A

traumatic bruising

6
Q

ulcers or vesicles on the labia minora may be a sign of

A

STIs

7
Q

General size of the clitoris

A

2cm or less in lenght and 0.5cm in diameter

8
Q

Enlarged clitoris may be a sign of

A

masculinizing condition

9
Q

a bright red polypoid growth that protudes from the urethral meatus

A

caruncle

10
Q

caruncle symptoms

A

none

11
Q

signs of irritation, inflammation, or dilation of the urethral orifice suggests

A

repeated UTI or insertion of foreign objects

12
Q

a thin verticle slit or a large orifice with irregular edges from hymenal remnants (myriform caruncles)

A

vaginal introitus

13
Q

How do you examine the skene glands

A

exerting upward pressure with index finger (2nd joint deep), milk the Skene gland by moving the finger outward on both sides of the urethra and directly on the urethra

14
Q

Discharge from skene glands or urethra indicates

A

infection, commonly gonococcal

15
Q

Where is the female bartholin gland located

A

posterolateral portion of the labia majora

16
Q

bartholin gland swelling that is painful, hot to touch, fluctuant is indicative of

A

infection of the gland

17
Q

Infection of the Bartholin gland is usually ___ or ___ in origin and ______.

A

gonococcal or staphylococcal in origin and filled with pus

18
Q

a nontender mass on the Bartholin gland is indicative of

A

Bartholin cyst

19
Q

Bartholin cysts are a result of what

A

chronic inflammation of the gland

20
Q

What is uterine prolapse marked by

A

protrusion of the cervix or uterus on straining

21
Q

episiotomy scarring may be evident in who

A

women who have borne children

22
Q

how should the perineum tissue feel in a nulliparous women

A

thick and smooth, and nontender

23
Q

how should the perineum tissue feel in a multiparous women

A

thin and rigid, and nontender

24
Q

how to hold a speculum

A

index finger over the top of the proximal end of the anterior bland and the other fingers around the handle.

25
Q

how do you apply pressure when opening the speculum

A

apply gentle downward pressure

26
Q

expected color of the cervix

A

pink, with the color evenly distributed

27
Q

bluish cervix indicates

A

vascularity, which may be a sign of pregnancy

28
Q

symmetric circumscribed redness around the os is a(n) ____ finding that indicates

A

expected finding that indicates exposed columnar epithelium fromt he cervical canal

29
Q

a pale cervix is associated with

A

anemia

30
Q

the anterior-posterior position of the cervix correlates with the position of the

A

uterus

31
Q

a cervix that is pointing anteriorly indicates

A

retroverted uterus

32
Q

a cervix that is pointing posteriorly indicates

A

anteverted uterus

33
Q

a cervix in the horizontal position indicates

A

uterus in midposition

34
Q

cervix deviating to left or right may indicate (3)

A

pelvic mass, uterine adhesion, or pregnancy

35
Q

Normal protusion of the cervix into the vagina

A

1-3cm

36
Q

projection of the cervix greater than 3cm into the vagina may indicate

A

a pelvic or uterine mass

37
Q

the cervix of a women of childbearing age is usually how big in diameter

A

2-3cm

38
Q

the junction of squamous and columnar epithelium cells is known as

A

transformation zone

39
Q

Where is the transformation zone barely visible

A

inside the external os

40
Q

____ occurs when eversion of the endocervix exposes columnar epithelium

A

cervical ectropion

41
Q

Everted epithelium appears ___ and ___

A

has a red, shiny appearance around the os and may bleed easily

42
Q

Ectropion is common in who

A

adolescents, pregnant women, or those taking estrogen-containing contraceptives

43
Q

is ectropion an abnormality?

A

No but because it is indistinguishable from early cervical carcinoma, further dx studies are needed (pap smear, biopsy)

44
Q

small, white or yellow raised, round areas on the cervix

A

Nabothian cysts

45
Q

are Nabothian cysts normal?

A

yes, an expected finding

46
Q

mucinous retetion cyst of the endocervical glands

A

nabothian cysts

47
Q

Occur during the process of metaplasia at the transformation zone when endocervical columnar cells continue to secrete but are covered by squamous epithelium

A

nabothian cysts

48
Q

T or F, Nabotian cyst can occur in multiples or singularly

A

T

49
Q

Friable tissue, red patchy polyps, granular areas, and white patche on the cervix could indicate

A

cervicitis, infection, or carcinoma

50
Q

Where do cervical polyps usually arise from

A

endocervical canal

51
Q

Bright red, soft, and fragile

A

cervical polyps

52
Q

Ususal cervix discharge

A

odorless, creamy or clear, thick/thin/or stringy, heavier at midcycle or immediately before menstruation

53
Q

odory discharge from cervix that varies from white to yellow, green or gray indicates

A

bacterial or fungal infection

54
Q

Os is small and round or oval in __ women

A

nulliparous

55
Q

the os is a horizontal slit or may be irregular and stellate in __ women

A

multiparous

56
Q

lateral transverse, bilateral transverse, or stellate scarring of the cervix is caused by

A

trauma from childbirth

57
Q

Trauma from induced abortion or difficult removal of an intrauterine device may change the shape of what

A

the os to a slit

58
Q

cylindric-type brush collects

A

endocervical cells only

59
Q

collect a sample of the ectocervix with a

A

spatula

60
Q

First collect cells from _____ then use ____ to collect from ______

A

ectocervix then use a brush to collect from cervical os

61
Q

rotate spatula ___ degrees

A

360 degrees

62
Q

rotate brush ___ degrees

A

180 degrees

63
Q

what device is used for collecting both ectocervical and endocervical cells at the same time

A

broom-type device

64
Q

what Pap testing requires the broom type device

A

liquid based cytology

65
Q

what sample is used to test for HPV

A

liquid sample

66
Q

how to test for gonoccocal culture

A

insert sterile swab into cervical os, hold for 10-30 sec then spread specimen in a large Z pattern

67
Q

what do you use when DNA testing for organisms

A

Dacron swab (with plastic or wire shaft)

68
Q

single organsim tests are available for

A

chlamydia trachonmatis and N. gonorrhea

69
Q

multiorganism tests are available for

A

Trichomonas vaginalis, Gardnerella vaginalis, and Candida species

70
Q

in a woman with vaginal discharge, ___ and ___ examinatios can demonstrate the presences of Trichomonas vaginalis, bacterial vaginosis, or candidiasis

A

wet mount and potassium hydroxide (KOH) exams

71
Q

KOH dissolves what and facilitates what

A

epithelial cells and debris and facilitates visualization of the presence of mycelia of a fungus

72
Q

appearance of vaginal walls in premenopausal women

A

will have rugae

73
Q

appearance of vaginal walls in postmenopausal women

A

will be smooth

74
Q

hernial protrusion of the urinary bladder through the anterior wall of the vagina, sometimes even exiting the introitus

A

cystocele

75
Q

a hernial protrusion of part of the rectum through the posterior vaginal wall

A

rectocele or proctocele

76
Q

make sure the speculum is fully closed when the blades pass through the ___

A

hymenal ring

77
Q

consistency of the cervix in a nonpregnant woman will be

A

firm

78
Q

consistency of the cervix in a pregnant woman will be

A

soft

79
Q

the cervix should move ____ in each direction

A

1-2cm with minimal or no pain

80
Q

painful cervical movement suggests

A

pelvic inflammatory process such as pelvic inflammatory disease or ruptured tubal pregnancy

81
Q

if you feel the fundus between the fingers of your 2 hands at the level of the pubis, the uterus is ___

A

anteverted or anteflexed (most common)

82
Q

a ___ uterus will be felt by placing the intravaginal fingers together in teh posterior fornix, with the abdominal hand immediately above the symphysis pubis, press down firmly wiht the adominal hand when you press against the cervix inward with the other

A

retroverted

83
Q

expected shape and size of the uterus

A

pear shaped, 5.5-8cm long

84
Q

the uterus is ___ in all dimension in multiparous women

A

larger

85
Q

uterus contour smoothness will be interrupted by

A

pregnancy or tumor

86
Q

uterus should be mobile in what plane

A

anteroposterior plane

87
Q

a fixed uterus indicates

A

adhesions

88
Q

palpable ovaries should feel

A

firm, smooth, ovoid

89
Q

approximate size of ovaries

A

3 x 2 x 1cm

90
Q

lower abdominal pain associated wiht ovulation

A

Mittelschmerz

91
Q

cervical screening should being at age

A

21

92
Q

pap testing should be done how often for women 21-29

A

every 3 years

93
Q

women 30-65 need what testing

A

pap plus an HPV every 5 years or pap test alone every 3 years

94
Q

a woman with CIN grade 2 or 3 should be tested for at least ___ years after diagnosis

A

20 years

95
Q

women vaccinated against HPV should follow up __

A

same as recommendatins for their age group

96
Q

rectovaginal exam allows you to reach almost ___ higher into the pelvis

A

2.5cm or 1 inch

97
Q

gonorrhea is caused by

A

a bacteria

98
Q

Trichomoniasis is caused by a

A

protozoan

99
Q

a prolapsed bladder

A

cystocele

100
Q

cessation of menses for 1 year because of age.

A

menopause

101
Q

menarche

A

the first menstruation

102
Q

Amenorrhea

A

no menstruation

103
Q

when are Skene glands, Bartholin glands, and the urinary meatus examined

A

external genitalia examinaton

104
Q

benign cysts that may appear on the cervix after childbirth.

A

nabothian cysts

105
Q

to collect a gonococcal culture you would use a ___ and collect it from ___

A

use a sterile swab and collect it from the cervical os

106
Q

to collect a gonococcal culture you would ____ then ___ with it

A

hold it in place for 10-30 seconds then spread in on a plate in a Z formation

107
Q

What would you use to collect DNA for chlamydia and gonorrhea? and where would you collect the specimen?

A

Dacron swab, and the cervical os

108
Q

to collect the specimen for DNA chlamydia and gonorrhea you would ___ with the swab and ___ after with it

A

rotate it for 30 seconds then, put it in a special tube containing specimen reagent

109
Q

What would you use to collect trichomonas vaginalis? and where would you collect the specimen?

A

sterile cotton swab, vaginal discharge

110
Q

collection time for trichomonas vaginalis? and then what do you do with the sample?

A

no specific time, place it on a glass and add a drop of normal saline

111
Q

What would you use to collect bacterial vaginosis or candida vulvovaginitis? and where would you collect the specimen?

A

sterile cotton swab, vaginal discharge

112
Q

collection time for bacterial vaginosis or candida vulvovaginitis? and then what do you do with your sample

A

no specific time, Place it on a glass slide and add a drop of aqueous 10% KOH

113
Q

male escutcheon pattern

A

pubic hair narrowing midline to umbilicus

114
Q

amount of hair on scrotum

A

scant amount

115
Q

what vein should be apparent on the penis

A

dorsal vein

116
Q

A white cheesy sebaceous matter that collects between the glans penis and foreskin

A

smegma

117
Q

tight foreskin that cannot be retracted

A

phimosis

118
Q

when does phimosis occur or what causes it

A

may occur first 6 yrs of life or as a result of recurrent balanitis or balanoposthitis

119
Q

balantitis

A

inflammation of the glans penis

120
Q

balanoposthitis

A

inflammation of the glans penis or prepuce

121
Q

cause of balanoposthitis

A

bacteria or fungal infections

122
Q

balanoposthitis is commonly seen in men with

A

uncircumcised penis or poorly controlled DM

123
Q

if a man is circumcised, how should the glans appear

A

erythematous and dry, no smegma

124
Q

where is the male urtethral meatus located

A

ventral surface just millimeters from tip on the glans

125
Q

normal appearance of the male urethral meatus

A

glistening and pink

126
Q

bright erythema or discharge on the male urethral meatus indicates

A

inflammatory disease

127
Q

pinpoint or round urethral meatus opening on a male indicates

A

meatal stenosis

128
Q

presence of discharge while palpating the penile shaft and striping the urethra may indicate

A

STI

129
Q

priapism

A

prolonged penile eretion

130
Q

cause of priapism (4)

A
  1. often idiopathic
  2. leukemia patients
  3. hemoglobinopathies such as sickle cell
  4. a result of mediation for impotence
131
Q

Why is the scrotum asymmetric

A

bc left testicle has a longer spermatic cord and therefore often lower

132
Q

thickness of scrotum varies with

A

age and temperature

133
Q

lumps in scrotal skin are commonly caused by

A

sebaceous cysts (aka epidermoid cysts)

134
Q

sebaceous cysts or epidermoid cysts may appear ___

A

small, enlarged, and discharge oily material

135
Q

scrotum edema typically indicates fluid retention associated w/ what?

A

cardiac, renal, or hepatic disease

136
Q

bowel sounds are present in what type of hernia

A

reducible hernia

137
Q

if the hernia lies within the inguinal canal (or comes through the external canal and even pass inot the scrotum) it is described as

A

a indirect hernia

138
Q

if viscus is felt medial to the external canal the hernia is described as

A

a direct inguinal hernia

139
Q

testis totally insensitive to painful stimuli is often seen in what diseases?

A

syphilis and diabetic neuropathy

140
Q

Where is the epididymis located

A

posterolateral surface of the testis

141
Q

how should the epididymis feel with palpation

A

smooth, discrete, larger cephalad, and nontender

142
Q

beaded or lumpy vas deferen may indicate

A

diabetes or old inflammatory changes (ex. TB)

143
Q

length of non-erect penis at birth

A

2-3cm

144
Q

microphallus

A

unusually small penis

145
Q

microphallus may be associated with

A

conditions with abnormal testicular development (ex. Klinefelter syndrome)

146
Q

clitoromegalgy

A

enlarged clitoris

147
Q

a hooked, downward bowing of the penis suggests

A

chordee

148
Q

male foreskin is fully retracted by age

A

3-4y/o

149
Q

dribbling or reduced forece or caliber in male infants may indicate

A

stenosis of urethral meatus

150
Q

scrotum appearance of a preterm infant vs full-term neonate

A

premature infant- appear underdeveloped, w/o rugae, w/o testes
full term infant- loos, pendulous scrotum, w/ rugae, and midline raphe

151
Q

what end of the infant scrotum should be the widest?

A

proximal end

152
Q

bifid scrotum is usually associated w/

A

GU anomalies or ambigous genitalia

153
Q

testicle diameter of a newborn

A

~1cm

154
Q

a retractile testis has significant risk of becoming

A

an ascending or an acquired undescended testis

155
Q

a testicel that is palpable in inguinal canal but cannot be pushed inot scrotum or not palpable at all is considered

A

an undescended testicle

156
Q

well formed rugae in male children indicate

A

the testes have descended during infacny even if the testes are not apparent in scrotum

157
Q

a scrotum that remains small, flat, and undeveloped indicates

A

cryptorchidism

158
Q

cryptorchidism

A

undescended testes

159
Q

most common type of hernia

A

indirect hernia

160
Q

least common hernia

A

femoral hernia

161
Q

direct hernias are more common in what gender

A

males

162
Q

femoral hernias are more common in what gender

A

females

163
Q

what hernia has the pathway of: through internal inguinal ring, can remain in canal, exit the external ring and pass into the scrotum; may be bilateral

A

indirect inguinal hernia

164
Q

what hernia has the pathway of: through external inguinal ring; located in regionof hesselbach triangle; rarely enters scrotum

A

direct inguinal hernia

165
Q

what hernia has the pathway of: through femoral ring, femoral canal, and fossa ovalis

A

femoral hernia

166
Q

what hernia presents with: soft swelling in area of internal ring; hernia comes down canal and touches fingertip on exam

A

indirect inguinal hernia

167
Q

what hernia presents with: bulge in area of hesselbach triangle; usually painless; easily reduced; hernia bulges anteriorly, pushes against side of finger on exam

A

direct inguinal hernia

168
Q

what hernia presents with: right-sided presentation more common than left; pain may be severe; inguinal canal empty on exam

A

femoral hernia

169
Q

What term is used to describe a loop of bowel that cannot be reduced

A

incarcerated hernia

170
Q

rectal exam can be performed in these positions (4)

A
  1. knee-chest
  2. lithotomy
  3. left lateral w/ hips and knees flexed
  4. standing with hips flexed and upper body supported by exam table
171
Q

__ infections are more common in adults with diabetes

A

fungal infections

172
Q

__ infections are more common in children

A

pinworm infestation

173
Q

skin around anus should appear

A

coarsr and more darkly pigmented

174
Q

a lax sphincter may indicate

A

neurologic deficit or sexual abuse

175
Q

internal hemorrhoids are felt when

A

they are thrombosed

176
Q

nodules palpable just above the prostate in males and in the cul-de-sac in females

A

shelf lesions

177
Q

you palpate the prostate on what wall of the rectum

A

anterior wall (may feel urge to urinate)

178
Q

the size of a healthy prostate

A

4cm diameter w/ less than 1cm protrusion into the rectum

179
Q

a rubbery or boggy consistency of the prostate may indicate

A

benign hypertrophy

180
Q

stony hard nodularity prostate may indicate

A

carinoma, prostatic calculi or chronic fibrosis

181
Q

the ___ or ___ uterus maybe be palpable through rectal exam

A

retroflexed or retroverted uterus

182
Q

cervix may be palpable through what rectal wall?

A

anterior

183
Q

very light tan or gray stool could indicate

A

obstructive jaundice

184
Q

taryy black stool could indicate

A

upper intestinal tract bleeding

185
Q

chemial guaiac procedure is used to

A

test for blood in stool

186
Q

rectal prolapse results from

A

constipation, diarrhea, or something sever coughing or straining

187
Q

hemorrhoids in children could indicate

A

portal hypertension

188
Q

small flat flaps of skin around the rectum

A

condylomas

189
Q

condylomas are commonly from ___

A

HPV infections

190
Q

light touching anal opening in children should produce

A

anal contraction or wink

191
Q

lack of anal contraction with touch may indicate

A

lower spinal cord lesion or chronic abuse

192
Q

to determine patency in a child, insert catheter no more than __ into the rectum

A

1cm

193
Q

suspect ___, if there is no passage of stool in 24 hrs in a newborn

A

rectal atresia, hirschsprung disease, or cystic fibrosis

194
Q

the cervix and prostate should or should not be palpable in a rectal exam in children?

A

Should not

195
Q

what tool is used to further evaluate for suspected fissures, fistulae, or polyps

A

small proctoscope

196
Q

Bidigital palpation is used to detect

A

perianal abcesses