Phys Di Female Genetalia

Front 1

Location of supernumerary nipple

Back 1

In nipple line

Front 2

Non tender, small nodules on areola

Back 2

Montgomery tubercles

Front 3

Positions for breast examination

Back 3

Arms at side, hips, raised, leaning forward

Front 4

Tool used for assessing growth & development in breasts

Back 4

Tanner Staging

Front 5

Tanner Stage ?: Breast more elevated, extends beyond areola which is still contour w/ surrounding breast

Back 5

III

Front 6

Tanner ?: Breast reaches final adult size, areol returns to surrounding contour, projecting central papilla

Back 6

Tanner V

Front 7

Tanner ? Breast bud forms, small area of surrounding glandular tissue; areola widens

Back 7

Tanner II

Front 8

Tanner ? No glandular tissue, areola follows skin contour

Back 8

Tanner I

Front 9

Tanner? Increased breast size & elevaiton, areola & papilla form a secondary mound projecting from contour

Back 9

Tanner IV

Front 10

Thickened, porous/dimpled skin (d/t edema) secondary to blocked lymph gland;

Back 10

Pea d'orange

Front 11

Surface manifestation of underlying ductal CA; Red scaling, crusty patch on nipple & surrounding skin

Back 11

Paget's Dz

Front 12

Mass pulls on suspensory ligament of Copper

Back 12

DImpling

Front 13

Normal, nontender, small nodules on areola

Back 13

Montgomery tubercles

Front 14

Methods of breast palpation

Back 14

Vertical stripe
Circular
Wedge

Front 15

Divisions of breast

Back 15

4 quadrants & Tail of SPence

Front 16

Most B CA occur:

Back 16

Tail

Front 17

Breast masses characterized by (8)

Back 17

Location
Size
Shape
Consistency
Tenderness
Mobility
Borders
Retraction

Front 18

Multiple benign, bilateral mobile cysts, increase in pain w/ premenstrual

Back 18

Fibrocystic dz

Front 19

Benign neoplasm, bilateral, mobile, nontender, doesn't vary w/ menstrual cycle

Back 19

Fibroadenoma

Front 20

Unilateral, single nonmobile, non tender, non cyclic

Back 20

Malignant breast tumor

Front 21

Increased breast tissue in males; bi or unilateral

Back 21

Gynecomastia

Front 22

Causes for Gynecomastia

Back 22

Testicular, pituitary tumors, liver failure, meds, pot smoking

Front 23

Lactation not associated w/ child bearing

Back 23

Galactorrhea

Front 24

Causes of Galactorrhea

Back 24

Meds, prolactin secreting tumors, hypothyroid

Front 25

Infection & inflammation of breast tissue, common in lactating women

Back 25

Mastitis

Front 26

Female external genetalia AKA

Back 26

Vulva

Front 27

Vulva includes: (8)

Back 27

Mons pubis
Labia majora
Labia minora
Clitorus
Vestibular glands
Vaginal vestible
Vaginal orifice
Urethral openin

Front 28

Mastitis tx in lactation

Back 28

Mom on Bactrim (for MRSA!)

Front 29

Unilateral, redness, tender labial swelling

Back 29

Bartholin gland abscess

Front 30

Labia minor enclose:

Back 30

Vestibule

Front 31

Discharge, polyp, fistula on urethra indicates

Back 31

UTI

Front 32

Skene's gland fxn

Back 32

Drain grou of urethral glands

Front 33

Skene's gland exam

Back 33

Index finger into vagina up to 2nd joint, palm facing upward, milk glands, should see no discharge

Front 34

Bartholin's glands location & fxn & exam

Back 34

Posterolateral portion of vaginal opening; secrete mucus during intercourse; "pinch" between fingers

Front 35

Is milking skene's gland routine?

Back 35

No

Front 36

Prior to speculum insertion/bimanual check for

Back 36

Cystocele or Rectocele

Front 37

Hernia protrusion of urinary bladder through anterior wall of vagina, may exit introitus, felt as pt bears down

Back 37

Cystocele

Front 38

Major SE of cystocele

Back 38

Urinary stress incontinence

Front 39

Hernia protrusion of rectom through posterior wall of vagina

Back 39

Rectocele

Front 40

When to lubricate speculum w/ only water:

Back 40

If plan to obtain cytologic study

Front 41

Placement of speculum

Back 41

Place left 2 & 3 fingers into vagina, palm downward, apply pressure downware, separate minor so opening is clear, insert full length of vagina

Front 42

Position of ____ correlates with position of uterus

Back 42

Cervix

Front 43

If cervix points ____, uterus is retroverted

Back 43

Anteriorly

Front 44

If cervix points ____, uterus is anteverted

Back 44

Posteriorly

Front 45

If cervix points ____, uterus is mid-position

Back 45

Horizontal

Front 46

Normal discharge:

Back 46

Odorless, creamy or clear, thick, thin, or stringy

Front 47

Small, round, oval os = ____parous

Back 47

Null

Front 48

Horizontal slit or irregular/stellate os = ___ parous

Back 48

Multip

Front 49

NL Color of cervix

Back 49

Pint

Front 50

Blue cervix=

Back 50

INcrease vascularity --> pregnancy

Front 51

Red, friable cervix =

Back 51

Infxn

Front 52

Small white or yellow cysts on cervix (NL finding)

Back 52

Nabothian cysts

Front 53

PAP: Vaginal specimens obtained when?

Back 53

While speculum in place, after cervix & surrounding tissues have been inspected

Front 54

PAP: ___ sample collected first

Back 54

Ectocervical

Front 55

Devices that can be used to obtain ectocervical sample

Back 55

Spatula
Brush

Front 56

PAP ___ sampel collected 2nd

Back 56

Endocervical

Front 57

PAP: Cervex-Brush device collects
Procedure:
-Pro

Back 57

-Collects both endo & ectocervical
-Long brush endo; lateral ecto; twist 3 times L & R,
-Less bleeding

Front 58

PAP: Gonococcal culture procedure

Back 58

Place sterle dacron Q tip into cervical os, hold for 30 seconds, spread Z pattern over medium while rotating swab

Front 59

PAP: DNA probe for gonoccocal/chlamydia
-Use what device?
-Pro

Back 59

Dacron swab
Rapid & sensitive

Front 60

PAP: If woman complains of vaginal d/c or recent unprotected sex, do ___

Back 60

Wet prep

Front 61

Wet prep IDs: (3)

Back 61

Trich
Candidiasis
BV

Front 62

Wet prep procedure

Back 62

1Swab vaginal discharge (w/ 2 swabs), place on slide, add drop of NL saline, cover slip
2 Separate slide - drop of aqueous 10% KOH

Front 63

Fish odor (whiff test) indicates

Back 63

BV

Front 64

KOH dissolves___, making ___ more visbile

Back 64

Dissolves debris, making hyphae & budding of yeast more visible

Front 65

What to do as removing speculum

Back 65

Inspect vaginal walls

Front 66

Color of vaginal wall compared to cervix

Back 66

A little lighter pink

Front 67

Spatula is getting ___ cells from inner perimeter of os

Back 67

Endocervical or transitional cells

Front 68

Remember, ___ is separate from wet prep

Back 68

Gon & chlamyd

Front 69

If cervical motion tenderness is present, must:

Back 69

Tx for PID

Front 70

Structures felt in bimanual exam (4)

Back 70

Cervix
Uterus
Adnexa & ovaries
Rectovaginal

Front 71

Cervix felt for:

Back 71

Size, length, shape
Nodules, hard/roughness, ruptured tubal pregnancy

Front 72

Difference in uterus during pregnancy/not pregnant

Back 72

Not preg - Hard; Preg- soft

Front 73

How to test for PID during cervix bimanual exam

Back 73

Move to side; if painful - think PID

Front 74

Approx size of uterus

Back 74

5x8 cm

Front 75

Common, benign, uterine tumors; feel firm & irregular

Back 75

Fibroids

Front 76

IF ovaries palpable, shoudl feel:

Back 76

firm, smooth

Front 77

Expected position of uterus

Back 77

Anteverted

Front 78

Other positions seen

Back 78

Anteflexed, retroverted

Front 79

Exam maneuver that allows you to reach almost 1 inch higher into pelvis

Back 79

Rectovaginal

Front 80

Rectovaginal procedure

Back 80

Index finger in vagina, middle finger in rectum

Front 81

rectovaginal good exam for :

Back 81

Older pts, retroverted uterus

Front 82

Growth of endometrial tissue outside of uterus, causes pain, dysmenorrhea

Back 82

Endometriosis

Front 83

Thin white or gray d/c, fishy odor, clue cell on wet prep, hx of rough sex, douching, hot bath

Back 83

Bacterial vaginosis

Front 84

Is BV a sexually transmitted dz?

Back 84

No

Front 85

White curdy d/c, itching, wet prep KOH w/ budding yeast

Back 85

Candidiasis

Front 86

Genital warts AKA

Back 86

Condyloma Acuminatum

Front 87

#1 contributor of cervical cancer
sessile exophytic papillomas

Back 87

HPV

Front 88

PainLESS ULCER of primary syphilis

Back 88

Syphilitic chancre

Front 89

PainLESS LESION/growth of Secondary syphilis

Back 89

Condyloma latum

Front 90

Fever
dysuria
lymphadenopathy
PainFUL genital vesicle --> then ulcer
oral ulcer
Tingling prodrome

Back 90

Herpes

Front 91

genital papules
acute onset:painful genital ulcer
lymphadenitis and buboes
Haemophilus ducreyi.

Back 91

Chancroid

Front 92

Mostly asymptomatic in women
+/- PID symptoms
+/- Yellow/cloudy cervical discharge
friable cervix
abnormal vaginal bleeding

Back 92

Chlamydia

Front 93

Diagnostic test for chlamydia

Back 93

nucleic acid amplification test (DNA probe)

Front 94

May look similar to chlamydia
mucopurulent or purulent exudate at the endocervix
anterior cervical lymphadenopathy
conjunctivitis

Back 94

Gonorrhea

Front 95

Diagnostic test for gonorrhea

Back 95

DNA probe

Front 96

Medially protruding cystic structure at the inferior aspect of the labia majora, in the 5 or 7 o'clock position
Vulval pressure, pain while sitting/walking

Back 96

Bartholin gland abscess

Front 97

Bartholin gland abscess caused by; results in:

Back 97

Cyst: Noninfectious occlusion of the distal Bartholin duct with resultant retention of secretions.

Front 98

Most common bacterial cause of bartholin gland abscess

Back 98

Gonorrhea

Front 99

Copious Frothy green d/c, adherent to vaginal wall
Strawberry cervix
Pear shaped protozoa ("swimming footballs") on wet prep

Back 99

Trichomonisasis

Front 100

pearly papule with a central dell, pruritic

Back 100

Molluscum contagiosum

Front 101

Back 101

Bartholin abscess

Front 102

Back 102

bartholin?

Front 103

Back 103

Candidiasis

Front 104

Back 104

Chancroid

Front 105

Back 105

Clue cell

Front 106

Back 106

COndyloma

Front 107

Back 107

Cystocele & rectocele

Front 108

Back 108

Herpes

Front 109

Back 109

HPV

Front 110

Back 110

Molluscum

Front 111

Back 111

Montgomery Tubercle

Front 112

Back 112

Multiparous

Front 113

Back 113

Nabothian cyst

Front 114

Back 114

Nulliparous

Front 115

Back 115

Paget

Front 116

Back 116

Strawberry cervix

Front 117

Back 117

Syphilis Chancre

Front 118

Back 118

Syphilis condyloma latum

Front 119

Back 119

Trich