Breast And Female Wellness Exam

Question 1

What are the advantages of ThinPrep and SurePath?

Answer 1

• improved specimen adequacy and uniform preparation of cells on each slide
• decreased blood, mucus and artifact
• increased disease detection
• decreased incidence of equivocal diagnoses
• concurrent testing for HPV, chlamydia, trichomonas vaginalis and mycoplasma genitalium

Question 2

When would you examine the bartholin glands

Answer 2

If patient complains of labial swelling

Question 3

What should you be doing while sliding speculum in

Answer 3

Applying downward pressure

Question 4

What is p’eau d’orange?

Answer 4

Skin change in the breast that is thickened skin and enlarged pore. RED FLAG for cancer

Question 5

What is the best validated technique for detecting breast masses?

Answer 5

Vertical strip pattern

Question 6

What makes an inverted nipple very suggestive of underlying malignancy?

Answer 6

RECENT onset on ONE side

Question 7

When would you milk the urethra

Answer 7

If you have concern for infections

Question 8

What should we say instead of “looks good”

Answer 8

“Everything appears healthy and normal”

Question 9

Do we call them stirrups🐎

Answer 9

No 🐴

Question 10

How do you do a Pap smear with a spatula and brush?

Answer 10

Insert spatula into os, rotate 360 degrees to get ectocervical cells

Swirl in solution 10x

Insert endocervical brush into os and rotate 1/2 turn to get endocervical cells

Swirl in solution 10x

Question 11

What should you do before you insert the speculum?

Answer 11

Show it to the patient

Demonstrate how it opens

Tell them it may click

Might feel pressure

Should not hurt

Question 12

Should patient be supine or sitting up to check axillary nodes?

Answer 12

Either one

Question 13

When should you close the speculum?

Answer 13

After unclamping the cervix

Question 14

What is the axillary area of breast tissue called

Answer 14

Tail of SPence

Question 15

How do you check for cystoceles or rectoceles?

Answer 15

With two fingers inserted in vagina, ask patient to bear down

Question 16

What should we say instead of “feel”

Answer 16

Checking, examining or inspecting

Question 17

What makes a breast mass concerning vs not as concerning?

Answer 17

Concerning: fixed, nontender, irregular borders

Less concerning: mobile, tender, round

Question 18

What shape and consistency is the uterus

Answer 18

Pear shaped, round, firm and smooth

Also described as similar in shape and consistent to a fist

Question 19

What angle should the speculum be in when you insert it?

Answer 19

45 degree angle so you don’t injure the urethra

Question 20

What is the most common position of the uterus

Answer 20

Anteverted

Question 21

What does spontaneous vs induced nipple disachrg mean?

Answer 21

Induced- had to do with arousal/breastfeeding

Spontaneous- randomly found on bra at the end of the day

Question 22

When should you try to elicit nipple discharge?

Answer 22

If there is a history

Question 23

What are the two types of speculum

Answer 23

Pedersen- smaller and straight

Graves- bigger duck bill

Question 24

What is meant by gravity, parity and abortion?

Answer 24

Gravity- number of times pregnant

Parity- outcome of each pregnancy

Abortion- was it spontaneous or induced?

Question 25

What makes nipple discharge abnormal v normal?

Answer 25

Abnormal: serous or bloody

Maybe normal: light milky

Question 26

What should we do before we touch a patient’s breast

Answer 26

Talk to them

Question 27

Which speculum type is better for someone who has never had a vaginal delivery?

Answer 27

Pedersen

Question 28

Should you use KY jelly when doing the bimanual exam?

Answer 28

Yes because you already did the Pap smear

Question 29

Should you be sitting or standing for the bimanual exam

Answer 29

Standing

Question 30

Should you use KY jelly when you collect a Pap smear sample

Answer 30

No, just use water

Question 31

Where is the primary lymphatic drainage of the breast?

Answer 31

To axilla

Secondary drainage to internal mammary nodes. May also drain to supraclavicular and infraclaviualr nodes

Question 32

What are the 4 motions your patient should do for the inspection part of breast exam?

Answer 32

Arms overhead

Hands pressed against hips

Arms at sides and shrug shoulders

Leaning forward

Question 33

Should you tell the patient to spread her legs or push them apart?

Answer 33

No

Question 34

What is the chandelier sign?

Answer 34

If its painful for the pt when you rock the cervix from side to side.

Means they have PID

Question 35

What are the expected findings of palpating ovaries

Answer 35

Smooth and oval shaped

Mildly tender to palpating

Similar to an almond?

Question 36

Should you do a rectovaginal exam every time

Answer 36

No only if they have a retroverted or retroflexed uterus (or you suspect colon cancer)

Question 37

Where are most breast cancers?

Answer 37

Upper outer quadrant

Question 38

Should you wash your hands and wear gloves when doing a pelvic exam

Answer 38

Yes lol

After you got her into position, make sure you’re done touching the table and her feet, etc

Question 39

How do you do a papsmear with a broom

Answer 39

Insert central bristles into endocervical canal with the shorter bristles on the ectocervix

Rotate clockwise 5x

Push broom on bottom of vial 10x

Swirl vigorously

Question 40

How do you disengage the speculum from the cervix?

Answer 40

Open one more click

Tip front of speculum down and pull back

Now close the speculum and pull it out