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H & P 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Puberty age

A

8-13

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2
Q

Lactating engorgement

A

First 24-48 hours

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3
Q

4 positions for inspecting breasts seated

A

Arms at side
Arms overhead
Arms on hips with shoulders forward
Leaning forward at waist

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4
Q

Areolae changes in pregnancy

A

Darker brown

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5
Q

Best time for palpation of breasts

A

A week after their menstrual cycle

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6
Q

Do you routinely check for nipple discharge?

A

No

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7
Q

Tenderness on palpation of breasts

A

Cyst, inflammation, infection

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8
Q

Cords on breast palpation

A

Mammary duct ectasia

Tender cords may have mass as well

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9
Q

Describe mastectomy exam

A

2 fingers palpate scar
2-3 finger chest wall sweep
Lymph node exam

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10
Q

Age of breast cancer

A

80% of breast cancers are over the age of 50

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11
Q

Fibrocystic changes

A 
Bilateral
Multiple or single
Round
Soft-firm
Mobile
No retraction
Tender
Varies with menses
Well delineated
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12
Q

Fibroadenoma

A 
Usually bilateral
Usually single
Firm and rubbery
Mobile
Non tender
Well delineated
No variation with menses
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13
Q

Breast cancer characteristics

A 
Single
Irregular, stellate
Hard, stone
Fixed
Retraction
Non tender
Irregular
Peau d'orange
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14
Q

Breast cancer risk factors

A 
>50 age
Female
Hx of breast CA and family hx
Early menarche or late menopause
Alcohol, obesity
Nulliparity
First child after 30 years old
Dense breast tissue
Caucasian
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15
Q

Galactorrhea

A

Increased prolactin, multiductal, serous or milky discharge

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16
Q

Mammary duct ectasia

A

Subareolar ducts dilated or blocked, common in menopausal women, green/brown/sticky discharge

May or may not have a mass behind the nipple or. Retraction of nipple

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17
Q

Intraductal papillomas

A

Wartlike tumor, unilateral, single duct, serous or bloody discharge

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18
Q

Pagets disease

A

Ductal carcinoma manifested with malignant epithelial cells

Crusted nipple, watery discharge

Unilateral or bilateral

Red, scaling, does not respond to steroids

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19
Q

Mastitis

A

Staph aureus

MCC lactating women 2-3 weeks post partum

Swelling, tenderness, erythema, warm to touch, hard mass, purulent discharge

Sudden onset, fever/chills, could form an abscess

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20
Q

Gynecomastia

A

Imbalance of estrogens and androgens in male breast, unilateral or bilateral, usually nontender

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21
Q

Menarche begins

A

11-14 years of age

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22
Q

Size of uterus at 20 week pregnancy

A

Umbilicus

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23
Q

12 week pregnancy size of uterus

A

At symphysis pubis

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24
Q

GTPAL

A 
Gravida
Term birth
Pre term births
Abortion/miscarriage
Living children
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25
Q

Clitoris size

A

2 cm x .5 cm

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26
Q

Car uncle

A

Buldge in the urethra

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27
Q

Skene glands

A

Outward on either side of the urethra at the top of the vagina

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28
Q

Bartholin glands

A

Bilaterally palpate entire labial area with focus on posterolateral portion

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29
Q

Which patients do you assess muscle tone in for females?

A

Women who have had children, concerned about weak muscles or urinary incontinence

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30
Q

Lubricant for speculum

A

Usually water or only a scant amount because it could interfere with a sample

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31
Q

Inserting speculum

A

Oblique or downward slope

Insert length of canal along posterior wall, then rotate horizontal

THEN open blades and move speculum upward to visualize cervi

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32
Q

Cervix color

A

Pink, possible blue hue with pregnancy

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33
Q

Symmetrical red area around so

A

Exposed columnar epithelium

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34
Q

Anterior cervic

A

Retroverted uterus

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35
Q

Posterior cervix

A

Anteverted uterus

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36
Q

Horizontal cervix

A

Midposition uterus

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37
Q

Normal nulliparous cervix

A

Round or oval

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38
Q

Normal parous cervix

A

Slit like

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39
Q

Nabothian cysts

A

Within expected findings on cervix, can become infected

40
Q

Papsmere best results

A

Not mentruating

Avoid intercourse or douching 24-48 hours before

41
Q

Performing papsmere

A

Insert into os, circular clock and counterclockwise to include squamocolumnar junction

42
Q

Wet mount

A

Sample of vaginal discharge, place on slide and add saline

Look under microscope for trichomoniasis or clue cells

43
Q

KOH/whiff test

A

Add drop of 10% KOH to vaginal discharge sample then cover slip, looking for hyphae or budding yeast cells

Whiff- positive with fishy odor for bacterial vaginosis

44
Q

Rugated vaginal walls

A

Premenopausal

45
Q

Smooth vaginal walls

A

Postmenopausal

46
Q

Cystocele

A

Protrusion of the bladder into the vaginal wall

47
Q

Bimanual exam

A

Index and middle finger in the vagina, locate cervix, CMT

48
Q

Anteverted or anteflexed bimanual palpation

A

Internal hand push inward and upward, and downward on cervix

49
Q

Retroverted or retroflexed exam

A

Internal hand in posterior fornix push inward on cervix

50
Q

Uterus size

A

5.5 to 8 cm long, nulliparous, pear shaped

Should be mobile

51
Q

Ovaries on exam

A

3x2x1 cm, slight tenderness, firm and smooth

52
Q

Rectovaginal exam

A

Index finger in vagina and middle finger in rectum, can re evaluate adnexa and uterus and perform stool eval

53
Q

Infant exam

A

Hymen, .5 cm opening

Mucoid discharge up to 4 weeks after birth

Swelling of labia

Adhesions of labia minors

54
Q

Hysterectomy exam

A

Vaginal cuff scar as white or pink line, may Pap smear here if needed

55
Q

PMS

A

Bloating, weight gain, headache, breast swelling, mood swings, cravings all 5-7 days prior to mensstruation

56
Q

Ectopic pregnancy

A

Can be life threatening

Classic triad: vaginal bleeding, amenorrhea, abdominal pain

Pain on one side, could rupture

CMT, if abdominal can feel fetal movements

57
Q

Sites for ectopic pregnancy

A

80% ampullary, 12% isthmic

Both in the Fallopian tube, amupllary is closer to the ovary and isthmic is a little farther away

58
Q

Ovarian cysts

A

Could be asymptomatic

Hx of irregular menses, pain with intercourse

Sudden acute sharp pain could be rupture, peritoneal signs

Could cause torsion

59
Q

Polycystic ovarian syndrome

A

Hirsutism, infertility, oligomenorrhea, obesity, late onset acne with polycystic ovaries

60
Q

Endometriosis

A

Painfula nd heavy periods, pain with sex, associated with infertility in 30-40% of patients

Laparoscopic diagnosis

61
Q

Uterine prolapse

A

Three degrees, complains of heaviness in pelvis or tissue protruding through vagina

62
Q

Myomas

A

Can effect bowel and urination patters if large enough
Heavy menses
Pelvic discomfort

Irregular nodules on uterus

63
Q

Ovarian cancer

A

40 years old, nulliparous, endometriosis, white

64
Q

Ovarian cancer signs and symptoms

A

Abnormal vaginal bleeding, back pain, bloating, vague GI concerns over 40, enlarged ovary

65
Q

Endometrial/uterine carcinoma

A

Adenocarcinoma

Post menopausal 75%

Bleeding post menopausal #1 symptom, need endometrial biopsy

66
Q

Cervical cancer

A

Squamous cell carcinoma

HPV associated! 80% of women HPV infected by age 50

Multiple sexual partners, OCP for >5 years

Abnormal bleeding and ulcerations on cervix

67
Q

Medications that make it difficult to maintain erection

A

Opioids, benzo’s, beta blockers, h2 inhibitors

68
Q

5 p’s

A

Partners, practices, protection from STIs, past history of STIs, prevention of pregnancy

69
Q

Beginning sign of sexual development for a male

A

2.5cm teste and pubic hair stage 2

70
Q

Phimosis

A

Unable to retract the foreskin

71
Q

Paraphimosis

A

Cannot replace the foreskin after retracting it

72
Q

Smegma

A

Dead skin cells, will be around the foreskin and under the penis, this is a normal finding

73
Q

Balantitis

A

Inflammation of the penis

74
Q

Balanoposthitis

A

Inflammation including the glans penis

75
Q

Hypospadias

A

Congenital ventral discplacement of the urethral meatus

76
Q

Urethral meatus stenosis

A

Narrowing of urethral opening, appearing more rounded than slit

Upward stream, difficulty with aim

77
Q

Priapism

A

Sustained erection that cannot go away

Consider leukemia or sickle cell, possible medication use

78
Q

Peyronia disease

A

Shaft that is curved, typically from trauma

79
Q

Chordee

A

Curved shaft that is congenital

Associated with hypospadias

80
Q

Penile carcinoma

A

Unsealing ulcerations, more common in uncircumcised

Glans or foreskin, most often squamous cell

81
Q

Which testicle is typically lower hanging?

82
Q

Hydrocele

A

Usually anteriolateral testicle

Trans illuminates

83
Q

Spermatocele

A

Painless fluid filled benign cyst

Smooth firm lump felt on top of testicle (head of epididymis)

84
Q

Varicocele

A

Enlargement of papminiform venous plexus, heavy achy pain

Bag of worms

85
Q

Scrotal hernia

A

Large mass that reduces when patient lies down

86
Q

Cryptorchidism

A

Undescended testicle

87
Q

Where is the epididymis

A

Posterolateral surface of testes

88
Q

Epididymitis

A

Pain and swelling, erythema and warm to touch

Bacterial infection MCC

89
Q

Testicular carcinoma

A

Painless mass, possible enlargement of testicle or inguinal LAD

Maybe hydrocele

90
Q

Testicular torsion

A

Painful, acute swelling or discoloration

Adolescents commonly

NO cremasteric reflex noted

91
Q

Orchitis

A

Swelling of testicle, heavy and painful

Associated with epididymitis

92
Q

Indirect hernia

A

Most common, maybe bilateral and may progress to scrotum

Feel buldge at the tip of the finger in examination, pain with straining

Less likely to reoccur

93
Q

Direct hernia

A

Less common

Enters through hesselbach triangle and pushes on side of finger on exam

Painless, rarely enters scrotum

More likely to reoccur, buldge appears the same after reduction

94
Q

Femoral hernia

A

More common in females but overall uncommon

Through femoral ring

May have significant pain and strangulation

95
Q

Incarcertaed hernia

A

Cannot be reduced

96
Q

Strangulated hernia

A

Blood supply is compromised secondary to incarceration

Urgent!

97
Q

Foreskin retraction age

A

Partial to urinate but not fully until 3-4 years old

H & P 2 (3 decks)

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