Female Genitalia and Speculum Examination

Question 1

normal visible structures

Answer 1

rugae in vagina

nulliparous os (non-vaginal delivery)

multiparous os (vaginal delivery)

Question 2

indications for speculum

Answer 2

• abnormal bleeding
• pain (chronic pelvic pain, dyspareunia)
• vaginal foreign body (retained tampon)
• swelling

Question 3

positioning of patient

Answer 3

supine, bringing heels up to buttocks and knees , let knees fall outwards

Question 4

external examination

Answer 4

• swelling
• abnormalities
• discharge

Question 5

lubricating speculum

Answer 5

cover speculum in lubrication, except very tip because you don’t want to contaminate it

Question 6

inserting speculum

Answer 6

horizontally then rotate handles so that they are rotated upwards

keep non dominant hand on handle to keep speculum in

Question 7

internal inspection

Answer 7

may see IUD

Question 8

ectropian

Answer 8

red, inflamed cervix

caused by changes in fluctuations in hormones

e.g. in pregnancy

Question 9

candida

Answer 9

thrush infection

yellow creamy discharge

Question 10

trichomoniasis

Answer 10

discharge around os?

Question 11

thick white discharge

dysuria

pelvic pain

friable cervix

Answer 11

gonorrhoea

Question 12

yellow-green

itchy

frothy

foul smelling

Answer 12

trichomonas

Question 13

thin, grey/green discharge with fishy odour

Answer 13

bacterial vaginosis

Question 14

thick, white, cottage cheese discharge , itchiness

Answer 14

candida albicans

Question 15

high vaginal swab

Answer 15

lateral fornices to posterior to lateral forncies, rotating

Question 16

end of cervical swab

Answer 16

first brush to clean mucus

second to take swab