Female GU

Question 1

menopause

Answer 1

absence of menses for 12 consecutive months (usually age 48-55y/o)

Question 2

post-menopausal bleeding

Answer 2

• bleeding occurring 6 months or more after cessation of bleeding

Question 3

dysmenorrhea

Answer 3

pain with menses

Question 4

polymenorrhea

Answer 4

menses at abnormally frequent intervals

Question 5

oligomenorrhea

Answer 5

abnormally scant or infrequent menses

Question 6

menorrhagia

Answer 6

excessive bleeding

Question 7

metrorrhagia

Answer 7

bleeding b/w periods

Question 8

gravida-para notion

Answer 8

• G - gravida - number of pregnancies
• P - para - outcome of pregnancies
  1. T = term > 37 weeks
  2. P = premature
  3. A = abortion < 20 weeks
  4. L = living

Question 9

palpation of Skene’s glands and Bartholin’s glands

Answer 9

• Skene’s glands - 10 and 2 o’clock

- Bartholin’s glands - 4 and 8 o’clock

Question 10

cystocele

Answer 10

prolapsed bladder

Question 11

rectocele

Answer 11

prolapsed rectum

Question 12

insertion of speculum

Answer 12

• hold at 45 degree angle and point downward or posterior

Question 13

gravid cervical os shape

Answer 13

slit-like

Question 14

transitional landmarks

Answer 14

• transformation zone (TZ)

- true squamocolumnar junction (SCJ)

Question 15

transformation zone

Answer 15

• where premalignant changes and neoplasia occur

- encompasses immature and mature squamous metaplasia

Question 16

true squamocolumnar junction

Answer 16

• proximal limit of squamous metaplasia

- usually not visualized (within endocervical canal, approx 3cm from observed SCJ)

Question 17

cervix in fertile phase

Answer 17

• os is open, soft

- fertile mucus

Question 18

cervix in infertile phase

Answer 18

• os closed, hard

- no mucus

Question 19

bimanual exam

Answer 19

• palpate cervix
• palpate uterus
• palpate each ovary - often not palpable

Question 20

version and flexion of uterus

Answer 20

• version - relationship b/w fundus of uterus and vagina

- flexion - relationship b/w fundus of uterus and cervix

Question 21

rectovaginal exam

Answer 21

• to palpate retroverted and retroflexed uterus and uterosacral ligaments
• screen for colorectal cancer in women >50 y/o
• assess pelvic pathology in posterior rectovaginal pouch (Pouch of Douglas)

Question 22

location of mature female breast

Answer 22

• extends from level of 2nd rib to inframammary fold at 6th rib
• extends transversely from the lateral border of the sternum to MAL

Question 23

mm the breasts rest on

Answer 23

deep or posterior surface of the breast rests on the fascia of:

1. pec major
2. serratus ant
3. ext oblique abdominal

Question 24

suspensory ligaments of Cooper

Answer 24

• fibrous bands of CT

- travel through breast, insert perpendicularly into the dermis, and provide structural support

Question 25

lactiferous sinus epithelium

Answer 25

stratified squamous epithelium

Question 26

major ducts epithelium

Answer 26

2 layers of cuboidal cells

Question 27

minor ducts epitheium

Answer 27

single layer of columnar or cuboidal cells

Question 28

arterial supply of the breast

Answer 28

- perforating branches of the internal mammary artery - lateral branches of posterior intercostal arteries - branches from the axillary artery, including the highest thoracic, lateral thoracic, and pectoral branches of the thoracoacromial artery

Question 29

medial mammary arteries

Answer 29

consist of 1. 2nd, 3rd, and 4th ant intercostal perforators 2. branches of the internal mammary artery

Question 30

lateral mammary branches

Answer 30

arises from lateral thoracic artery

Question 31

axillary tail drains into which node

Answer 31

subscapular group of axillary nodes

Question 32

upper portion of breast drains into which node

Answer 32

infraclavicular nodes

Question 33

medial part of breast drains into which nodes

Answer 33

- sub mammary plexus of the opposite breast | - lymph glands along the internal thoracic artery and then to the mediastinal nodes

Question 34

inferior part of the breast drains into which nodes

Answer 34

lymphatics of abdominal wall and to extra peritoneal lymphatic plexus

Question 35

most of the lymph from subareolar and and submammary plexus drain where

Answer 35

anterior or pectoral groups of axillary nodes

Question 36

breast inspection position

Answer 36

patient in seated position, inspect breasts with 1. arms at sides 2. arms over head 3. hands against hips 4. palms pressed together 5. arms extended and bent forward at the waist

Question 37

palpation of breast - patient position

Answer 37

- perform with patient supine and ipsilateral arm above head | - used finger pads and not fingertips

Question 38

palpation of breast - different levels of pressure

Answer 38

- light pressure - feel tissue closest to skin - medium pressure - feel a little deeper - firm pressure - feel tissue closest to chest and ribs