Female GU abnormals Flashcards
_______ areas can have epidermoid cysts, are these infectious?
glandular areas can have epidermoid cysts, not infectious
what are the Bartholin’s glands? what if there is a cyst there?
located on each side of the vaginal opening. These glands secrete fluid that helps lubricate the vagina
- more likely an abscess there.
HPV leads to _____ ________
secondary syphilis leads to _______ _______
HPV leads to condyloma acuminatum
Secondary syphilis leads to condyloma latum
what is the vaginal introitus?
The vaginal introitus is the opening that leads to the vaginal canal
types of sores: Herpes lesion is….
Syphilitic chancre is …..
Herpes lesion is painful, shallow, small, with red base
Syphilitic chancre is painless, firm
vaginal cancer: Can be _______ or ______.
Can be ulcerated or raised; skin “looks different”. maybe outgrowths of irregular, cauliflower-like growths
what should the cervix look like? what about the cells around the os ?
Color should be shiny pink; may still have columnar cells around os which will be darker red
abnormal finding of cervix: cervicitis (caused by gonorrhea)
Look for mucopurulent yellow drainage from the os in cervicitis
3 types of vaginitis discharge
Trichomonal vaginitis
Candidal vaginitis
Bacterial vaginitis
if someone has a strawberry cervix and lots of frothy discharge?
trichomonas
what will DM patients likely get?
candidiasis
5 things to note about the cervix on bimanual exam
Position, Shape, Consistency, Regularity,
mobility- (should be mobile and nontender)
two abnormal positions of the uterus
retroverted: angle between cervix and uterus is normal ( but TOGETHER is abnormal)
retroflexed: angle BETWEEN cervix and uterus is abnormal (wider) - uterus tipped back
- no problems with these, just congenital differences
what does pedunculated mean?
pedunculated = has a stalk its hanging off of
ovary, Hard to palpate so if you find one in a postmenopausal woman think _____
cancer
May be able to palpate one in _____ ______ _____
thin relaxed women
Palpate the adnexa for ______ or ______
Tenderness may be______, ______ or ______
often described as _____ in the adnexa
Palpate the adnexa for tenderness or masses
Tenderness may be infectious, ectopic pregnancy, or ovarian cyst
Oftentimes described as “fullness” in the adnexa
what does adnexa mean?
the parts adjoining an organ.
pelvic muscle strength: Weakness can be from….
Can also have tightening from ….
Weakness can be from aging, vaginal deliveries, neurologic conditions,
Can also have tightening from spasm of muscles
rectovaginal exam to assess the posterior uterine wall for … (4)
To assess the posterior uterine wall…
Retroverted uterus
Cul-de-sac
Adnexa
Colorectal cancer in women 50 years or older
also endometriosis … (Airey didnt specifically say.. but talked about it when we talked about this exam)
what is endometriosis?
can grow between uterus and anus: uterine tissue comes out of uterus and implants around abdominal cavity - reacts to hormones throughout menstrual cycle= painful , sex is painful, blood into abdomen with every period
what is the most common type of hernia?
Indirect inguinal hernia : At or through the internal inguinal ring , Located above the inguinal ligament
what is the second most common type of hernia? what it is hard to differentiate from?
femoral hernia: Hernia appears below the inguinal ligament, Hard to differentiate from lymph nodes
inspection for a hernia: what two things do you look for? what do you ask the pt to do?
look for any asymmetry or bulges. Ask patient to bear down and look for any changes
palpation for a hernia:
Have patient stand in front of you
______ the index finger into the scrotum and palpate …
Ask patient to bear down checking for …
Palpate for femoral hernia by …
Invaginate the index finger into the scrotum and palpate the external inguinal ring just lateral to the pubic tubercle
Ask patient to bear down checking for any bulges or masses that are appreciated against the side of the finger or at the finger pad. Same with left side
Palpate for femoral hernia by asking patient to bear down while palpating the femoral canal.
possible scrotal hernia? what do you do? what do you look and listen for?
Ask patient to lay down
look to see if mass retracts
Listen for bowel sounds
what is balanitis? what could this indicate that the patient has?
inflammation of the glans penis, pt might have DM
phimosis vs paraphimosis
phimosis is when you can’t retract the foreskin, paraphimosis is when the foreskin can’t be replaced back over the glans (gets stuck behind it)
hypospadias
urethra meatus is displaced
Starts as a small red papule and becomes a painless erosion up to 2 cm in diameter; base is clean, red, smooth, and glistening with raised indurated borders.
what is this?
sphylitic chancre
Small scattered grouped vesicles 1-3 mm in size on glans or shaft; may appear as an erosion of vesicle opens; usually caused by what?
HSV 2
single or multiple papules or plaques of variable shapes; raised, flat, cauliflower-like (verrucous). what is this?
venereal wart
Palpable, nontender, hard plaques just below skin usually along dorsum of penis; complaints of crooked, painful erections. what is this?
peyroine’s disease
spontaneous descent of undescended testes usually occur by __ months old.
3, rarely occurs after 4 months
if you still have undescended testes (cryptochordism) after __ months, need for fix unless what?. how do you count this?
if still have after 6 months, need to fix (unless they were born early… start counting from the time they were SUPPOSED to be born)
what is this?
Dome-shaped white or yellow papules/nodules on the scrotum
epidermoid cyst
follicles clogged with keratin debris of desquamated follicular epithelium; common; frequently multiple; benign
what is a hydrocele and how do you test for it?
Abnormal collection of fluid between the tunical layers and is congenital or acquired
Dx: transillumination ( “glows like a pumpkin”)
“bag of worms” appearance of the scrotum, likely on the left side. Slowly collapses when scrotum is elevated in supine patient. what is this?
varicocele. Spermatic cord or scrotal enlargement caused by dilation of pampiniform venous plexus
what is a spermatocele? how do you diagnose it? how it is different from an epidermoid cyst?
Cystic dilation of epididymis involving upper or epididymal head. Usually small and painless following an episode of epididymitis
Dx. Transilluminating cystic mass above and separate from testis
- similar to EC but Fluid contains dead spermatozoa
acute epididymitis presentation
tender, swollen, may be difficult to distinguish from testis. Scrotum may be red and vas deferens inflamed; usually in adults
tuberculous epididymitis presentation
chronic inflammation of tuberculosis produces a firm enlargement of epididymis; sometimes tender; thickened/beaded vas
who does epididymitis present more commonly in? bilateral or uni?
young men, unilateral usually
what is “sterile” epididymitis?
no infectious cause found, associated with vigorous physical activity
testical giant red and inflamed, VERY tender. what is this?
epididymitis
