Female GU exam

Question 1

Menorrhagia

Answer 1

excessive bleeding

Question 2

oligomenorrhea

Answer 2

abnormal or scant or infrequent menses

Question 3

metrorrhagia

Answer 3

bleeding b/w periods

Question 4

post-menopausal bleeding

Answer 4

bleeding occurring 6 mo. or more after cessation of bleeding
*sign of cervical cancer**

Question 5

dysmenorrhea

Answer 5

pain with menses

Question 6

polymenorrhea

Answer 6

menses at abnormally frequent intervals

Question 7

Gravida-Para notation

Answer 7

G#P-term, premature,abortions, living

Question 8

bartholins glands

Answer 8

within the labia majora 
secrete lubrication 
duct that opens into the labia minora that can easily become plugged 
(can cause an abscess) 
4 and 8 o'clock

Question 9

Skene’s glands

Answer 9

opening is adjacent to urethra
also secrete lubricant
make sure there is no swelling etc

10 and 2 oclock

Question 10

Cystocele

Answer 10

as the bladder distends
can actually bulge out of the vagina

can cause urinary incontinence

Question 11

rectocele

Answer 11

occurs as the floor (posterior wall) of the vagina becomes weak and bulges into the vagina

generally asymptomatic

often occurs in women with a lot of pregnancies, causes weakening of the muscular layer

Question 12

cervical os

Answer 12

flattened in women who has delivered children

in nulliparous women it tends to be more rounded
look for shape, polyps, pus, cancer, cysts

transformation zone from columnar to squamous

Question 13

transformation zone

Answer 13

transformation from columnar to squamous at the cervical os

cell types bumping up against each other
site of dysplasia where you need to collect samples

immature and mature squamous metaplasia

Question 14

true squamocolumnar junction

Answer 14

prox limit of squamous metaplasia
usu not visualized, within the endocervical canal
3 cm from observed SCJ

Question 15

cervical polyps

Answer 15

overgrowth of columnar epithelium

tend to be benign

Question 16

Nabothian cytsts

Answer 16

inflammation of glandular cysts over the cervix
also benign
can be confused with a cancer

Question 17

Version

Answer 17

the relationship b/w the fundus of the uterus and the vagina

anteverted Fundus is less than 180deg from the vagina

Retroverted is greater than 180 deg from vagina

Question 18

flexion

Answer 18

relationship b/w the fundus of the uterus and the cervix
is the uterus bent

anteflexed= the uterus is flexed anteriorly (most common is anteverted and anteflexed) 
retroflexed= the uterus is "extended" (i.e. bent posteriorly

Question 19

Rectovaginal exam: 3 purposes of

Answer 19

1) palpate a retroverted and retroflexed uterus and uterosacral ligaments
2) screen for colorectal cancer in women 50yrs or older
3) assess pelvic pathology in the posterior rectovaginal pouch (pouch of Douglas)

Question 20

breast vascular supply

Answer 20

internal mammary
lateral branches of the posterior intercostal a.
branches off the axillary a.

Question 21

lymphatic drainage of the breast

Answer 21

most of the lymph from the subareolar and sub mammary plexi drain into the anterior or pectoral group of lymph nodes

Question 22

optimal time to examine breast

Answer 22

5-7 days following the LMP

due to lowest influence of E2 on the glandular tissue

Question 23

axillary tail drainage

Answer 23

drains into the subscapular group of axillary nodes

Question 24

upper portion of breast drainage

Answer 24

drains into the infraclavicular group

Question 25

medial drainage of breast

Answer 25

drained by submammary plexus of the opposite breast and lymph nodes along the internal thoracic a and then to the mediastinal nodes

Question 26

inferior part of the breast drainage

Answer 26

to the lymphatics of the abdominal wall and extra peritoneal lymphatic plexus