GU (Female AND Male) Flashcards
Which segment of the breast is most common for breast CA?
Upper outer quadrant is most common for breast CA
What four characteristics of a lump/mass are more concerning for breast CA?
- Irregular
- Fixed
- Hard
- Non-tender
What four motions will you have a patient perform while inspecting the breasts?
- Arms overhead with palms together
- Hands on hips and press down
- Shrug shoulders
- Lean forward
What four skin changes of the breast should be evaluated for?
- Dimpling
- P’eau d’orange
- Nipple inversion
- Supernumerary nipple/extra nipple
What is p’eau d’orange?
Thickened, red/dusky skin concerning for inflammatory BCA
What presentation of nipple inversion is more concerning for breast CA?
Recent onset of inversion that is unilateral = concerning for malignancy
What type of nipple discharge is more concerning?
Bloody or serous, only 1 duct
- Light milky is normal
How do you perform an axillary nodes examination on a female? 4 steps
- 1st hand sweep: anterior axillary region, including Pectoralis muscle
- 2nd hand sweep: mid-axillary HIGH into apex
- 3rd hand sweep: posterior axillary region beneath Teres Minor muscle
- 4th hand sweep: down medial aspect of upper arm
What are the six steps for the female external pelvic examination?
- Palpate inguinal nodes
- Inspect pubic region
- Inspect clitoris, urethral meatus – use one finger of each hand to lift up/out on clitoral hood)
- Inspect labial folds by separating labia minor and labia majora
- Inspect introitus (entrance into vaginal canal); look for atrophy
- Inspect perineum – using back of hands, lift up/out to spread cheeks of buttocks
What are two normal presentations of a cervix?
Parous and nonparous
What does a parous cervix look like?
External os is smooth, circular
What does a nonparous cervix look like? What does this indicate?
External os is large, transverse (indicates history of vaginal delivery)
When using the Spatula/Cytobrush cervical sampling device, what is the protocol for inserting/rotating each part (spatula, brush)?
- Insert spatula into cervical os and rotate 360 degrees
2. Insert endocervical brush (Cytobrush) into cervical os and rotate ½ turn in one direction
When using the Broom cervical sampling device, what is the protocol for inserting/rotating the broom?
Insert central bristles into endocervical canal with shorter bristles contacting ectocervix, and rotate clockwise 5 times
For both the Spatula/Cytobrush cervical sampling device and Broom cervical sampling device, how many times should the device by swirled in solution before discarding?
Swirl in solution at least 10 times
What are three advantages to using the ThinPrep and SurePath pap smears?
- Decreased artifact/ unwanted blood or mucous
- Increased disease detection
- Can test for HPV, STIs simultaneously
What is very important to remember when performing the bimanual exam on a female?
TUCK THE THUMB!
What are the four different types of uterus positions? Which is most common?
- Anteverted (most common): tilted forward slightly
- Anteflexed: flexed/tilted forward
- Retroverted: tilted backward slightly
- Retroflexed: flexed/tilted backward
Which two uterine positions would warrant a rectovaginal examination?
- Retroverted
- Retroflexed
Where are the Bartholin’s glands located and why would you check them (specialized test)?
Bartholin’s glands are at the 5 and 7 o’clock positions of the introitus (entrance to vaginal canal)
- Check for cyst or abscess
Why might you perform Milk the Urethra (specialized exam)?
Complaints of discharge
What two characteristics of a lymph node might indicate cancer?
Hard or immobile nodes suggest cancer
What three structures are you checking for when examining the scrotal contents?
Testes, epididymis, spermatic cord
What should a normal testicle feel like on palpation?
Regular-shaped eraser, or hard-boiled egg-like
