Initial Assessment and Communication in Gynecology

Question 1

promote patient–physician interaction and trust

Answer 1

interpersonal and communication skills

Question 2

Variables that Influence the Status of the Patient:

Patient

Answer 2

• Age
• History of illness
• Attitudes and perceptions
• Sexual orientation
• Habits (e.g., use of alcohol, tobacco, and other drugs)

Question 3

Variables that Influence the Status of the Patient:

Family

Answer 3

• Patient’s status (e.g., married, separated, living with a partner, divorced)
• Caregiving (e.g., young children, children with disabilities, aging parents)
• Siblings (e.g., number, ages, closeness of relationship)
• History (e.g., disease)

Question 4

Variables that Influence the Status of the Patient:

Environment

Answer 4

• Social environment (e.g., community, social connectedness)
• Economic status (e.g., poverty, insuredness)
• Religion (e.g., religiosity, spirituality)
• Culture and ethnic background (e.g., first language, community)
• Career (e.g., work environment, satisfaction, responsibilities, stress)

Question 5

essential to patient assessment and treatment

Answer 5

Good communication

Question 6

The foundation of communication is based on key skills:

Answer 6

empathy, attentive listening, expert knowledge, and rapport

AERE

Question 7

the fundamental element that encourages open communication of the patient’s feelings, concerns, and thoughts, rather than withholding information

Answer 7

Trust

Question 8

the fundamental element that encourages open communication

Answer 8

Trust me

Question 9

very basic element of communication

Answer 9

sharing a common language and culture

Question 10

traditional role of the physician was

Answer 10

paternalistic

Question 11

can influence interactions with the patient

Answer 11

pattern of the physician’s speech

Question 12

Important Components of Communication between the Patient and Physician:

Physician Is:
The Physician Is Not:

Answer 12

Physician is:
GGFF
CHER

Question 13

essential to the maintenance of a relationship between the patient and physician that will foster ongoing care

Answer 13

Good communication

Question 14

Female physicians

Answer 14

Less talkative
Tends to listen
Less assertive
Speech is characterized by, silence, questions and proposals

L
A
T
S - SPQ

Question 15

The art of communication and persuasion

Answer 15

Style

Question 16

Following are techniques to help achieve rapport with patients:

Answer 16

• Use positive language (e.g., agreement, approval, and humor).
• Build a partnership (e.g., acknowledgment of understanding, asking for opinions, paraphrasing, and interpreting the patient’s words).
• Ask rephrased questions.
• Give complete responses to the patient’s questions

Question 17

suggests that the patient will follow the physician’s recommendations or
“orders.”

Answer 17

Compliance

Question 18

an essential component that promotes open communication

Answer 18

Humor

Question 19

can be used as an appropriate means of relaxing the patient and making her feel better.

Answer 19

Laughter

Question 20

a “metaphor for the full range of the positive emotions.”

Answer 20

Laughter

Question 21

the response of human beings to incongruities

Answer 21

Laughter

Question 22

characterize good medical interviewing techniques.

Answer 22

Attentiveness, rapport, and collaboration

A R C

Question 23

Gynecologic History

Answer 23

• Menstrual history
• Contraceptive use
• Sexual history
• Coitarche/ with whom
• Number of partners
• Last sexual contact
• History of Sexually transmitted infection

Question 24

are considered to be essential parts of the gynecologic examination

Answer 24

examination of the breasts and abdomen and a complete examination of the pelvis

P B A

Question 25

The abdomen should be inspected for signs of an intra-abdominal mass, organomegaly, or distention that would suggest ascites or intestinal obstruction.

Answer 25

OK

Question 26

A fullness in the upper abdomen could be consistent with an __

Answer 26

“omental cake.”

Question 27

The instrument should be warmed with tap water—not lubricated—if vaginal or cervical smears are to be obtained for the test or if cultures are to be performed.

Answer 27

OK

Question 28

Discharge - should be studied to detect trichomoniasis, monilia, and clue cells and to obtain cultures, primarily for gonococci and chlamydia.

Answer 28

OK

Question 29

Unusual bleeding from the cervical canal, except during menstruation, merits an evaluation for __

Answer 29

cervical or uterine neoplasia

Question 30

Hot to do Bimanual palpation

Answer 30

PPT pg 60

Question 31

Smear the stool to test for occult blood

Answer 31

guaiac

Question 32

Ulcerative or purulent lesions of the vulva should be evaluated and __ as outlined in subsequent chapters, and __ should be performed on any lesions.

Answer 32

cultured

biopsy

Question 33

Sexually active adult:
__ speculum is typically used

Answer 33

Pederson speculum i

Question 34

women who have
- lax vaginal walls,
- are pregnant,
- will be undergoing cervical or
- endometrial biopsies or procedures:
__ speculum may be required

Answer 34

larger Graves speculum

Question 35

“Virginal” speculum

Answer 35

Huffman

Question 36

An endometrial biopsy usually is performed with a __ or __

Answer 36

flexible cannula or a Novak curette

Question 37

Stool testing for occult blood has been found to reduce colon cancer mortality for individuals older than age __

Answer 37

50

Question 38

Nodularity and tenderness within the rectovaginal septum suggests __;
nodularity may also suggest the spread of an intra-abdominal malignancy such as __

Answer 38

endometriosis

ovarian cancer

Question 39

•A speculum examination should not be performed in a prepubertal child in the office - __ position

Answer 39

“frog leg” position

Question 40

very young girls (toddlers or infants) - __ position may also be helpful for the examination

Answer 40

knee-chest position

Question 41

The keys to a successful examination in an adolescent lie in __

Answer 41

earning the patient’s trust

Question 42

an important issue in adolescent health care

Answer 42

Confidentiality

Question 43

Breast examination
• Should be a part of the physical examination of female patients specially those __ years old and above

Answer 43

40 years old and above.