Modue 7 Review Flashcards

1
Q
Posteriorly, the labia minora meets as two ridges that fuse to form:
A. Fourchette
B. Vulva
C. Clitoris 
D. Perineum
A

A

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2
Q

A cervical polyp usually appears as a:
A. Grainy area at the endocervical joint
B. Bright red, soft protrusion from the endocervical canal
C. Transverse or Stellate scar
D. Hard granular surface at or near the os

A

B

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3
Q
Which structure is located Posteriorly on each side of the vaginal orifice?
A. Skene glands
B. Clitoris 
C. Perineum
D. Bartholin glands
A

D

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4
Q

During sexual excitement, how is the vaginal introitus lubricated?

A. The Bartholin glands
B. The clitoris produces moisture
C. The skene glands drain fluid
D. The urethral surfaces secrete water

A

A

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5
Q

The vaginal mucosa of a woman of childbearing years should appear:’

A. Smooth and pink
B. Moist and excoriated
C. Dry and popular
D. Transversely rugated

A

D

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6
Q

The adnexa of the uterus are composed of the:

A. Corpus and cervix
B. Fallopian tubes and ovaries
C. Uterosacral and broad ligaments
D. Vagina and fundus

A

B

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7
Q

A bluish color of the cervix during pregnancy is called the:

A. McDonald sign
B. Spinnbarkeit
C. Goodell sign
D. Chadwick sign

A

D

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8
Q

The pelvic joint that separates most appreciably during late pregnancy is the:

A. Sacroiliac joint
B. Symphasis
C. sacrococcygeagl
D. Illofemoral

A

B

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9
Q

Pregnancy-related cervical changes include:

A. Flattening and lengthening
B. Thinning and reddening
C. Hardening and pallor
D. Softening and bluish color

A

D

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10
Q

Mrs. Robinson, a 49-year-old patient, presents to the office complaining of missing her menstrual period. She asks about menopause. You explain to her that the conventional definition of menopause is:

a. the first day of the last menstrual period.
b. 1 year with no menses.
c. the last day of the last menstrual period.
d. the cessation of ovulation.

A

B

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11
Q

Which systemic feature is related to the effects of menopause?

a. Increased abdominal fat distribution
b. Decreased LDL levels
c. Cold intolerance
d. Decreased cholesterol levels

A

A

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12
Q

Ms. A, age 32, states that she has a recent history of itchy vaginal discharge. Ms. A has never been pregnant. Her partner uses condoms and she uses spermicide for birth control. Which of the following data are most relevant to Ms. A’s problem?

a. Bowel habits
b. Douching routines
c. Menstrual flow
d. Nutritional factors

A

B

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13
Q

Which risk factor is associated with cervical cancer?

a. Endometriosis
b. Low parity
c. Multiple sex partners
d. Obesity

A

C

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14
Q

The risk of ovarian cancer is increased by:

a. the use of oral contraceptives.
b. cigarette smoking.
c. age between 35 and 50 years.
d. early age at first intercourse.

A

A

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15
Q

The form of gynecologic cancer that is increased in obese women is:

a. vaginal.
b. cervical.
c. ovarian.
d. endometrial.

A

D

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16
Q

The mother of an 8-year-old child reports that she has recently noticed a discharge stain on her daughter’s underwear. Both the mother and daughter appear nervous and concerned. You would need to ask questions to assess the child’s:

a. drug ingestion.
b. fluid intake.
c. risk for sexual abuse.
d. hormone responsiveness.

A

C

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17
Q

The female patient should ideally be in which position for the pelvic examination?

a. Fowler
b. Prone
c. Lateral supine
d. Lithotomy

A

D

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18
Q

When you plan to obtain cytologic studies, speculum introduction may be facilitated by:

a. lubrication with gel.
b. lubrication with warm water.
c. use of a plastic speculum.
d. opening the blades completely.

A

B

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19
Q

Which one of the following is a proper technique for the use of a speculum during a vaginal examination?

a. Allow the labia to spread, and insert the speculum slightly open.
b. Insert one finger, & insert the opened speculum.
c. Press the introitus downward, and insert the closed speculum obliquely.
d. Spread the labia, & insert closed speculum horizontally.

A

C

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20
Q

When collecting specimens, which sample should be obtained first?

a. Chlamydial swab
b. Gonococcal culture
c. Pap smear
d. Wet mount

A

C

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21
Q

The presence of a fishy odor after adding potassium hydroxide to a wet mount slide containing vaginal mucus suggests:

a. bacterial vaginosis.
b. yeast infection.
c. chlamydial infection.
d. pregnancy.

A

A

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22
Q

The assessment of which structure is not part of the bimanual examination?

a. Cervix
b. Bladder
c. Uterus
d. Ovaries

A

B

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23
Q

Mrs. Reilly brings her 6-year-old daughter in with complaints of a foul vaginal discharge noted in her underpants. The most common cause of a foul vaginal discharge in children is a(n):

a. accident.
b. foreign body.
c. infection.
d. ruptured hymen.

A

B

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24
Q

A 3-year-old girl is being seen because of a foul vaginal odor. To inspect the vaginal vault, you should first:

a. insert a pediatric vaginal speculum.
b. place the child prone and in the fetal position.
c. insert a cotton-tipped applicator and press down.
d. pull the labia forward and slightly to the side.

A

D

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25
Q

A mother brings her 8-year-old daughter to the clinic because the child says it hurts to urinate after she fell while riding her bicycle. On inspection, you find posterior vulvar and gross perineum bruising. These findings are consistent with:

a. chronic masturbation.
b. congenital defects.
c. acute urinary tract infection.
d. sexual abuse.

A

D

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26
Q

What accommodations should be used for the position of a hearing-impaired woman for a pelvic examination?

a. The patient should assume the M or V position.
b. Her legs should be farther apart.
c. The head of the table should be elevated.
d. The lithotomy position with obstetric stirrups should be used.

A

C

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27
Q

Asking the woman to close the introitus during a pelvic examination is a test for:

a. endometriosis.
b. rectocele.
c. cervical polyps.
d. sphincter tone.

A

D

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28
Q

Itchy, painful, small red vesicles are typical of:

a. condyloma acuminatum.
b. condyloma latum.
c. herpes simplex lesions.
d. syphilitic chancre.

A

C

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29
Q

A young, sexually active woman comes to the urgent care clinic complaining of suprapubic abdominal pain. She is afebrile with rebound tenderness to the right side. There is no dysuria and no vaginal discharge or odor. A pelvic examination is done. She has pain with cervical motion, and you palpate a painful mass over the left adnexal area. Your prioritized action is to:

a. swab for gonococcal infection & dip her urine.
b. obtain a surgical consult immediately.
c. remove the foreign body.
d. dip her urine and then swab for Chlamydia.

A

B

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30
Q

While examining an 18-year-old man, you note that his penis and testicles are more darkly pigmented than the body skin. You should consider this finding to be:

a. within normal limits.
b. suggestive of a skin fungus.
c. suggestive of psoriasis.
d. caused by excessive progesterone

A

A

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31
Q

In an uncircumcised male, retraction of the foreskin may reveal a cheesy white substance. This is usually:

a. evidence of a fungal infection.
b. a collection of sebaceous material.
c. indicative of penile carcinoma.
d. suggestive of diabetes.

A

B

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32
Q

Inspection of the scrotum should reveal:

a. lightly pigmented skin.
b. two testes per sac.
c. smooth scrotal sacs.
d. the left scrotal sac lower than the right.

A

D

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33
Q

Expected genitalia changes that occur as men age include that:

a. the ejaculatory volume decreases with age.
b. erections develop more quickly.
c. the viability of sperm increases.
d. the scrotum becomes more pendulous.

A

D

34
Q

Inspection of the male urethral orifice requires the examiner to:

a. ask the patient to bear down.
b. insert a small urethral speculum.
c. press the glans between the thumb and forefinger.
d. transilluminate the penile shaft.

A

C

35
Q

You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should:

a. chart the finding as paraphimosis.
b. inquire about previous penile infections.
c. retract the foreskin firmly.
d. transilluminate the glans.

A

B

36
Q

Which type of hernia lies within the inguinal canal?

a. Umbilical
b. Direct
c. Indirect
d. Femoral

A

C

37
Q

Which condition is of minor consequence in an adult male?

a. Adhesions of the foreskin
b. Continuous penile erection
c. Lumps in the scrotal skin
d. Venous dilation in the spermatic cord

A

C

38
Q

Mr. L has an unusually thick scrotum, with edema and pitting. He has a history of cardiac problems. The appearance of his scrotum is most likely a(n):

a. congenital defect that has worsened.
b. indication of general fluid retention.
c. normal consequence of aging.
d. complication of the development of mumps.

A

B

39
Q

A characteristic related to syphilis or diabetic neuropathy is testicular:

a. dropping, with asymmetry.
b. enlargement.
c. insensitivity to painful stimulation.
d. recession into the abdomen.

A

C

40
Q

On palpation, a normal vas deferens should feel:

a. beaded.
b. smooth.
c. ridged.
d. spongy.

A

B

41
Q

A premature infant’s scrotum will appear:

a. bifid.
b. loose.
c. ridged.
d. smooth.

A

D

42
Q

An enlarged painless testicle in an adolescent or adult male may indicate:

a. epididymitis.
b. testicular torsion.
c. a tumor.
d. an undescended testicle.

A

C

43
Q

You palpate a soft, slightly tender mass in the right scrotum of an adult male. You attempt to reduce the size of the mass, and there is no change in the mass size. Your next assessment maneuver is to:

a. use two fingers to attempt to reduce the mass.
b. palpate the left scrotum simultaneously.
c. lift the right testicle and then compare pain level.
d. transilluminate the mass.

A

D

44
Q

The most common cancer in young men ages 15 to 30 years is:

a. testicular.
b. penile.
c. prostate.
d. anal.

A

A

45
Q

The most emergent cause of testicular pain in a young male is:

a. testicular torsion.
b. epididymitis.
c. tumor.
d. hydrocele.

A

A

46
Q

An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria or fever. Your priority action should be to:

a. obtain urine and DNA probe urethral samples.
b. lift the left scrotum to confirm epididymitis.
c. establish absent cremasteric reflex.
d. transilluminate the left and right scrotum.

A

C

47
Q

The most common type of hernia occurring in young males is:

a. hiatal.
b. incarcerated femoral.
c. indirect inguinal.
d. umbilical.

A

C

48
Q

Difficulty replacing the retracted foreskin of the penis to its normal position is called:

a. paraphimosis.
b. Peyronie disease.
c. phimosis.
d. priapism.

A

A

49
Q

Which genital virus infection is known to have a latent phase followed by the production of viral DNA capsids and particles?

a. Condyloma acuminatum
b. Molluscum contagiosum
c. Herpetic lesions
d. Lymphogranuloma venereum

A

A

50
Q

Pearly gray, smooth, dome-shaped, often umbilicated lesions of the glans penis are probably:

a. herpetic lesions.
b. condylomata.
c. molluscum contagiosum.
d. chancres.

A

C

51
Q

A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not painful on palpation. The left inguinal canal is without masses. The mass transilluminates with a penlight. This collection of symptoms is consistent with:

a. orchitis.
b. a hydrocele.
c. a rectocele.
d. a scrotal hernia.

A

B

52
Q

Which condition is a complication of mumps in the adolescent or adult?

a. Cystitis
b. Epididymitis
c. Orchitis
d. Paraphimosis

A

C

53
Q

Parents of a 6-year-old boy should be asked if he has:

a. erections.
b. nocturnal emissions.
c. rapid detumescence.
d. scrotal swelling.

A

D

54
Q

The male with Peyronie disease will usually complain of:

a. painful, inflamed testicles.
b. deviation of the penis during erection.
c. lack of sexual interest.
d. painful lesions of the penis.

A

B

55
Q

A cremasteric reflex should result in:

a. testicular and scrotal rise on the stroked side.
b. penile deviation to the left side.
c. bilateral elevation of the scrotum.
d. immediate erection of the penis.

A

A

56
Q

Baby Sue is born with an imperforate anus. However, her outward anal appearance is normal. Which sign would indicate to the healthcare provider that she has a closed anal passageway?

a. Development of a scaphoid abdomen
b. Vomiting after her first feeding
c. Bleeding from the rectum
d. Failure to pass meconium stool

A

D

57
Q

In males, which surface of the prostate gland is accessible by digital examination?

a. Median lobe
b. Posterior
c. Superior
d. Anterior

A

B

58
Q

The prostatic sulcus:

a. divides the right and left lateral lobes.
b. is the site of the seminal vesicle emergence.
c. refers to the anterior aspect of the prostate.
d. secretes clear viscous mucus.

A

A

59
Q

The rectal past medical history of all patients should include inquiry about:

a. bowel habits.
b. dietary habits.
c. hemorrhoid surgery.
d. laxative use.

A

C

60
Q

The effects of aging on the gastrointestinal system lead to more frequent experiences of:

a. constipation.
b. prolonged satiety.
c. diarrhea.
d. prostate glandular atrophy.

A

A

61
Q

Factors associated with increased risk of prostate cancer include:

a. African descent.
b. cigarette smoking.
c. a low-fat diet.
d. alcoholism.

A

A

62
Q
The caliber of the urinary stream is routine information in the history of:
a. adolescents.
b. infants.
c. older adults.
D. Sexually active young men
A

C

63
Q

Equipment for examination of the anus, rectum, and prostate routinely includes gloves and:

a. a hand mirror and gauze.
b. a lubricant and penlight.
c. slides and normal saline.
d. swabs and culture medium.

A

B

64
Q

Which is a risk factor for colorectal cancer?

a. High-fiber diet
b. Diet low in animal fats and proteins
c. Irish descent
d. Inherited BRAC2 mutation

A

D

65
Q

Nodules found in the peritoneum through the anterior rectal wall:

a. are found with bidigital palpation.
b. are called shelf lesions.
c. are chronic fibrosis.
d. are found by having the patient bear down.

A

B

66
Q

Perianal abscesses, fissures, or pilonidal cysts will cause the patient to experience:

a. bulging and wrinkling.
b. constipation and pallor.
c. diarrhea and redness.
d. tenderness and inflammation.

A

D

67
Q

Palpation of the anal ring is done by:

a. bidigital palpation with the thumbs.
b. inserting the smallest finger into the anus.
c. pressing a gauze pad over the anus.
d. rotation of the forefinger inside the anus.

A

D

68
Q

The posterior surface of the prostate can be located by palpation of the:

a. anal canal and perineum.
b. anterior wall of the rectum.
c. lateral wall of the anus.
d. lower abdomen and perineum.

A

B

69
Q

The cervix may be palpated through the:

a. anterior rectal wall.
b. internal umbilical wall.
c. lateral urethral meatus.
d. posterior uterine surface.

A

A

70
Q

Your patient’s chief complaint is repeated, pencil-like stools. Further examination should include:

a. a stool culture.
b. parasite testing.
c. a digital rectal examination (DRE).
d. a prostate examination.

A

C

71
Q

Very light tan or gray stools may indicate:

a. upper gastrointestinal bleeding.
b. obstructive jaundice.
c. lower gastrointestinal bleeding.
d. polyposis.

A

B

72
Q

Tarry black stools should make you suspect:

a. internal hemorrhoids.
b. rectal fistula.
c. upper intestinal tract bleeding.
d. prostatic cancer.

A

C

73
Q

Prostate-specific antigen (PSA) screening is controversial because:

a. there are many false-negative results.
b. PSA is produced by many other tissues.
c. it is less sensitive than digital rectal examination.
d. no data have proved that it decreases mortality.

A

D

74
Q

Which finding in an infant may indicate lower spinal deformities?

a. Perirectal redness
b. Shrunken buttocks
c. Rectal prolapse
d. Dimpling in the pilonidal area

A

D

75
Q

A lower spinal cord lesion may be indicated by which finding?

a. Lack of an anal wink
b. Rectal prolapse
c. Anal fistula
d. Small flaps of anal skin

A

A

76
Q

Pinworms and Candida may both cause:

a. constipation.
b. hemorrhoids.
c. perirectal irritation.
d. perirectal protrusion.

A

C

77
Q

Thrombosed hemorrhoids are:

a. flabby skin sacs.
b. red, inflamed, and painful.
c. fluctuant soft papules.
d. blue, shiny, painful masses.

A

D

78
Q
Palpation of a normal prostate in an older adult is likely to feel:
a. cool.
b. grainy.
c. polypoid.
D. Rubbery
A

D

79
Q

Mr. Dunn is a 62-year-old man who has presented for a routine annual examination. On examination of the prostate you note a hard, irregular, painless nodule and obliteration of the median sulcus. These are signs of:

a. benign prostatic hypertrophy.
b. cancer of the prostate.
c. long-standing prostatitis.
d. swelling as a result of aging.

A

B

80
Q

The mother brings her 4-year-old to the clinic because the child complains of perianal itching. As part of your examination you complete a cellulose tape test. The cellulose tape test is used for the detection of:

a. enterobiasis.
b. carcinoma.
c. amebiasis.
d. steatorrhea.

A

A

81
Q

Mr. Sweeney is a 58-year-old man who has presented for a routine annual prostate examination. On examination, you note a normal prostate gland. Which of the following characteristics should describe the normal prostate? (Select all that apply.)

a. Rubbery consistency
b. About 4 cm in diameter
c. Fluctuant softness
d. Gland protruding 1 cm into the rectum
e. Firm, smooth, and slightly movable

A

B, D, E