Sensitive Exams (BRMG)

Question 1

What should the genital hair distribution be for male genitalia?

Answer 1

Hair should be abundant in the pubic region and may continue in a narrowing midline pattern to the umbilicus; the penis is not covered with hair and the scrotum generally has a scant amount

Question 2

What is phimosis?

Answer 2

A condition where the foreskin is tight and can’t be retracted

Question 3

What can cause phimosis?

Answer 3

Recurrent balanitis (inflammation of the glans) or balanoposthitis (inflammation of the glans penis and prepuce) caused by either bacterial or fungal infections

Question 4

Phimosis is most commonly seen in men with what condition?

Answer 4

Poorly controlled diabetes mellitus

Question 5

When examining the urethral meatus, bright erythema or a discharge indicates what?

Answer 5

Inflammatory disease

Question 6

Why does the scrotum usually appear asymmetric?

Answer 6

The left testicle has a longer spermatic cord and therefore is often lower

Question 7

The thickness of the scrotum varies with what factors?

Answer 7

Temperature and age

Question 8

What should you feel with palpation of the testes?

Answer 8

The testes should feel smooth and rubbery and be free of nodules. They should be sensitive to gentle compression but not tender.

Question 9

Irregularities in texture or size of the testes may indicate what?

Answer 9

An infection, a cyst, or a tumor

Question 10

What should the vas deferens feel like upon palpation?

Answer 10

Smooth and discrete; it should not feel beaded or lumpy in its course as you palpate from the testicle to the inguinal ring

Question 11

The presence of unexpected findings (lumpiness, etc) during palpation of the vas deferens may indicate what?

Answer 11

Diabetes or old inflammatory changes, especially tuberculosis

Question 12

What can cause perianal irritation?

Answer 12

Fungal infection and pinworm irritation

Question 13

Fungal infection leading to perianal irritation is more common in which age group?

Answer 13

Adults with diabetes

Question 14

Pinworm infestations leading to perianal irritation is more common in which age group?

Answer 14

Children

Question 15

What are symptoms of a yeast diaper rash?

Answer 15

Red skin with dots or pimples; rash doesn’t respond to standard diaper creams and takes a while to treat; rash may occur more in the fold of legs, genitals, or buttocks; rash may occur along with thrush infection in baby’s mouth; may have satellite spots of rash outside the border of the rest of the rash

Question 16

The discovery of tenderness and inflammation near the anus indicates the possibility of what?

Answer 16

Perianal abscess (collection of pus near the anus)

Question 17

What are perianal abscesses caused by?

Answer 17

Usually by a tear in the lining of the rectum or anus through which bacteria can pass

Question 18

Patients at increased risk for perianal abscesses include who?

Answer 18

Those with diabetes mellitus, immunocompromised patients, patients with IBD, and those that engage in receptive anal sex

Question 19

What is an anorectal fistula?

Answer 19

An abnormal communication between the anus and the perianal skin

Question 20

How can anorectal fistulas occur?

Answer 20

Spontaneously or secondary to a perianal abscess

Question 21

What should a normal prostate feel like?

Answer 21

A normal prostate has a diameter of about 4 cm, with less than 1cm of protrusion into the rectum. It should feel like a pencil erase (firm, smooth, and slightly moveable) and should be nontender.

Question 22

How is prostate enlargement classified?

Answer 22

By the amount of protrusion into the rectum

Question 23

A positive result for the guaiac-based FOBT may indicate what?

Answer 23

Abnormal bleeding occurring somewhere in the digestive tract

Question 24

A positive result for the fecal immunochemical test indicates what?

Answer 24

Abnormal bleeding in the lower digestive tract

Question 25

The fecal immunochemical test detects which type of hemoglobin?

Answer 25

Only human hemoglobin, so other sources of blood (like from the diet) don’t cause a positive result

Question 26

Why does the fecal immunochemical test not detect hemoglobin from bleeding in the upper digestive tract?

Answer 26

It is already broken down to other elements before it reaches the lower digestive tract

Question 27

When inspecting the breasts, you should compare each breast to the other for which characteristics?

Answer 27

Size, symmetry, contour, skin color and texture, venous patterns, and lesions

Question 28

How should the patient sit for a breast inspection?

Answer 28

Arms hanging loosely at the sides

Question 29

Retractions and dimpling of the breast signify what?

Answer 29

The contraction of fibrotic tissue that may occur with carcinoma

Question 30

A peau d’orange appearance of the skin of the breast indicates what?

Answer 30

Edema of the breast caused by blocked lymph drainage in advanced or inflammatory breast cancer

Question 31

Venous networks of the breast, though they may be visible, are usually only pronounce when?

Answer 31

In the breasts of pregnant or obese women

Question 32

Unilateral venous patterns of the breast can be produced by what?

Answer 32

Dilated superficial veins as a result of increased blood flow to a malignancy

Question 33

What should the areola look like?

Answer 33

It should be round or oval and bilaterally symmetrical or nearly so

Question 34

In light-skinned women, when would the areola turn brown?

Answer 34

It may begin as a pinkish color, but usually turns brown with the first pregnancy and then remains dark

Question 35

What are Montgomery tubercles?

Answer 35

Nontender, nonsuppurative tubercles; sebaceous glands on the areolae of the breast that lubricate the breast during breast feeding. These are a common, expected finding.

Question 36

Recent unilateral inversion of a previously everted nipple suggests what?

Answer 36

Malignancy

Question 37

What should the nipples look like?

Answer 37

They should be a homogenous color that matches with the areolae and may be smooth or wrinkled, but they should be free of crusting, cracking, or discharge

Question 38

What are supernumerary nipples?

Answer 38

One or more extra nipples that appear on the embryonic mammary ridge; they are pink or brown and are usually small, so some may be mistaken for moles

Question 39

In some cases, supernumerary nipples may be associated with what?

Answer 39

Congenital renal or cardiac anomalies, particularly in white women

Question 40

Repositioning the patient to a seated position with the arms over the head or flexed behind the neck does what for breast inspection?

Answer 40

Adds tension to the suspensory ligaments, accentuates dimpling, and may reveal variations in contour and symmetry

Question 41

Repositioning of the patient to a seated position with the hands pressed against the hips with shoulders rolled forward does what for breast inspection?

Answer 41

Contracts pectoral muscles, which can reveal deviations in contour and symmetry

Question 42

Repositioning of the patient to a seated position leaning forward from the waist does what for breast inspection?

Answer 42

Causes tension in the suspensory ligaments

Question 43

How should the breast tissue of adult women feel?

Answer 43

Dense, firm, and elastic, with expected variations including the lobular feel of glandular tissue (soft, nondiscrete bumps diffusely dispersed throughout the breast tissue) and the fine, granular feel of breast tissue in older women

Question 44

When is the cyclical pattern of breast enlargement, increased nodularity, and tenderness least noticeable?

Answer 44

The week after menses

Question 45

If a breast mass is felt, what should you note?

Answer 45

Its characteristics; palpate its dimensions, consistency, and mobility

Question 46

What are three different methods of breast palpation?

Answer 46

Vertical strip, circular, wedge

Question 47

What are the common characteristics of a breast mass caused by cancer?

Answer 47

Usually unilateral, irregular or stellate shape, hard and stonelike consistency, fixed mobility, retraction signs often present, and poorly delineated/irregular borders