Week 13-GU Flashcards
Benign breast development in men.
Gynecomastia
Accumulation of subareolar fat
Psuedogynecomastia
What nodes are most likely to be felt in a breast exam?
Central nodes
Malignant cells from breast cancer may spread directly to the:
Infraclavicular nodes or into the internal mammary chain of LN within the chest
Usually bilateral, multi ductal, promoted by stim and ranges in color from white to yellow to green
Physiologic discharge
Usually unilateral, bloody or serous and associated with a mass in women over 40.
Pathologic discharge
Mass over 50:
Consider cancer first until proven otherwise
Irregular, firm, mobile, or fixed to surrounding tissue:
Cancer
Mass age 15-25 consider:
Fibroadenoma - smooth, rubbery, round, mobile, nontender
Mass 25-50 consider:
Cysts: soft firm, round, mobile, often nontender
How to assess lateral portion breast.
Hand on forehead with shoulders against bed (flattens tissue)
How to assess medial portion of breast:
Hand on neck with shoulders against bed.
Spontaneous, unilateral, bloody discharge from 1-2 ducts consider:
Papilloma, DCIS, or Paget’s disease of the breast
Vaginal surface of the cervix, what is seen with speculum.
Ectocervix
Opening of the cervix, marks the opening into the endocervical canal.
Cervical os
Continuation with the vaginal lining.
Squamous epithelium
During puberty, the broad band of columnar epithelium encircling the os is gradually replaced with squamous epithelium.
Ectropion
Forms the boundary between squamous epithelium and columnar epithelium. This migrates toward the os and creates the transformational zone.
Squamocolumnar junction
Area at risk for later dysplasia and is the area sampled with Pap smear
Transformation zone
Defined as cessation of bleeding for 12 months
Menopause
Causes of post-menopausal bleeding:
Endometrial cancer, HRT, and uterine and cervical polyps
Painful intercourse
Dyspareunia
Most common cause of acute GU pain?
PID May also be ruptured ovarian cysts or appendicitis
Chronic GU pain associated with;
Endometriosis, uterine fibroids, PID, consider sexual abuse
When to stop cervical cancer screening?
65 and has had 3 consecutive negative cytology tests
3 major symptoms of ovarian cancer:
Abdominal distention Abdominal bloating Urinary frequency (usually reported within 3 months of dx)
Sti screening in sexually active females over 25:
Annual GC/chlamydia
STI testing in pregnancy:
Chlamydia, hepatitis B, syphilis, hiv
STI testing in gay, bisexual, MSM, multiple or anonymous partners:
Chlamydia, GC, and syphilis annually of 3-6 months based on risk
HIV testing recommendation:
At least once btwn 13-64; once a year for unsafe sex practices or IVDU, gay, and bisexual men (q3-6 months)
Enlarged clitoris May signal:
Endocrine disorders
Herniation of the rectum into the posterior vaginal wall.
Retrocele
Seen in the upper 2/3 of anterior vaginal wall.
Cystocele
With entire anterior vagina wall, together with the bladder and urethra.
Cystourethrocele
Cervix faces forward and uterus body may not be felt by abdominal hand.
Retroversion of the uterus
Backward angular ion of the body of the uterus in relation to the cervix.
Retroflexion of the uterus
Myomas (uterine fibroids):
Benign tumors
Results for weakness of the supporting structures of the pelvic floor muscles and associated with cystocele and rectocele.
Prolapse of the uterus
Arises more medically and are due to weakness in the floor of the inguinal canal. (Often associated with heavy lifting or straining)
Direct inguinal hernia
If the peritoneal lining remains an open channel to the scrotum, it can give rise to an ____ which develop at the internal inguinal ring where the spermatic cord exits the abdomen.
Indirect inguinal hernia
The parietal and visceral layers form a potential space for the abnormal fluid accumulation of a :
Hydrocele
An undescended testicle- May see poorly developed scrotum on uni/bilaterally.
Cryptorchisim
May be associated with indirect inguinal hernia, hydrocele, scrotal edema and rarely testicular cancer
Scrotal swelling
Dome shaped white or yellow papules formed by occluded follicles; common, benign, and frequently multiple
Epidermal cysts
Scrotal edema is commonly seen in:
CHF and nephritic syndrome
Nontender, fluid filled, positive transillumination
Hydrocele
Usually comes through the external inguinal ring.
Scrotal hernia
