Week 6 - Sensitive Exams Flashcards
2 ROS Questions
- Any skin changes, pain, or nipple discharge?
2. Any problems or changes with your urination?
Gravida
Total number of pregnancies
Term
Number of pregnancies that ended at 38 weeks
Preterm
Number of pregnancies that ended between 20-37 weeks
Abortions
Number of pregnancies that ended prior to 20 weeks
What might a “Peau D’Orange” breast be caused by?
Blocked lymph drainage in advance or inflmmatory breast cancer
Should venous patterns be symmetric in the breasts?
Yes
Light-Skinned Women Areola Chagnes
Turns brown with first pregnancy and remains dark
Dark-Skinned Women Areola Changes
Brown before pregnancy
Montogmery Tubercles
Sebaceous glands on areola of breast that lubricate during breast-feeding
What should the nipples be free of?
- Crusting
- Cracking
- Discharge
Areola color variations
Light pink to very dark brown or black
Are supernumerary nipples more common in black or white women? Where are they often located?
Black; embryonic mammary line or “milk line”
What are supernumery nipples possibly associated with? Particulary in who?
Congenital renal or cardiac anomalies; whites
Arms over head or flexed behind the neck promote what? Seated and leaning forward?
Suspensory ligaments, dimpling
How do we assess pectoral muscles?
Seated with hands pressed against hips with shoulders rolled forward
Where do we systematically palpate?
- Breasts
- Axillae
- Supraclavicular/infraclavicular regions
How should the breasts feel?
Dense, firm, and elastic
When are changes in breasts least noticeable?
Week after menses
Cancer of breast for: Number Shape Consistency Mobility
- Single
- Irregular or stellate
- Hard, stonelike
- Fixed
What does Tanner Stages describe?
- Breast development
- Pubic hair distibution
- Growth and maturation of genitalia
Stage 1 Tanner
Prepubertal state
Stage 5 Tanner
Adult development
What would UNILATERAL labial swelling, redness, or tenderness indicate?
Bartholin Gland Infection
Normal clitoris size
2cm in length and 0.5cm in diameter; increase in this could be masculinizing condition
2 Glands we look for in the vagina
- Skene glands (up top)
2. Bartholin glands
Cystocele
Hernial protrusion of urinary bladder through anterior wall of vagina
More severe cystocele’s are accompanied by what?
Urinary stress incontinence
What is a rectocele seen as?
Bulge on posterior wall of vagina; hernia of part of rectum
What is “Chadwick’s Sign”?
Bluish color (vascular) of cervix, possible sign of pregnancy
What is a pale cervix associated with?
Anemia
Bacterial Discharge
Odor w/ color varying from white to yellow, green, or gray
Difference in vaginal walls for premenopausal/post
Pre = tugae on walls Post = smooth walls
How big should the uterus be?
5.5-8cm
3 things associated with large uterus
- Pregnancy
- Fibroid
- Tumor
Should the uterus be midline? If not?
Yes; possible adhesions, pelvic masses, or pregnancy
Ovaries size?
3X2X1cm
What would cause an extremely tight spincter?
- Anxiety about examination
- Scarring
- Spasticity caused by fissures, lesions, or inflammation
What would cause a lax sphincter?
Neurological deficit
Balanitis
Inflammation of the glans of the penis (could cause foreskin to not be retractable)
When is Balanitis most commonly seen?
Men with poorly contolled diabetes
Priapasm
Erection lasting longer than 4 hours
When could Priapasm occur when not idiopathic?
Leukemia, hemoglobinopathies, sickle cell, medications
Which testicle should be further down?
L; longer spermatic cord
What does thickness of scrotum vary with?
Temp and age
Irregular size of testes could be what?
- Infection
- Cyst (spermatocele of epididymis)
- Tumor
What could an unsmooth vas derens be caused by?
Diabetes or TB
What can cause perianal irritation?
- Fungal infection (more common in adults)
2. Pinworms (more common in children)
When is the best time to visualize pinworms?
While they are asleep
Perianal Abscess
Collection of pus outside anus
What are nodules in the anus called?
Shelf lesions
Where are the shelf lesions?
Just above prostate in men and in cul-de-sac of females
Size of prostate?
4cm with 1cm protrusion into rectum
Should the prostate be tender?
No
How is prostate classified?
Amount of protrusion into rectum
Grades of Prostate Enlargement
1: 1-2cm
2. 2-3cm
3. 3-4cm
4. >4cm
Do we have pre-test dietary restrictions in FIT? (fecal immunochemical test) Percentages?
No; sens=5-63% and spec = 95-98%
Stool DNA test?
No pre-test dietary restrictions; should be done every 3 years
Stool DNA test percentages?
Sens = 93% and Spec = 87%
What does a positive guaiac-based FOBT test indicate?
Abnormal bleeding somehwere in digestive tract
FIT postive test
Abnormal bleeding in lower GI tract
What does FIT only detect?
Human Hgb; other souces of blood don’t make for positive test
Hgb from upper digestive tract bleeding
Broken down into other elemetnst before it reaches lower digestive tract
