COMPLETE QUESTIONS AND SOLVED
SOLUTIONS
◉ On which specific diseases should history be taken in the STD
history? Answer: Exposure to or history of:
+ Gonorrhea
+ Syphilis
+ HIV
+ Herpesvirus
+ Hepatitis
+ Chlamydia
+ Papillomavirus
Also ask about: hx of vaginitis and how/if it was treated, treatment
or hospital admissions for treatment of salpingitis, enometritis or
tubo-ovarian abcesses.
DeCherney p 557
◉ What specific diseases/illnesses are of great interest in taking the
family history?. Answer: + Heart disease
,+ DM
+ Hypertensive renal or vascular disease
+ Vascular accidents
+ Hematologic abnormalities
+ Hirsutism
+ Breast/ovarian/colon CA
+ Time of menopause for mother/grandmothers
+ Hx of osteoporosis in mother/grandmothers
DeCherney p 557
◉ What additional vital sign should be measured in post-
menopausal patients?. Answer: Height, to document any loss of
height r/t osteoporosis and vertebral fractures
DeCherney p 558
◉ Initial chest exam in OB/GYN patient. Answer: + Visual
assessment for skin lesions and symmetry of movement
+ Auscultaiton and percussion of lungs (exclude pulm problems like
asthma and pneumonia)
+ Percussion of heart for size and auscultation for arrhythmias and
murmurs
,DeCherney p 558
◉ Breast cancer will occur in 1 in _____ women in the US in her
lifetime. Answer: EIGHT
DeCherney p 558
◉ Scaly ecezmatous nipple can mean _____?. Answer: Paget's Disease
DeCherney p 558
◉ Suprapubic palpation is designed to detect _____?. Answer: Uterine,
bladder or ovarian enlargements.
DeCherney p 558
◉ The clitoris should be no more than ____ in length. Answer: 2.5 cm
DeCherney p 561
, ◉ How do you palpate vestibular glands?. Answer: Index finger in
the vagina, and thumb outside gently feeling for enlargement or
tenderness
DeCherney p 561
◉ Components of the pelvic examination. Answer: 1) External
genitalia
2) Hymen
3) Perineal support - Spread labia with 2 fingers and ask patient to
bear down.
4) Urethra - "strip" to express discharge from gland
DeCherney p 562j
◉ Different types of specula. Answer: Pederson - Narrower blades.
Good for sexually active patient (comfort) and for patients with
small introitus.
Graves -- Wider than Pederson for better visualization
Huffman -- Very small, for a child
Kelly air cystoscope - Can be used for a child.
DeCherney p 562-3