NR 509 Final Exam
Suspicious breast mass
-A mobile mass that becomes fixed when the arm relaxes is attached to the ribs and intercostal
muscles; if fixed when the hand is pressed against the hip, it is attached to the pectoral fascia.
-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues, strongly
suggest cancer
Risk for Breast cancer
--Age
-family history of breast/ovarian CA
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogen exposure
related to early menarche
-age of first full-term pregnancy
- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.
,Characteristics of a breast cyst
Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast
-Have pt roll onto the opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then move the fingers
medially and palpate in a vertical strip up the chest to the clavicle. Continue in vertical
overlapping strips until you reach the nipple
Bacterial Vaginosis (BV)
-Caused by overgrowth of anaerobic bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the vaginal walls, usually not
profuse, may be minimal
- Fishy/musty genital odor
-Normal vulva and vaginal mucosa
, -Scan saline wet mount for clue cells (epithelial cells with stippled borders); sniff for fishy odor
after applying KOH ("whiff test"); test the vaginal secretions for pH > 4.5
Candidal Vaginitis
-Cause: Candida albicans, a yeast (normal overgrowth of vaginal flora); many factors predispose,
including antibiotic therapy
-Discharge: white and curdy, may be thin but usually thick, not as profuse as trichomonal
infection, not malodorous
- vaginal soreness, pruritus, pain on urination, dyspareunia (painful intercourse)
-The vulva and surrounding skin are inflamed and sometimes swollen to a variable extent; the
vaginal mucosa is reddened, with white tenacious patches of discharge; the mucosa may bleed
when these patches are scraped off; in mild cases, the mucosa looks normal
-Scan potassium hydroxide (KOH) preparation for the branching hyphae of Candida
Trichomonal Vaginitis
-Trichomonas vaginalis, a protozoan; often but not always acquired sexually
- Discharge:Yellowish green or gray, possibly frothy; often profuse and pooled in the vaginal
fornix; may be malodorous
-Pruritus (though not usually as severe as with Candida
infection); pain on urination (from skin inflammation or possibly urethritis); dyspareunia
Suspicious breast mass
-A mobile mass that becomes fixed when the arm relaxes is attached to the ribs and intercostal
muscles; if fixed when the hand is pressed against the hip, it is attached to the pectoral fascia.
-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues, strongly
suggest cancer
Risk for Breast cancer
--Age
-family history of breast/ovarian CA
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogen exposure
related to early menarche
-age of first full-term pregnancy
- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.
,Characteristics of a breast cyst
Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast
-Have pt roll onto the opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then move the fingers
medially and palpate in a vertical strip up the chest to the clavicle. Continue in vertical
overlapping strips until you reach the nipple
Bacterial Vaginosis (BV)
-Caused by overgrowth of anaerobic bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the vaginal walls, usually not
profuse, may be minimal
- Fishy/musty genital odor
-Normal vulva and vaginal mucosa
, -Scan saline wet mount for clue cells (epithelial cells with stippled borders); sniff for fishy odor
after applying KOH ("whiff test"); test the vaginal secretions for pH > 4.5
Candidal Vaginitis
-Cause: Candida albicans, a yeast (normal overgrowth of vaginal flora); many factors predispose,
including antibiotic therapy
-Discharge: white and curdy, may be thin but usually thick, not as profuse as trichomonal
infection, not malodorous
- vaginal soreness, pruritus, pain on urination, dyspareunia (painful intercourse)
-The vulva and surrounding skin are inflamed and sometimes swollen to a variable extent; the
vaginal mucosa is reddened, with white tenacious patches of discharge; the mucosa may bleed
when these patches are scraped off; in mild cases, the mucosa looks normal
-Scan potassium hydroxide (KOH) preparation for the branching hyphae of Candida
Trichomonal Vaginitis
-Trichomonas vaginalis, a protozoan; often but not always acquired sexually
- Discharge:Yellowish green or gray, possibly frothy; often profuse and pooled in the vaginal
fornix; may be malodorous
-Pruritus (though not usually as severe as with Candida
infection); pain on urination (from skin inflammation or possibly urethritis); dyspareunia
