Posteriorly, the labia minora meet as two ridges that fuse to form the:
a. fourchette.
b. vulva.
c. clitoris.
d. perineum.
a. fourchette.
The labia
... [Show More] minora join posteriorly at a junction called the fourchette.
What structures are located at the 5 o'clock and the 7 o'clock positions of the vaginal orifice and open onto the sides of the vestibule in the groove between the labia minora and the hymen?
a. Skene glands
b. Perineal bodies
c. Labia majora
d. Bartholin glands
e. Labia minora
D. Bartholin glands
Bartholin glands are found posteriorly on each side of the vaginal orifice and open onto the sides of the vestibule.
A cervical polyp usually appears as a:
a. grainy area at the ectocervical junction.
b. bright red, soft protrusion from the endocervical canal.
c. transverse or stellate scar.
d. hard granular surface at or near the os.
b. bright red, soft protrusion from the endocervical canal.
Cervical polyps are bright red, soft, and fragile. They usually protrude from the endocervical canal.
Which structure is located posteriorly on each side of the vaginal orifice?
a. Skene glands
b. Clitoris
c. Perineum
d. Bartholin glands
d. Bartholin glands
Bartholin glands are found posteriorly on each side of the vaginal orifice.
During sexual excitement, how is the vaginal introitus lubricated?
a. The Bartholin glands secrete mucus.
b. The clitoris produces moisture.
c. The Skene glands drain fluid.
d. The urethral surfaces secrete water.
a. The Bartholin glands secrete mucus into the introitus for lubrication during sexual stimulation.
The vaginal mucosa of a woman of childbearing years should appear:
a. smooth and pink.
b. moist and excoriated.
c. dry and papular.
d. transversely rugated.
d. transversely rugated.
Between puberty and menopause, the vagina is transversely rugated; after menopause, it loses its rugation.
The adnexa of the uterus are composed of the:
a. corpus and cervix.
b. fallopian tubes and ovaries.
c. uterosacral and broad ligaments.
d. vagina and fundus.
b. fallopian tubes and ovaries.
A bluish color to the cervix during pregnancy is called (the):
a. McDonald sign.
b. Spinnbarkeit.
c. Goodell sign.
d. Chadwick sign.
d. Chadwick sign.
The Chadwick sign is a bluish color to the cervix during pregnancy. The Goodell sign is an increase in vascularity and softening of the cervix. Spinnbarkeit refers to the quality of elastic mucus during mittelschmerz, and the McDonald sign is fundal flexing on the cervix.
Mittelschmerz may occur in which phase of the menstrual cycle?
a. Menstrualb.
b. Postmenstrual
c. Ovulation
d. Secretory
e. Luteal
Ans: C. Ovulation
Mittelschmerz, lower abdominal pain associated with ovulation, may also be accompanied by tenderness on the side where ovulation took place that month.
The pelvic joint that separates most appreciably during late pregnancy is the:
a. sacroiliac.
b. symphysis pubis.
c. sacrococcygeal.
d. iliofemoral.
b. symphysis pubis.
Of the four pelvic joints, the one that moves appreciably later in pregnancy is the symphysis pubis.
Pregnancy-related cervical changes include:
a. flattening and lengthening.
b. thinning and reddening.
c. hardening and pallor.
d. softening and bluish coloring.
d. softening (Goodell sign) and bluish coloring(Chadwick sign).
Mrs. Robinson, a 49-year-old patient, presents to the office complaining of missing her menstrual period. She asks about menopause. You explain to her that the conventional definition of menopause is:
a. the first day of the last menstrual period.
b. 1 year with no menses.
c. the last day of the last menstrual period.
d. the cessation of ovulation.
b. 1 year with no menses.
Which systemic feature is related to the effects of menopause?
a. Increased abdominal fat distribution
b. Decreased LDL levels
c. Cold intolerance
d. Decreased cholesterol levels
a. Increased abdominal fat distribution
Systemic effects of menopause include increased intraabdominal body fat, increased LDL and cholesterol levels, and hot flashes.
Ms. A, age 32, states that she has a recent history of itchy vaginal discharge. Ms. A has never been pregnant. Her partner uses condoms and she uses spermicide for birth control. Which of the following data are most relevant to Ms. A's problem?
a. Bowel habits
b. Douching routines
c. Menstrual flow
d. Nutritional factors
b. Douching routines
When obtaining history of present illness information for the woman with a vaginal discharge, you should inquire about her douching habits. Douching is not only medically unnecessary but it can also mask, or even worsen, conditions such as bacterial vaginosis or a yeast infection.
Which risk factor is associated with cervical cancer?
a. Endometriosis
b. Low parity
c. Multiple sex partners
d. Obesity
c. Multiple sex partners
Cervical cancer is associated with certain HPV strains. Multiple sex partners increase the risk of HPV infection.
Which of the following cancers is not associated with human papillomavirus (HPV) infection?
a. Cervical
b. Vaginal
c. Vulvar
d. Ovarian
e. Penile
ANS: C. Vulvar
HPV infection can cause cervical, vaginal, and vulvar cancers in women; penile cancer in men; anal and oropharyngeal cancer and genital warts in both men and women. Vaccination against HPV before exposure to the virus through sexual contact is recommended for preadolescent and adolescent girls and boys
The risk of ovarian cancer is increased by:
a. the use of oral contraceptives.
b. cigarette smoking.
c. age between 35 and 50 years.
d. early age at first intercourse.
a. the use of oral contraceptives.
There is a relationship between the number of menstrual cycles and risk of ovarian cancer. Early menarche and menopause after 50 years of age increase the risk.
The form of gynecologic cancer that is increased in obese women is:
a. vaginal.
b. cervical.
c. ovarian.
d. endometrial.
d. endometrial.
Obesity increases a woman's chance of developing endometrial cancer by twofold to fivefold.
When performing a gynecologic examination, the examiner should change gloves after touching the patient's:
a. anal area.
b. Bartholin glands.
c. Skene glands.
d. cervix.
e. urethra.
ANS: A. anal area
Whenever the anal surface is touched, the examiner should change gloves to prevent bacterial cross-contamination to other genital areas.
The mother of an 8-year-old child reports that she has recently noticed a discharge stain on her daughter's underwear. Both the mother and daughter appear nervous and concerned. You would need to ask questions to assess the child's:
a. drug ingestion.
b. fluid intake.
c. risk for sexual abuse.
d. hormone responsiveness.
c. risk for sexual abuse.
Vaginal discharge in a child could be related to a chemical irritation from soaps, lotions, or powders or to urinary tract infections. Concerned parents and children should be assessed for the risk of sexual abuse.
The female patient should ideally be in which position for the pelvic examination?
a. Fowler
b. Prone
c. Lateral supine
d. Lithotomy
d. Lithotomy
Ideally, the woman should be in a lithotomy position for a pelvic examination.
When you plan to obtain cytologic studies, speculum introduction may be facilitated by:
a. lubrication with gel.
b. lubrication with warm water.
c. use of a plastic speculum.
d. opening the blades completely.
b. lubrication with warm water.
It is generally thought that gel lubrication may interfere with cytologic studies; therefore, most clinicians lubricate the speculum with warm water. Although gel lubrication would facilitate speculum introduction, the gel could interfere with cytologic studies. Use of a plastic speculum or opening the blades completely would not facilitate speculum introduction.
Which of the following findings indicates a possible gonococcal infection?
a. Bulging of the anterior or posterior vaginal wall
b. Discharge from urethra or Skene glands
c. Irregular urethral orifice in midline
d. Irregular vaginal edges at introitus
b. Discharge from urethra or Skene glands
Use two fingers of one hand to push the introitus down to relax the pubococcygeal muscle. Then hold the closed speculum with the other hand, and insert the speculum past your fingers obliquely.
The examiner should change gloves after touching the patient's:
a. anal area.
b. Bartholin glands.
c. Skene glands.
d. urethra.
a. anal area.
During a digital examination of the vagina, the cervix is noted to be positioned posteriorly. On bimanual examination of this woman, you would expect to palpate a(n) ___________ uterus.
a. retroverted
b. anteverted
c. midline
d. laterally deviated
b. anteverted
The presence of cervical motion tenderness may indicate:
a. pregnancy.
b. nulliparity.
c. pelvic inflammatory disease.
d. vulvovaginitis.
c. pelvic inflammatory disease.
Which one of the following is a proper technique for the use of a speculum during a vaginal examination?
a. Allow the labia to spread, and insert the speculum slightly open.
b. Insert one finger, and insert the opened speculum.
c. Press the introitus downward, and insert the closed speculum obliquely.
d. Spread the labia, and insert the closed speculum horizontally.
c. Press the introitus downward, and insert the closed speculum obliquely.
Gently insert a finger of one hand to push the introitus down to relax the pubococcygeal muscle. Then hold the closed speculum with the other hand and insert the speculum past your finger obliquely.
Small, pale yellow, raised, and rounded areas are visualized on the surface of the cervix. You should:
a. chart this as nabothian cysts.
b. chart this as a friable cervix.
c. obtain a viral culture.
d. test the pH of the cervical os.
a. chart this as nabothian cysts.
This describes nabothian cysts, which are retention cysts of the endocervical glands and are considered a normal variant. No further testing is warranted.
An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection?
a. Gonococcal culture
b. Cytology smear
c. Haemophilus smear
d. Trichomonas smear
b. Cytology smear
When collecting specimens, which sample should be obtained first?
a. Chlamydial swab
b. Gonococcal culture
c. Pap smear
d. Wet mount
c. Pap smear
A Pap smear is obtained first and then other samples to test for gonorrhea, chlamydia, Trichomonas, bacterial vaginosis, or candidiasis are obtained. Pap smear results are affected by the presence of blood, and vaginal infections result in more friable tissues; therefore, the Pap smear should be obtained first.
Dacron swabs are necessary when testing for which condition?
a. Gonorrhea
b. Pregnancy
c. Trichomoniasis
d. Chlamydia
d. Chlamydia
The visualization of a large proportion of "clue cells" on your wet mount slide examination suggests:
a. trichomonal infection.
b. bacterial vaginosis.
c. candidiasis.
d. gonorrhea.
b. bacterial vaginosis.
Clue cells are present in bacterial vaginosis. Hyphae are present in candidiasis, and flagella are present in trichomonal infection. Gonorrhea and cervical cancer cannot be identified on a wet mount
The presence of a fishy odor after adding potassium hydroxide to a wet mount slide containing vaginal mucus suggests:
a. bacterial vaginosis.
b. yeast infection.
c. chlamydial infection.
d. pregnancy.
a. bacterial vaginosis.
A positive whiff test suggests bacterial vaginosis.
Bimanual examination of the uterus includes:
a. grasping the cervix between the examining fingers.
b. grasping the vaginal wall and pulling it downward.
c. inserting one finger into the fundus.
d. placing the thumb on the clitoris and the forefinger on the cervix.
a. grasping the cervix between the examining fingers.
The assessment of which structure is not part of the bimanual examination?
a. Cervix
b. Bladder
c. Uterus
d. Ovaries
b. Bladder
The bimanual examination consists of assessing the cervix, uterus, adnexa, and ovaries.
The rectovaginal examination is an important component of the total pelvic examination because it:
a. is the most direct cervical examination route.
b. is a more comfortable examination for the posthysterectomy patient.
c. is an alternate source for cytology specimens.
d. allows the examiner to reach almost 2.5 cm higher into the pelvis.
d. allows the examiner to reach almost 2.5 cm higher into the pelvis
The rectovaginal examination allows you to reach almost 2.5 cm higher into the pelvis to
examine structures not reached with the bimanual examination. It is more uncomfortable for the patient and is not the source for cytology specimens or more complete evaluation of the bladder.
Prominent labia minora are a normal finding in:
a. adolescents.
b. menopausal women.
c. newborns.
d. pregnant women.
c. newborns.
Newborn genitalia findings are the result of maternal hormones. Both the labia majora and minora are swollen, with the minora often being more prominent. [Show Less]