QUESTIONS
◉ Erectile dysfunction may be from psychogenic causes, especially
if. Answer: early morning erection is preserved.
it may also reflect decreased testosterone, decreased blood flow in
the hypogastric arterial system, impaired neural innervation, and
diabetes
◉ When performing a breast exam, know what abnormal masses
should do when the arm. Answer: may be fixed to skin or underlying
tissues (may cause dimpling of skin or retraction when arms are
lifted over head or hands are pressed against hips)
◉ Fibroadenoma and cysts mobility. Answer: very mobile/mobile
◉ Know that a high proportion of breast masses are noted during
________. Answer: BSE
◉ Breast stage 1. Answer: preadolescent- elevation of nipple only
◉ Breast stage 2. Answer: breast bud stage- elevation of breast and
nipple as a small mound; enlargement of areolar diameter
,◉ breast stage 3. Answer: further enlargement of elevation of breast
and areola, with no separation of their contours
◉ breast stage 4. Answer: projection of areola and nipple to form a
secondary mound above the level of breast
◉ breast stage 5. Answer: mature stage- projection of nipple only;
areola has receded to general contour of the breast (although in
some individuals the areola continues to form a secondary mound)
◉ Know where pain is located with pancreatitis: acute. Answer:
epigastric, may radiation straight to the back of other areas of the
abdomen; 20% with severe sequelae of organ failure
◉ Know where pain is located with pancreatitis: chronic. Answer:
epigastric, radiating to back
◉ Know how hepatitis A is transmitted. Answer: Transmitted
through fecal-oral route. Fecal shedding followed by poor
handwashing contaminates water and foods leading to infection of
household and sexual contacts
◉ Stress incontinence. Answer: the urethral sphincter is weakened
so that transient increases in intra-abdominal pressure raise the
, bladder pressure to levels that exceed urethral resistance. Causes
include childbirth and surgery, postmenopausal atrophy of the
mucosa, and urethral infection. May follow prostate surgery in men.
◉ urge incontinence. Answer: detrusor contractions are stronger
than normal and overcome the normal urethral resistance. The
bladder is typically small. Mechanisms: Decreased cortical inhibition
of detrusor contractions from stroke, brain tumor, dementia, and
lesions of the spinal cord above sacral level. Also hyperexcitability of
sensory pathways ie: bladder infections, tumors, and fecal
impaction. Deconditioning of voiding reflexes ie: frequent voluntary
voiding at low bladder volumes.
◉ overflow incontinence. Answer: detrusor contractions are
insufficient to overcome urethral resistance, causing urinary
retention. The bladder is typically flaccid and large, even after an
effort to void. Mechanisms: obstruction of the bladder outlet ie: BPH
or tumor. Weakness of the detrusor muscle associated with
peripheral nerve disease at S2-4 level. Impaired bladder sensation
that interrupts the reflex arc ie: diabetic neuropathy.
◉ functional incontinence. Answer: the patient is functionally able to
reach the toilet in time because of impaired health or environmental
conditions. Mechanism: problems in mobility resulting from
weakness, arthritis, poor vision, or other conditions. Also
environmental factors such as an unfamiliar setting, distant
bathroom facilities, bed rails, or physical restraints.