}
,How would you perform the single alcohol screening question (SASQ)? - CORRECT
ANSWERS-"How many times in the past year have you had five or more drinks in a day
(men) or four or more drinks in a day (women).
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
CORRECT ANSWERS-psychologic
Erectile dysfunction may be from psychogenic causes, especially if - CORRECT
ANSWERS-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
- CORRECT ANSWERS-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 - CORRECT ANSWERS-very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - CORRECT
ANSWERS-BSE
Breast stage 1 - CORRECT ANSWERS-preadolescent- elevation of nipple only
Breast stage 2 - CORRECT ANSWERS-breast bud stage- elevation of breast and
nipple as a small mound; enlargement of areolar diameter
breast stage 3 - CORRECT ANSWERS-further enlargement of elevation of breast and
areola, with no separation of their contours
breast stage 4 - CORRECT ANSWERS-projection of areola and nipple to form a
secondary mound above the level of breast
breast stage 5 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-
epigastric, radiating to back
Know how hepatitis A is transmitted - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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.
Incontinence secondary to medications - CORRECT ANSWERS-drugs may contribute
to any type of incontinence listed. Ex: sedatives, tranquilizers, anticholinergics,
sympathetic blockers, and potent diuretics
Know where lymph nodes should be with strep - CORRECT ANSWERS-Strep throat
streptococcal pharyngitis, bacterial infection that may cause a sore, scratchy throat·
Common childhood infection has a classic presentation of erythema of the posterior
pharynx and palatal petechiae· Enlarged swollen cervical lymph nodes -> superficial
cervical lymph nodes.Superficial cervical -> superficial to the sternocleidomastoid
, What vaccines are safe during pregnancy - CORRECT ANSWERS-tdap, flu,
Pneumococcal, meningococcal, Hepatitis B, rho gam*NOT MMR, polio, or varicella
Know what to be concerned about if you note an irregular rectal mass - CORRECT
ANSWERS-· Any masses with irregular borders suspicious for rectal cancer.A tender
purulent reddened mass with fever or chills suggests an anal abscess. Abscesses
tunneling to the skin surface from the anus or rectum may form a clogged or draining
ano-rectal fistula. Fistulas may ooze blood, pus, or feculent mucus. Consider
colonoscopy or sigmoidoscopy for better visualization.
Know what HPV Vac protects against - CORRECT ANSWERS-· Prevents infection from
HPV subtypes 16, 18, 6 & 11 which cause 90 % of genital warts
· The bivalent vaccine prevents infection from subtypes 16 and 18.
· Recommended for prevention of cervical, vulvar, and vaginal cancers and precancers
in females as well as anal cancer, precancers, and genital warts in both female and
males
· Vaccinated women should still get cervical cancer screening because vaccines do not
prevent all HPV subtypes
· Condoms do not eliminate the risk of cervical HPV infection
Recommended for those with compromised immune systems including HIV
Know what a 3-year-old can do in regard to jumping and balancing - CORRECT
ANSWERS-· Climbs well, runs easily· Pedals a tricycle· Walks up and down stairs, one
foot on each step
Know where to place measuring tape when measuring uterus in a pregnant patient -
CORRECT ANSWERS-· Measure the fundal height if gestational age is >20 weeks
- fundus should reach the umbilicus
· Place tape measure on pubic symphysis and place the "zero" end of the tape measure
when you can firmly feel that bone.
· Extend the tape measure to the very top of uterine fundus and note the number of cm
measured.
Subject to error between 16-36 weeks
· Number should roughly equal the number of weeks of gestation
If fundal height is >4cm than expected -multiple gestation, large fetus, extra amniotic
fluid, uterine leiomyoma
If fundal height is < 4cm than expected - low-level amniotic fluid, missed abortion,
intrauterine growth retardation, or fetal anomaly
The _______ _______ occupies most of the anterior cardiac surface - CORRECT
ANSWERS-right ventricle
Know what bleeding between periods is called - CORRECT ANSWERS-Abnormal
uterine bleeding, Intermenstrual bleeding
,How would you perform the single alcohol screening question (SASQ)? - CORRECT
ANSWERS-"How many times in the past year have you had five or more drinks in a day
(men) or four or more drinks in a day (women).
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
CORRECT ANSWERS-psychologic
Erectile dysfunction may be from psychogenic causes, especially if - CORRECT
ANSWERS-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
- CORRECT ANSWERS-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 - CORRECT ANSWERS-very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - CORRECT
ANSWERS-BSE
Breast stage 1 - CORRECT ANSWERS-preadolescent- elevation of nipple only
Breast stage 2 - CORRECT ANSWERS-breast bud stage- elevation of breast and
nipple as a small mound; enlargement of areolar diameter
breast stage 3 - CORRECT ANSWERS-further enlargement of elevation of breast and
areola, with no separation of their contours
breast stage 4 - CORRECT ANSWERS-projection of areola and nipple to form a
secondary mound above the level of breast
breast stage 5 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-
epigastric, radiating to back
Know how hepatitis A is transmitted - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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 - CORRECT ANSWERS-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.
Incontinence secondary to medications - CORRECT ANSWERS-drugs may contribute
to any type of incontinence listed. Ex: sedatives, tranquilizers, anticholinergics,
sympathetic blockers, and potent diuretics
Know where lymph nodes should be with strep - CORRECT ANSWERS-Strep throat
streptococcal pharyngitis, bacterial infection that may cause a sore, scratchy throat·
Common childhood infection has a classic presentation of erythema of the posterior
pharynx and palatal petechiae· Enlarged swollen cervical lymph nodes -> superficial
cervical lymph nodes.Superficial cervical -> superficial to the sternocleidomastoid
, What vaccines are safe during pregnancy - CORRECT ANSWERS-tdap, flu,
Pneumococcal, meningococcal, Hepatitis B, rho gam*NOT MMR, polio, or varicella
Know what to be concerned about if you note an irregular rectal mass - CORRECT
ANSWERS-· Any masses with irregular borders suspicious for rectal cancer.A tender
purulent reddened mass with fever or chills suggests an anal abscess. Abscesses
tunneling to the skin surface from the anus or rectum may form a clogged or draining
ano-rectal fistula. Fistulas may ooze blood, pus, or feculent mucus. Consider
colonoscopy or sigmoidoscopy for better visualization.
Know what HPV Vac protects against - CORRECT ANSWERS-· Prevents infection from
HPV subtypes 16, 18, 6 & 11 which cause 90 % of genital warts
· The bivalent vaccine prevents infection from subtypes 16 and 18.
· Recommended for prevention of cervical, vulvar, and vaginal cancers and precancers
in females as well as anal cancer, precancers, and genital warts in both female and
males
· Vaccinated women should still get cervical cancer screening because vaccines do not
prevent all HPV subtypes
· Condoms do not eliminate the risk of cervical HPV infection
Recommended for those with compromised immune systems including HIV
Know what a 3-year-old can do in regard to jumping and balancing - CORRECT
ANSWERS-· Climbs well, runs easily· Pedals a tricycle· Walks up and down stairs, one
foot on each step
Know where to place measuring tape when measuring uterus in a pregnant patient -
CORRECT ANSWERS-· Measure the fundal height if gestational age is >20 weeks
- fundus should reach the umbilicus
· Place tape measure on pubic symphysis and place the "zero" end of the tape measure
when you can firmly feel that bone.
· Extend the tape measure to the very top of uterine fundus and note the number of cm
measured.
Subject to error between 16-36 weeks
· Number should roughly equal the number of weeks of gestation
If fundal height is >4cm than expected -multiple gestation, large fetus, extra amniotic
fluid, uterine leiomyoma
If fundal height is < 4cm than expected - low-level amniotic fluid, missed abortion,
intrauterine growth retardation, or fetal anomaly
The _______ _______ occupies most of the anterior cardiac surface - CORRECT
ANSWERS-right ventricle
Know what bleeding between periods is called - CORRECT ANSWERS-Abnormal
uterine bleeding, Intermenstrual bleeding
