NR 509 SHADOW HEALTH PHYSICAL
EVALUATION STUDY PACKAGE WEEKS 5 6 7
DISTINCTION LEVEL 2026
◉ Risk for Breast cancer. Answer: --*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. Answer: Soft to firm, round, mobile,
often tender.
,◉ The best way to examine the lateral portion of the breast. Answer: -
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). Answer: -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. Answer: -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. Answer: -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
-Vestibule and labia minora may be erythematous; the vaginal mucosa
may be diffusely reddened, with small red granular spots or petechiae in
the posterior fornix; in mild cases, the mucosa looks normal
- Scan saline wet mount for trichomonads
◉ Syphillis. Answer: This ulcerated papule with an indurated edge
usually appears after 3 to 6 weeks of incubating infection from the
spirochete Treponema pallidum. These lesions may resemble a
carcinoma or crusted cold sore. Similar primary lesions are common in
the pharynx, anus, and vagina but may escape detection since they are
EVALUATION STUDY PACKAGE WEEKS 5 6 7
DISTINCTION LEVEL 2026
◉ Risk for Breast cancer. Answer: --*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. Answer: Soft to firm, round, mobile,
often tender.
,◉ The best way to examine the lateral portion of the breast. Answer: -
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). Answer: -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. Answer: -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. Answer: -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
-Vestibule and labia minora may be erythematous; the vaginal mucosa
may be diffusely reddened, with small red granular spots or petechiae in
the posterior fornix; in mild cases, the mucosa looks normal
- Scan saline wet mount for trichomonads
◉ Syphillis. Answer: This ulcerated papule with an indurated edge
usually appears after 3 to 6 weeks of incubating infection from the
spirochete Treponema pallidum. These lesions may resemble a
carcinoma or crusted cold sore. Similar primary lesions are common in
the pharynx, anus, and vagina but may escape detection since they are
