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Intimate Examinations for Finals. Katie Baxter & Douglas Findlay FY1s MRI. References. MasterPass- The Easy Guide to OSCEs for Specialties Muhammed Ajunjee, Syed Jalali + Shoaib Siddiqui MasterPass- The Easy Guide to OSCEs for Final Year Medical Students Nazmul Akunjee + Muhammed Akunjee.
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Intimate Examinations for Finals Katie Baxter & Douglas Findlay FY1s MRI
References MasterPass- The Easy Guide to OSCEs for Specialties Muhammed Ajunjee, Syed Jalali + Shoaib Siddiqui MasterPass- The Easy Guide to OSCEs for Final Year Medical Students Nazmul Akunjee + Muhammed Akunjee
PR exam • CHAPERONE + CHECK IDENTITY + CONSENT • Present findings in logical manner • If abnormal, be ready with suggestions for differentials; further Ix; management • Enlarged prostate • Rectal mass • Irregular prostate • Anal tag/fissure/fistula • PR bleed/malaena
Testicular exam • CHAPERONE, CONSENT, GLOVES, LYING + STANDING, TRANSILLUMINATING • Confident approach; reassure patient • TESTICULAR MASS- hydrocoele, tumour, orchitis • NON-TESTICULAR- epididymal cyst, epididymitis • HERNIA
Gynaecology exam • Chaperone, consent, have equipment laid out and ready beside patient • Do swabs + smear first! • Get patient to cough ?prolapse • Cervix- size, shape, consistency, excitation, mobility ?dilation • Uterus- size, consistency, mobility, position, masses • Ovaries- ?enlarged in adnexae
Speculum + Smear/Swabs • TURN LIGHT ON!! • HVS- candida + BV • Endocervical- chlamydia (red swab) + gonorrhoea (charcoal swab)
Breast • Chaperone, consent, position • Arms by side (not elevated); above head; pressed on hips • Nipple change/discharge • AXILLAE!! LYMPH NODES!! • Presence of lump- o’clock position in relation to areola • Tail of Spence • Both breasts • Liver + lung + spine
Discharge • White- lactation • Yellow- fibroadenosis, abscess • Green- fibroadenosis, duct ectasia • Red- duct Ca, papilloma
Triple Assessment • Hx + examination • Imaging- mammography (>35y) + ultrasound (35y) • Biopsy (FNA, cytology +/- core biopsy histology)
CONSENT! • CHAPERONE! • CONFIDENCE! • POSITION PATIENT • HAVE EQUIPMENT READY + TO HAND • CHECK FOR CLUES- ?NOTES @ BEDSIDE ?WRISTBAND