Course material

1. Special Examinations—Breast, Genital, Prostate, And Rectal GENITALIA
ASSESSMENT
Special Examinations—Breast, Genital, Prostate, And Rectal GENITALIA
ASSESSMENTSpecial Examinations—Breast, Genital, Prostate, And Rectal GENITALIA
ASSESSMENTFor this assignment, you will analyze an Episodic note case study that
describes abnormal findings in patients seen in a clinical setting. You will consider what
history should be collected from the patients, as well as which physical exams and
diagnostic tests should be conducted. You will also formulate at least 5 differential diagnosis
with several possible conditions. Please remember to pretend that this is an actual patient
and gives as much detail as possible!CASE STUDY:Subjective: • CC: “I have bumps on my
bottom that I want to have checked out.”• HPI: AB, a 21-year-old WF college student reports
to your clinic with external bumps on her genital area. She states the bumps are painless
and feel rough. She states she is sexually active and has had more than one partner during
the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal
discharge. She is unsure how long the bumps have been there but noticed them about a
week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam
results were normal. She reports one sexually transmitted infection (chlamydia) about 2
years ago. She completed the treatment for chlamydia as prescribed.ORDER
COMPREHENSIVE SOLUTION PAPERS ON Special Examinations—Breast, Genital, Prostate,
And Rectal GENITALIA ASSESSMENT• PMH: Asthma•Medications: Symbicort
160/4.5mcg•Allergies: NKDA•FH: No hx of breast or cervical cancer, Father hx HTN, Mother
hx HTN, GERD •Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2
boys)Objective: • VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs•Heart: RRR,
no murmurs• Lungs: CTA, chest wall symmetrical• Genital: Normal female hair pattern
distribution; no masses or swelling. Urethral meatus intact without erythema or discharge.
Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round,
small, painless ulcer noted on external labia• Abd: soft, normoactive bowel sounds, neg
rebound, neg murphy’s, negMcBurney•Diagnostics: HSV specimen obtainedAssessment: •
ChancreREQUIRED READINGSBall, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R.
W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.).
St. Louis, MO: Elsevier Mosby.· Chapter 17, “Breasts and Axillae”This chapter focuses on
examining the breasts and axillae. The authors describe the examination procedures and
the anatomy and physiology of breasts.· Chapter 19, “Female Genitalia”In this chapter, the

2. authors explain how to conduct an examination of female genitalia. The chapter also
describes the form and function of female genitalia.· Chapter 20, “Male Genitalia”The
authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland,
and seminal vesicles. Additionally, the chapter explains how to perform an exam of these
areas.· Chapter 21, “Anus, Rectum, and Prostate”This chapter focuses on performing an
exam of the anus, rectum, and prostate. The authors also explain the anatomy and
physiology of the anus, rectum, and prostate.Dains, J. E., Baumann, L. C., & Scheibel, P.
(2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St.
Louis, MO: Elsevier Mosby.Credit Line: Advanced Health Assessment and Clinical Diagnosis
in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by
Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.Chapter 5,
“Amenorrhea”Amenorrhea, or the absence of menstruation, is the focus of this chapter. The
authors include key questions to ask patients when taking histories and explain what to
look for in the physical exam.Chapter 6, “Breast Lumps and Nipple Discharge”This chapter
focuses on the important topic of breast lumps and nipple discharge. Because breast cancer
is the most common type of cancer in women, it is important to get an accurate diagnosis.
Information in the chapter includes key questions to ask and what to look for in the physical
exam.Chapter 7, “Breast Pain”Determining the cause of breast pain can be difficult. This
chapter examines how to determine the likely cause of the pain through diagnostic tests,
physical examination, and careful analysis of a patient’s health history.Chapter 27, “Penile
Discharge”The focus of this chapter is on how to diagnose the causes of penile discharge.
The authors include specific questions to ask when gathering a patient’s history to narrow
down the likely diagnosis. They also give advice on performing a focused physical
exam.Chapter 36, “Vaginal Bleeding”In this chapter, the causes of vaginal bleeding are
explored. The authors focus on symptoms outside the regular menstrual cycle. The authors
discuss key questions to ask the patient as well as specific physical examination procedures
and laboratory studies that may be useful in reaching a diagnosis.Chapter 37, “Vaginal
Discharge and Itching”This chapter examines the process of identifying causes of vaginal
discharge and itching. The authors include questions on the characteristics of the discharge,
the possibility of the issues being the result of a sexually transmitted infection, and how
often the discharge occurs. A chart highlights potential diagnoses based on patient history,
physical findings, and diagnostic studies.Sullivan, D. D. (2019). Guide to clinical
documentation (3rd ed.). Philadelphia, PA: F. A. Davis.· Chapter 3, “SOAP Notes” (Previously
read in Week 8)Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing
adenosis of the breast: Report of two cases and review of the literature. Polish Journal of
Radiology, 80, 122–127. doi:10.12659/PJR.892706. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/ Sabbagh , C., Mauvis, F.,
Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best
position for analyzing the lower and middle rectum and sphincter function in a digital rectal
examination? A randomized, controlled study in men. Digestive and Liver Disease, 46(12),
1082–1085. doi:10.1016/j.dld.2014.08.045Westhoff , C. L., Jones, H. E., & Guiahi, M. (2011).
Do new guidelines and technology make the routine pelvic examination obsolete? Journal of
Women’s Health, 20(1), 5–10.This article describes the benefits of new technology and

3. guidelines for pelvic exams. The authors also detail which guidelines and technology may
become obsolete.Centers for Disease Control and Prevention. (2019). Sexually transmitted
diseases (STDs). Retrieved from http://www.cdc.gov/std/#This section of the CDC website
provides a range of information on sexually transmitted diseases (STDs). The website
includes reports on STDs, related projects and initiatives, treatment information, and
program tools.