Clinical Examinations in Gynaecology:
Examination of the Abdomen
Prepared for students at the University of Ghana Medical School - College of Health Sciences

Self-Assessment

1. On inspection of the abdomen the following be easily identified:
a. The hair distribution
b. Polycystic ovaries
c. All sizes of uterine fibroids
d. Imperforate hymen
e. Pelvic mass of less than 12 weeks gestational size

A. Correct. This is seen on inspection and could be described as normal female hair distribution or a male pattern hair distribution.

B. Polycystic ovaries are seen on ultrasound examination

C. Uterine fibroids are easily identified by palpation not inspection.

D. A pelvic examination is required to diagnose this.

E. A mass of this size will not even be noticed on inspection of the abdomen

2. On light palpation of the abdomen which of the following can be easily identified
a. Renal enlargement
b. A large abdominal mass
c. Mild splenomegaly
d. Hepato-jugular reflux
e. The diaphragm

A. This requires deep abdominal palpation.

B. Correct.

C. This requires deep abdominal palpation.

D. This cannot be demonstrated on light abdominal palpation.

E. The diaphragm is not palpated during the abdominal examination.

3. It is possible to differentiate between an abdominal mass and a mass arising out of the pelvis. Which of the following techniques are helpful?
a. Fundal palpation
b. Pawlick's grip
c. Vaginal speculum examination
d. Bimanual pelvic examination
e. None of the above

A. This is not correct. It is a technique used in obstetric palpation.

B. This is not correct. It is a technique used in obstetric palpation.

C. This is not correct. This will not help in differentiating between the masses.

D. This is the correct method for clinically differentiating between an abdominal mass and a mass arising out of the pelvis.

E. No. There is a correct answer in the list.

4. Mid-cycle pain:
a. Is also known as dysmenorrhoea
b. Is also known as postpartum haemorrhage
c. May coincide with ovulation
d. May be caused by sexual intercourse
e. May be caused by unruptured ectopic pregnancy

A. Dysmenorrhea is pain associated with menstruation.

B. Postpartum haemorrhage refers to excessive bleeding after delivery.

C. This is correct. Mid-cycle pain is suggestive of ovulation.

D. This is not correct.

E. Unruptured ectopic pregnancy causes abdominal pain; not mid-cycle pain.