5 stations / 51 steps/ 5 script lines

Breast and pelvic

Intimate examinations are scored on consent, draping and narration as much as on technique. Each station here starts with what to say before anyone undresses.

Timed station Script drill Trans-affirming and trauma-informed care

0 of 51 steps

The complaint

Presenting problems: lump or change in texture or contour, pain, nipple discharge, nipple changes (retraction, scaling, ulceration), skin changes (rash, redness, dimpling), axillary or supraclavicular lump.Presenting problems: lump or change in texture or contour, pain, nipple discharge, nipple changes (retraction, scaling, ulceration), skin changes (rash, redness, dimpling), axillary or supraclavicular lump.
CharacterizeCharacterize“How and when was it found? Has it changed, grown or progressed? One side or both? Constant or intermittent? How long? Any change with your periods? Any tests so far? Any fever or other symptoms?”
DischargeDischarge“Does it come on its own or only when squeezed? What colour? How often? Has it happened before?”Only truly spontaneous, unilateral, single-duct bloody, serosanguinous or clear discharge is concerning.

Risk

Past breast history: high-risk benign pathology (atypical hyperplasia), prior screening over 50, breast density if known.Past breast history: high-risk benign pathology (atypical hyperplasia), prior screening over 50, breast density if known.
Reproductive history: menarche, menopause, cycle pattern, pregnancies and age at first term delivery, breastfeeding and duration, hormonal therapy and duration (contraception, infertility, HRT).Reproductive history: menarche, menopause, cycle pattern, pregnancies and age at first term delivery, breastfeeding and duration, hormonal therapy and duration (contraception, infertility, HRT).
Alcohol, smoking, chest wall or neck irradiation; previous non-breast malignancy, especially ovarian.Alcohol, smoking, chest wall or neck irradiation; previous non-breast malignancy, especially ovarian.
Family history: siblings and ages, mother's age or age at death, breast, ovarian and early prostate cancer on either side with ages at diagnosis; ethnicity and country of origin.Family history: siblings and ages, mother's age or age at death, breast, ovarian and early prostate cancer on either side with ages at diagnosis; ethnicity and country of origin.

The scrotal mass

Row	Tender	Findings	Special tests
Testicular torsion	Yes	Abnormal lie of the testis	Prehn negative; cremasteric reflex absent
Orchitis	Yes	Swollen testis	Prehn positive; cremasteric reflex normal
Epididymitis	Yes	Swollen epididymis	Prehn positive; cremasteric reflex normal
Testicular cancer	No, unless hemorrhagic	Nodules	No transillumination
Hydrocele	No	Swollen, testis not separable from it	Transilluminates
Spermatocele	No	Swollen above the testis, testis separable	Transilluminates
Hematocele	Yes	Swollen	No transillumination
Varicocele	No	Bag of worms in the cord, larger with Valsalva	No transillumination

Indirect versus direct inguinal hernia

Row	Indirect	Direct
Frequency and age	Common; babies and children	Uncommon; older patients
Pathophysiology	Patent processus vaginalis	Weakened abdominal wall
Course	Lateral to the inferior epigastric vessels, through the deep ring	Medial to the inferior epigastric vessels, behind the superficial ring
Examination	Pressure at the tip of the finger in the superficial ring	Pressure against the side of the finger
Enters the scrotum	Common	Uncommon

The prostate on digital rectal examination

Row	Key features
Normal	Rubbery, non-tender
Benign prostatic hyperplasia	Enlarged, smooth contours, non-tender
Prostatitis	Enlarged, tender
Prostate cancer	Hard, irregular contours, nodules

Recall quiz

The scrotal mass

Tenderness, findings and special tests in; the diagnosis out.

Score 0 / 8Streak 0

Shuffling the deck...

Demonstration videos are embedded from their creators’ own YouTube channels (Geeky Medics and Stanford Medicine 25) and remain theirs; each frame credits the channel and links out to it.