Which of the following findings on the bimanual exam of a female patient requires further investigation?
A. Retroverted uterus
B. Varicose veins in vaginal wall
C. Cervical motion tenderness
D. Anteflexed uterus
ANS: C
The uterus should be pear-shaped, smooth, mobile, non-tender, and firm but not hard. Malignancies may occur, causing the uterus to be hard and fixed. Tenderness with movement of the cervix and uterus occurs in PID, termed cervical motion tenderness. Variations in the position of the uterus are not considered abnormal, but significant variations may be related to back pain, especially during menses or childbirth, and occasionally to infertility. Common uterine positions are retroverted, retroflexed, anteverted, and anteflexed.
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