6.1 Introduction to gynaecology

Question 1

List the common gynecological conditions.

Answer 1

1. Clinic(planned consultations)
   2.Emergencies
2. Malignancies

Question 2

Clinic

Answer 2

• Abnormal uterine bleeding
• Infertility
• Incontinence
• Pelvic prolapse
• Amenorrhea
• Sexual dysfunction
• Termination of pregnancy
• Contraceptive services

Question 3

Emergencies

Answer 3

• Early pregnancy complications
• Acute salpingo oophoritis
• Heavy menstrual bleeding
  Puerperal sepsis

Question 4

Malignancies

Answer 4

• Cervical
• Endometrial
• Ovarian

Question 5

Regarding the approach to a gynecological history which aspects are important to note.

Answer 5

• Appreciate the sensitive nature of the consultation.
• Insure report, privacy and good communication.
• Start with gathering information on the main complaint
• Open questions
• Non judgmental
• No assumptions
  -Then gynaecological history

Question 6

NB: Test question.
Gynaecological History
What do we ask and why?

Answer 6

• LNMP
• Menarche
• Age of menopause
• Menstrual cycle,pattern and trends.
• Bleeding,associated pain and other symptoms
• Urogenital and GIT : triplets
• Vaginal discharge
• Sexual history
• Contraceptive use
• Cervical smear
• Gynaecological surgery
• Obstetrics History
• Medical,surgical,social and family history.

Question 7

Gynaecological examination

Answer 7

• Consent
• Explain why
• Chaperone
• Privacy
• Clean surroundings
• Position patient on bed: lithotomy
• Vulva: Inspection and palpation

Question 8

Commonly used special investigations

Answer 8

• Wet mount smear: Vaginitis
• Smears for cervical cytology: Pap smear
• Ultrasound: Abdominal/transvaginal to assess uterus,adnexa pouch of Douglas.
• If there is blood it willl gather in this pouch, e.g blood may come from a fallopian tube rupture
• Blood: HIV,Syphilis, B-HCG,TSH,FSH,Prolactin
• Urine: Dipstick, MCS
• Semen analysis
• Biopsies
• CT/MRI