GPA - Amenorrhea, vaginal discharge, bleeding, dyspareunia Flashcards
(32 cards)
DDX - Amenorrhea40F, morning nausea, vomiting, fatigue, polyuria
Lase menses 6 weeks prior
tender breasts
Rhythem birth control
Pregnancy
PID
UTI
hyperprolactemia
Workup - Amenorrhea 40F, morning nausea, vomiting, fatigue, polyuria Lase menses 6 weeks prior tender breasts Rhythem birth control
Urine HGC UA- Culture CBC CMP, electrolytes Prolactin, TSH Papsmear - cultures, HIV VDLR/RPR : syph
DDX - Amenorrhea 35YO f Galacgtorrhea visual field defects Headaches x 6 weeks
Prolactinoma Pregnancy Thyroid disease Pituitory tumor Premature ovariian failure
WOrkup - Amenorrhea 35YO f Galacgtorrhea visual field defects Headaches x 6 weeks
Urine Hgc Prolactin TSH MRI - Brain (not moveing LH and FSH Pelvic and breast exam (whats doing weird stuff)
DDX - Amenorrhea
46yo F x 6 months
hot flashes, night sweats, emotional lability
dyspareunia
Premenopause
Pregnancy
Pituitary tumor
Thyroid disease (hot)
Workup - Amenorrhea
46yo F x 6 months
hot flashes, night sweats, emotional lability
dyspareunia
Urine HGC TSH LH, FSH, TSH, Prolactin CBC MRI
DDX - Amenorrhea
35yo, cold intolerance
course hair, wt loss, fatigue,
Abruptio placentae, followed by hypovolemic shock and failure of lactation 2 years ago
Sheehan syndrom Pituitory tumor Thyroid diesease Asheman syndrom premature ovarian syndrome
Workup - Amenorrhea
35yo, cold intolerance
course hair, wt loss, fatigue,
Abruptio placentae, followed by hypovolemic shock and failure of lactation 2 years ago
Uring HGC TSH Pelvic exam CBC LH, FSH, Prolactin (the menses hormones) ACTH MRI-brain
DDX - Amenorrhea
29yo x 6 months
palpitations, dizziness, lost fiance in car accident
Depression
Thyroid disease
Anxiety induced amenorrhea
Workup - Amenorrhea
29yo x 6 months
palpitations, dizziness, lost fiance in car accident
Urine HGC TSH Pelvic exam LH, FSH, Prolactin ACTH Urine cortisol- stress)
DDX - vaginal bleeding
17 yo prolongues, excessive menstural bleeding, irregulary withing past 6 months
Dysfunctional uterine bleeding coagulation: vonwilebrands, hemophelia Cervical cancer Hypothyroidism Diabetes mellitus
Workup - vaginal bleeding
17 yo prolongues, excessive menstural bleeding, irregulary withing past 6 months
Pelvic exam: Pap, cultures Uring HGC CBC, ESR : PTT, PT Prolactin, LH/FSH TSH US - Pelvis (cancer)
DDx: Vaginal bleeding 61 yo obease F, profuse vag bleeing x 1 months 10 years menopausal, Hx of HTN and DM Nulliparous
Endometrial cancer Cervical cancer Entometrial hyperplasia Endometrial polyups atrophic vaginitis
Workup: Vaginal bleeding 61 yo obease F, profuse vag bleeing x 1 months 10 years menopausal, Hx of HTN and DM Nulliparous
Pelvic exam: pap, cultues Pelvic ultrasound CBC, ESR Endometrial biopsy Colposcopy Hysteroscopy
DDX vaginal bleeding
45, 5 kits,
postcoital bleeding
smoker and takes OCP
Cervical cancer (smoker)
Cervical polyup (bleed when bumped)
Cervicitis
Trauma
Workup: vaginal bleeding
45, 5 kits,
postcoital bleeding
smoker and takes OCP
Pelvic exam: pap,
Colposcopy and biopsy
DDX vaginal bleeding
28 yo F,
8 weeks pregnant, lower abd pain and vag bleeding
Spontaneous abortion
ectopic pregnancy
Molar pregnancy
Workup vaginal bleeding
28 yo F,
8 weeks pregnant, lower abd pain and vag bleeding
Pelvic exam Urine hCG US pelvis CBC, PT, PTT Quanitative serum hcg
DDX vaginal bleeding
32 yo, sudden onset, left lowe abddomina pain
radiate to scapula and back, with vaginal bleeding
5 weeks since last menses
Hx of PID, unprotected intercourse
Ectopic pregnacy
PID
Ruptured ovarian cyst
ovarian torsion
WOrkup : vaginal bleeding
32 yo, sudden onset, left lowe abddomina pain
radiate to scapula and back, with vaginal bleeding
5 weeks since last menses
Hx of PID, unprotected intercourse
Urine hCg + quanitative serum
Pelvic Exam, cultures
Pelvic ultrasound
DDX - Vaginal discharge
28 yo, discharge
thin gray, white
foul smelling
Bacterial vaginosis : Thin grey white, odor
Vaginitis ; candidial: thick greay white, odorless
Vaginitis: trichomonal (green yellow, Fishy)
Cervisitis, Chylamidis Gonorrhea
Workup- Vaginal discharge
28 yo, discharge
thin gray, white
foul smelling
Pelvic : wet mount, cultures
KOH: whiff test (trich)
PH
DDX - Vaginal discharge
30 yo F,
thick white, cottage cheesey
odorless vag discharge
Vaginitis: candidial (thick white, odoless) Bacterial vaginosis (thin grey white, odor) Vaginitis _ trich
Workup - Vaginal discharge
30 yo F,
thick white, cottage cheesey
odorless vag discharge
Pelvic, wet mount, cultures
Koh: whiff test
Ph
