History & Examination Flashcards
What are the important things to ask about in a gynaecological history (extra to a standard history)?
Specific gynaecological symptoms Menstrual history Sex and contraception Gynaecological history Obstetric history
What specific gynaecological symptoms are important to ask about in a history?
Pain? - uterine or ovarian? Dyspareunia? - superficial or deep? Vaginal discharge? - amount, colour, consistency, smell, when Itching? Prolapse? Incontinence? - stress or urge? Effect on QoL? Bowel symptoms? - faecal incontinence, IBS
What is important to ask about in a menstrual history?
Date of last menstrual period/menopause? Was the last period normal? Cycles - no. Of bleeding days, no. Days from day 1 of one period to day 1 of the next Regular? Heavy? - clots/floods? Painful? Does he pain start before the period starts? Associated bowel symptoms? IMB, PCB, PMB Age at menarche
What is important to ask in a sex and contraception history?
Sexually active?
Physical or emotional problems with sex?
Contraception? Happy with it? Tried any others previously?
Problems conceiving? Treatment for subfertility?
STIs?
Date and result of last smear? History of abnormal smears?
What is important to ask about obstetrics in a gynaecological history?
How many children?
Antenatal problems, delivery, gestation, outcomes, birthweights
Puerperium
Terminations/miscarriages - what stage, why and how
What are the stages of a gynaecological examination?
General
Abdomen
Vaginal examination
Speculum examination
Describe examination of the abdomen in a gynaecological exam?
Inspect the abdomen
Palpate for peritonism and tenderness
If there is a mass, could it be pregnancy?
If distended, percussions for ascites
Describe the stages of a vaginal exam.
Inspect the vulva
Use a speculum to examine the vagina and cervix
Use finders to examine the uterus and adnexae bimanually
