Gynae history importance Gynae history importance.ppt.pptx

Important history points regarding gynae

1. Menstrual cycle Normal Menstrual cycle length: 19 to 35 days +- 2 days Past cycle: e:g 7/28 regular Present cycle: e:g 15/30 days Case #1 Heavy menstrual bleeding Amount of bleeding: no of pads soaked in a day; home made/ sanitory ; fully soaked / partially soaked. Passage of clots; flooding/soiling of clothes. Colour of blood. Symptoms of anaemia Effect on quality of life Associated with: dysmenorrhea, dyspareunia , IMB, Post coital bleeding, pain, vaginal discharge Causes: PALM COEIN GYNECOLOGICAL HISTORY

2. Dysmenorrhea Onset Duration Character: primary / secondary; Congestive/spasmodic Intensity Relieving factor: rest/ hot bath, warm packs/ NSAIDS DyspareuniaOnset Duration Character: superficial /deep Intensity Relieving factor Intermenstral and Postcoital bleeding Onset: spontaneous/trauma Episodes Amount of bleeding How it stopped: self limiting/drugs

3. PAIN O nset L ocation D irection (Radiation) C haracter A ggravating factor R elieving factor S everity VAGINAL DISCHARGE Characteristics Colour Consistency Amount Smell Itching Associated with menstruation : physiological/pathological Risk factors/causes: Immunosuppressive drugs, STI, antibiotics, DM, TB

4. CAUSES OF HMB P: Pregnancy polyp, PID A: adenomyosis L: leiomyoma M: malignancy C: coagulopathy O: ovulatory E: endometrial, endocrine I: iatrogenic: IUCD, Anticoagulant drugs N: not yet classified

5. CASE #2 PELVIC MASS Differential diagnosis Uterine mass e:g, Fibroid TO mass: TB, vaginal discharge Ovarian mass How she came to know: pain, incidental finding, cachexic features, menstrual irregularity, hormonal changes C achexic features: weight loss, anorexia, bloating, early satiety, nausea M enstrual irregularity M etastasis: headache, fits, jaundice, cough, hemoptysis , bone pain H ormonal: hirsuitism , acne, deepening of voice, breast atrophy or enlargement Pressure symptoms : Urinary: frequency, urgency, hesitancy, incontinence, retension Bowel : constipation, hemorrhoids Legs : varicosities UV prolapse

6. CASE #3 SUBFERTLITY PRIMARY/SECONDARY Duration Couple living together Coital frequency Knowledge about fertility period Any treatment taken Menstrual history CAUSES Ovulatory: PCO: weight gain , hirsuitism , acne Hyperprolactinemia: headache, visual disturbance, galactorhea POI: hot flushes, night sweats, mood swings, irritability Tubal : Vaginal discharge, PID Cervical: Trauma, radiation Male factor : Impotence, Smoking ,drugs, history of genital trauma, surgery, mumps and prolonged febrile illness, TB