1 - O+G - Hx + Ex - Gynae Hx Flashcards
how to start?
personal details
PC
specific gynae questions
what specific gynae topics must be covered
menstrual, sexual/contraceptive, cervical smear, urinary/prolapse Hx
Menstrual Hx – 10 things
how often (first day to first day) how long (eg 4/28 - 4d out of 28 cycle) regular or heavy? (clots? pads/tampons used?) Pain? IMB (inter menstrual bleeding) PCB (post coital bleeding) Discharge? premenstrual tension? LMP? V IMPORTANT Post - menopausal bleeding? (PMB)
Sexual/contraceptive Hx - 5 things
what contraception atm? what in the past? sexually active? regular partner/different partners? painful? (sf dyspareunia = penetration, or, deep dyspareunia = deep inside) during or after? (pain)
Cervical smear Hx - 3 things
when was last cervical smear (should be 3 yearly between 25-49, then 5 yearly till 64)
ever had abnormal smear?
what was done?
Urinary/prolapse Hx - 7 things
frequency? (>7x/day)
urgency?
nocturia?
any leakage? (incl nocturnal enuresis) is it severe? associated with?
any dysuria?
haematuria?
any dragging sensation or mas in/at vagina?
what other parts of the history mustn’t be missed…
Past obstetric Hx PMHx SR DHx + Allergies FHx SHx
What to screen for in PMHx
prev gynae operations venous thrombosis DM lung/heart disease HTN jaundice
What to screen for in FHx and SHx
fhx - breast/ovarian cancer, diabetes, VTE, heart disease, HTN
shx - smoke, drink, how much, support at home, accom, marital status
3 questions to think about when presenting back
1 - Sx manifestation of underlying disease that needs trt?
2 - Sx causing physical damage?
3 - are Sx causing distress? or is she unconcerned?
How to present
this is GIRL, a AGE year old of X gravida and Y parity, with TIME history of PC, who SIGNIFICANT HX POINTS
then detailed Hx + summarise
