14.) Gynecological Anamnesis And Examination

Question 1

Purpose of Gynecological Anamnesis

Answer 1

To collect comprehensive information on symptoms, reproductive and sexual history, menstrual cycle, contraceptive use, and previous conditions for accurate diagnosis and management.

Question 2

Common Presenting Complaints

Answer 2

Abnormal uterine bleeding, pelvic pain, pelvic masses, infertility, vaginal infections (e.g., discharge, itching), urogynaecological symptoms (e.g., incontinence), and dyspareunia.

Question 3

Initial Steps of Gynecological Examination

Answer 3

Introduce yourself, explain the procedure, obtain consent, and ensure patient comfort and privacy.

Question 4

Patient Positioning for Examination

Answer 4

Supine position with head elevated, legs bent, and feet in stirrups (if available) for optimal access to the pelvic area.

Question 5

External Inspection Focus Areas

Answer 5

Assess vulva for ulcers, abnormal discharge, scarring, vaginal atrophy, white lesions, and masses to identify conditions like genital herpes, Bartholin cysts, or vulvar malignancy.

Question 6

Assessment of Vaginal Prolapse

Answer 6

Instruct the patient to cough and observe for any bulging that may indicate pelvic organ prolapse.

Question 7

Steps for Speculum Insertion

Answer 7

Separate labia, insert speculum transversally and angled downward, rotate and open to view the cervix, lock the speculum, and inspect the cervix.

Question 8

Cervical Inspection Indicators

Answer 8

Check for erosions (e.g., cervical ectropion or cancer), ulcerations (e.g., herpes), and discharge, as these may suggest cervical pathology.

Question 9

Purpose of Bimanual Examination

Answer 9

To evaluate the uterus and adnexa for size, shape, position, surface, consistency, mobility, and tenderness, checking for masses or abnormalities.

Question 10

Recto-Abdominal Examination

Answer 10

For virginal patients, involves placing one finger in the rectum with the other hand palpating the abdomen to assess internal structures without disrupting the hymen.

Question 11

Importance of Urogynaecological Symptom Assessment

Answer 11

Identifies symptoms like incontinence or dysuria that may indicate pelvic floor issues or infections, aiding in comprehensive reproductive and urinary system assessment.