Chapter 21: Gynecologic Emergencies

Question 1

Discuss

Menarche

Answer 1

Onset of menstruation, typically 11-16 yo

Question 2

Discuss

Vaginal bleeding

Answer 2

Ask if it’s comparable to normal flow. Could be a sign of abnormal menstruation, vaginal trauma, ectopic pregnancy, spontaneous abortion, cervical polyps, cancer.

Question 3

Discuss

PID

Answer 3

Pelvic Inflammatory Disease. Infection of upper organs: ovaries, fallopian tubes, uterus. Almost always in sexually active women. Can cause scarring–>ectopic pregnancy or abcess. Generalized lower abdominal pain.

Question 4

Discuss

Chlamydia

Answer 4

Bacterium. Untreated can lead to PID. Often symptoms absent, sometimes lower ab pain, low back pain, nausea, fever, pain during intercourse, bleeding between periods.

Question 5

Discuss

Bacterial vaginosis

Answer 5

One of the most common conditions affecting women. Overgrowth of bacteria in vagina. Itching, burning, pain, fishy smelling discharge. Can lead to premature birth, make pt more susceptible to serious infections, and result in PID.

Question 6

Discuss

Gonorrhea

Answer 6

Painful urination, associated burning/itching. Yellowish of bloody vaginal discharge. Blood with intercourse. Untreated, bacteria can get into bloodstream, also PID.

Question 7

Discuss

Treatment of vaginal bleeding

Answer 7

Never insert anything into the vagina to control bleeding. Cover lacerations etc with moist dressing.

Question 8

Discuss

Sexual assault and rape

Answer 8

Don’t ask a lot of questions about the crime, protect psychology of victim. Preserve evidence. Bring clothes to hospital in brown paper bag. Gently persuage pt not to clean herself, urinate, move bowels.