Clinical/Comm Skills - Week 2 - B - Gynaecological History Taking Flashcards
Gynaecological history
Important to start by mentioning the patients name age and parity again
What is parity written as again?
Parity - Any live or stillbirth after 24 weeks + number lost before 24 weeks
Just as nomral histories start off, begin the gynae history by asking about the presenting complaint and HPC
What questions can be asked for the HPC? (state the key gynae symptoms to ask for)
Abdominal vaginal discharge
Vaginal bleeding
Vulval itching / discomfort / skin changes
Abdominal discomfort / pain
After questioning the patient on the HPC, start the gynae history
Main areas of gynaecological history:
- Menstrual history
- Cervical smear history
- Contraceptive history
- Sexual history
- Vaginal discharge
What questions should be asked regarding the menstrual history?
Menstrual history
Age of menarche/meopause, cycle frequency (ie days between day 1 of menstruation) and duration of menses (K= …/…), any abnomral bleeding, date of LMP
Main areas of gynaecological history:
- Menstrual history
- Cervical smear history
- Contraceptive history
- Sexual history
- Vaginal discharge
What is asked in the cervical smear history?
What is asked in the contraceptive history?
Cervical smear history
Date and result of last smear, do you attend each appointment, ever any abnormal smear
Contraceptive history
On any current contraceptive, or previous contraception
How often are cervical smears taken?
What is dysparenuia?
What is dysmenorrhea?
Cervical smears
From age 25 to 49 - every 3 years
From age 50-64 - every 5 years
Dysparenuia - painful sexual intercourse
Dysmenorrhea - painful periods
When asking about the sexual history, ask about frequency, libido and dysparenuia
What should be asked regarding vaginal discharge?
COlour of the discharge, odour and any vulval irritation
A brief obstetric history is taken in the gynae history
Ask about each individual pregnancy
What questions should be asked?
Year of birth/age of child and gestational age at birth
Problems - antenatal, intrapartum, postpartum
Outcome of pregnancy and birthweight
Finish off the history by asking about the PMH and surgery, FHx, drugs/allergies, Shx, Systemic enquiry
What can be asked regarding the systemic enquiry?
Nausea/vomiting/bowel habits (change in habit)
Urinary continence/frequency/dysuria
Can also run through the different systems
