Common gynae histories - Pelvic pain Flashcards

1
Q

What would you want to ask about pelvic pain?

A

SOCRATES

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2
Q

What systems would you want to ask about in someone with pelvic pain?

A
  • General
  • Gynaecological
  • Urological
  • Gostrointestinal
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3
Q

What gynaecological symptoms would you want to ask about on systemic enquiry for pelvic pain?

A
  • PV bleeding - menorrhagia, intermenstrual, post-coital, post-menopausal
  • PV discharge
  • Pain - dysmennorhoea, dyspareunia
  • Pregnancy risk
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4
Q

What general symptoms would you want to ask about on systemic enquiry for pelvic pain?

A
  • Fever
  • Sweats
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5
Q

What urological symptoms would you want to ask about on systemic enquiry for symptoms of pelvic pain?

A
  • Storage - frequency, volume, urgency, nocturia, incontinence
  • Infection - dysuria, haematuria, odour
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6
Q

What gastrointestinal symptoms would you ask about on systemic enquiry in someone with pelvic pain?

A
  • Weight loss
  • Appetitie change
  • Nausea/vomtiing
  • Bowel habits
  • Tenesmus
  • Blood/mucus in stool
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7
Q

What features associated with pelvic pain would suggest PID/acute salpingitis as a cause?

A
  • Bilateral pelvic pain
  • Vaginal discharge
  • Dyspareunia
  • Dysmennorhoea
  • Fever
  • Post coital/intermenstrual bleeding
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8
Q

What features assocaited with pelvic pain would suggest ectopic pregnancy?

A
  • Recent period of amenorrhoea
  • Trying to get pregnant or unprotected sex
  • May have vaginal spotting
  • Collapse + shoulder tip pain - rupture
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9
Q

What features associated with pelvic pain suggest ovarian cyst torsion/rupture/haemorrhage?

A
  • Sudden unilateral pelvic pain
  • Fever/vomting
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10
Q

What features assocaited with pelvic pain would suggest endometriosis?

A
  • Cyclical pelvic pain
  • Dysmenorrhoea
  • Deep dyspareunia
  • Menstrual disturbance
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11
Q

What features of pelvic pain would suggest pyelonephritis as the cause?

A
  • FEver/chills/rigors
  • Loin pain
  • Urinary frequency
  • Dysuria
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12
Q

What features of pelvic painw ould suggest appendicitis?

A
  • YOung patient
  • Periumbilical pain
  • Moves to RIF
  • Anorexia
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13
Q

What features associated with pelvic pain would suggest diverticulitis as a cause?

A
  • Elderly
  • LIF pain
  • Pyrexia
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14
Q

What features assocaited with pelvic pain suggest IBS/IBD?

A
  • Lower abdominal pain
  • Bowel habit change
  • May pass blood/mucus in IBD
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15
Q

What are causes of pelvic pain?

A
  • PID/acute salpingitis
  • Ectopic pregnancy
  • Ovarian cyst torsion/rupture/haemorrhage
  • Endometriosis
  • Pyelonephritis
  • Appendicitis
  • Diverticulitis
  • IBS/IBD
  • Mittelschmerz
  • Fibroid degeneration
  • Renal colic
  • Bowel obstruction
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