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First Aid: Step 2 CS > Differential & Work-up: Vaginal Bleeding, Discharge, Dyspareunia > Flashcards

Differential & Work-up: Vaginal Bleeding, Discharge, Dyspareunia Flashcards

1
Q

17 yo F presents with prolonged, excessive menstrual bleeding occurring irregularly for the past 6 months.

A
  1. Dysfunctional uterine bleeding
  2. Coagulation disorder (eg. von Willebrand disease, hemophilia)
  3. Cervical cancer
  4. Molar pregnancy
  5. Hypothyroidism
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2
Q

WORK UP FOR:

  1. Dysfunctional uterine bleeding
  2. Coagulation disorder (eg. von Willebrand disease, hemophilia)
  3. Cervical cancer
  4. Molar pregnancy
  5. Hypothyroidism
A
  1. Pelvic exam
  2. Pap smear
  3. CBC
  4. PT/PTT
  5. Urine hCG
  6. Cervical culture
  7. ESR
  8. LH/FSH, TSH, prolactin
  9. U/S-pelvis
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3
Q

61 yo obese F presents with profuse vaginal bleeding for the past month. Her last menstrual period was 10 years ago. She has a history of hypertension and diabetes mellitus. She is nulliparous.

A
  1. Endometrial cancer
  2. Cervical cancer
  3. Atrophic endometrium
  4. Endometrial hyperplasia
  5. Endometrial polyps
  6. Atrophic vaginitis
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4
Q

WORK UP FOR:

  1. Endometrial cancer
  2. Cervical cancer
  3. Atrophic endometrium
  4. Endometrial hyperplasia
  5. Endometrial polyps
  6. Atrophic vaginitis
A
  1. Pelvic exam
  2. Pap smear
  3. Endometrial biopsy
  4. Endometrial curettage
  5. U/S-pelvis
  6. Colposcopy
  7. Hydro-ultrasonography
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5
Q

45 yo G5P5 F presents with postcoital bleeding. She is a cigarette smoker and does not use contraceptive protection.

A
  1. Cervical cancer
  2. Endometrial cancer
  3. Cervical polyp
  4. Cervicitis
  5. Trauma ( eg. cervical laceration)
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6
Q

WORK UP FOR:

  1. Cervical cancer
  2. Endometrial cancer
  3. Cervical polyp
  4. Cervicitis
  5. Trauma ( eg. cervical laceration)
A
  1. Pelvic exam
  2. Pap smear
  3. Colposcopy and biopsy
  4. HPV testing
  5. Endometrial biopsy
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7
Q

28 yo F who is 8 weeks pregnant presents with lower abdominal pain and vaginal bleeding.

A
  1. Spontaneous Abortion
  2. Ectopic pregnancy
  3. Molar pregnancy
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8
Q

WORK UP FOR:

  1. Spontaneous Abortion
  2. Ectopic pregnancy
  3. Molar pregnancy
A
  1. Urine hCG
  2. Pelvic exam
  3. Quantitative serum hCG
  4. U/S-abdomen/pelvis
  5. CBC
  6. PT/PTT
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9
Q

32 yo F presents with sudden onset of left lower abdominal pain that radiates to the scapula and back and is associated with vaginal bleeding. Her last menstrual period was 5 weeks ago. She has a history of pelvic inflammatory disease and unprotected intercourse.

A
  1. Ectopic pregnancy
  2. Ruptured ovarian cyst
  3. Ovarian torsion
  4. Pelvic inflammatory disease
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10
Q

WORK UP FOR:

  1. Ectopic pregnancy
  2. Ruptured ovarian cyst
  3. Ovarian torsion
  4. Pelvic inflammatory disease
A
  1. Urine hCG
  2. Pelvic exam
  3. Quantitative serum hCG
  4. U/S-abdomen/pelvis
  5. Cervical cultures
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11
Q

28 yo F presents with a thin, grayish-white, foul-smelling vaginal discharge.

A
  1. Bacterial vaginosis
  2. Vaginitis-candida
  3. Vaginitis-trichomonal
  4. Cervicitis (chlamydia, gonorrhea)
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12
Q

WORK UP FOR:

  1. Bacterial vaginosis
  2. Vaginitis-candida
  3. Vaginitis-trichomonal
  4. Cervicitis (chlamydia, gonorrhea)
A
  1. Pelvic exam
  2. Wet mount, KOH prep, “whiff test”
  3. pH of vaginal fluid
  4. Cervical cultures
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13
Q

30 yo F presents with a thick, white, cottage

cheese-like, odorless vaginal discharge and vaginal

itching.

A
  1. Vaginitis-candidal
  2. Bacterial vaginosis
  3. Vaginitis-trichomonal
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14
Q

WORK-UP FOR:

  1. Vaginitis-candidal
  2. Bacterial vaginosis
  3. Vaginitis-trichomonal
A
  1. Pelvic exam
  2. Wet mount, KOH prep, “whiff test”
  3. pH of vaginal fluid
  4. Cervical cultures
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15
Q

35 yo F presents with a malodorous, profuse, frothy, greenish vaginal discharge with intense vaginal itching and discomfort.

A
  1. Vaginitis-trichomonal
  2. Vaginitis-candidal
  3. Bacterial vaginosis
  4. Cervicitis (chlamydia, gonorrhea)
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16
Q

WORK UP FOR:

  1. Vaginitis-trichomonal
  2. Vaginitis-candidal
  3. Bacterial vaginosis
  4. Cervicitis (chlamydia, gonorrhea)
A
  1. Pelvic exam
  2. Wet mount, KOH prep, “whiff test”
  3. pH of vaginal fluid
  4. Cervical cultures
17
Q

54 yo F reports painful intercourse for the past year. Her last menstrual period was 2 years ago. She has hot flashes.

A
  1. Atrophic vaginitis
  2. Endometriosis
  3. Cervicitis
  4. Domestic violence
18
Q

WORK UP FOR:

  1. Atrophic vaginitis
  2. Endometriosis
  3. Cervicitis
  4. Domestic violence
A
  1. Pelvic exam
  2. LH/FSH
  3. Wet mount, KOH prep
  4. Cervical cultures
19
Q

37 yo F presents with dyspareunia, dysmenorrhea, and infertility for the past 2 years.

A
  1. Endometriosis
  2. Cervicitis
  3. Vaginismus
  4. Vulvodynia
  5. Pelvic inflammatory disease
  6. Depression
20
Q

WORK UP FOR:

  1. Endometriosis
  2. Cervicitis
  3. Vaginismus
  4. Vulvodynia
  5. Pelvic inflammatory disease
  6. Depression
A
  1. Pelvic exam
  2. Wet mount, KOH prep
  3. Cervical cultures
  4. U/S-pelvis
  5. Laparoscopy
  6. Endometrial biopsy

First Aid: Step 2 CS (23 decks)

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