Differentials

Question 0

Differentials for vaginal discharge?

Answer 0

Physiological (discharge and mucus production)
Non-physiological
- genital tract infection
- vulvovaginitis: candidiasis, trichomoniasis, BV
- chlamydia, gonorrhoea
- local: chemical irritants, foreign body trauma
- neoplasms

Question 1

Differentials for dysmenorrhea?

Answer 1

Primary/idiopathic
Secondary 
- endometriosis
- adenomyosis
- uterine polyps
- uterine anomalies 
- leiomyoma
- ashermans syndrome 
- ovarian cysts

Question 2

Differentials for pelvic pain?

Answer 2

Acute

• gynae: infection, uterine, adnexal,
• GI: appendicitis, mesenteric, diverticulitis, IBD
• GU: UTI, renal colic
• preg: ectopic, spontaneous

Chronic

• gynae: chronic pid, endometriosis, adenomyosis, adhesions m, dysmenorrhea, ovarian cyst
• non-gynae: IBS, IBD, everything

Question 3

Differentials for dysparenia?

Answer 3

Introital

• inadequate luvrication
• lichen sclerosis
• vulvovaginitis

Mid vaginal

• urethritis
• trigonitis

Deep

• endometriosis
• adenomyosis
• fibroids
• pid
• ovarian cyst