G20 bloating abdominal discomfort

Question 1

history

Answer 1

1. pain history 
GI sx, GU sx 
2. bloating history 
3. other sx of malignancy, weight loss, appetite, night sweats, energy 
4. period hx; LMP, IMB, PCB, PMB, dyspareunia 
5. obstetric hx; 
6. smear 
7. STI; dysuria, discharge 
9. contraception
10. PMHx - cancers
11. medications HRT`
12. family PMHx gynae cancers 
13, smoking,

Question 2

ddx for mass

Answer 2

1. benign; fibroids, ovarian neoplasm (functional vs pathological, adenoma, dermoid) endometrioma, endomreiosis, inflammatory/infective mass
2. malignancy
   - ovarian cancer
   endometrial cancer
   cerivalca
   mets

Question 3

investigation

Answer 3

1. FBC, U+E, serum CA125
2. smear
3. USS to assess mass (TVU + abdo)
4. CXR CT if mets
5. ascites/ aspiration

Question 4

ovarian cancer- rx

Answer 4

1. acites/pleural effusion
2. bowel obs
3. DVT?VE
4. lymphatic/venous obstruction
   malnutirion
   psychological disterss/depression