Gynae histories

Question 1

WHat should be asked about in HPC, in terms of periods?

Answer 1

HPC

-Menses:
Menarche- age of first period (10-16 normal)
Menopause – date last period (40-55 normal)
Climactic- years before menopause with symptoms

duration
cycle
Heaviness
Change?

IMB? PCB? PMB?

Last period- normal? On time? Expressed as X/Y X being duration (2-7 days) and Y being cycle (21-35 days ie days between day 1 of period and day 1 of next period)
-PMS

Question 2

What other vaginal sx should be asked about in a gynae hx?

Answer 2

• vaginal discharge- colour, itching, amount and when
• Pain – in relation to cycle!!, QOL, if dyspareunia is it superficial (lesion, warts, fissure, valval cancer, dryness) or deep (endometriosis, ovarian cancer, IBS, PID)
• —–> uterine pain may be colicky and felt in sacrum and groin, ovarian pain in iliac fossa that radiates down to knee
• Feeling of something coming down? -proplapse

Question 3

What else should be asked in HPC for gynae?

Answer 3

• fertility plans and contraception
• Sexual history (date last sex, number partners, gender, area exposure, contraception use, previous STIs, vaccine history and blood borne virus risk)
• smear tests!!- dates and results
• urinary symptoms- freq., urgency, incontinence, caffeine
• bowel symptoms- can cause pelvic pain

Question 4

What should be asked about in PMH for gynae?

Answer 4

• Past gynae (how do we know that diagnosis and how is it managed)
• PMH- T2DM (risk of endometrial Ca increases, link to PCOS), thyroid, bleeding disorders, cancers
• past surgical history- previous abdo or pelvis surgery

Question 5

WHat should be asked about in Fhx for gynae?

Answer 5

breast and ovarian Ca (BRCA gene test?)