Gynae history and exam Flashcards
What do you cover in a gynae history?
o After menopause, you still want to know about the previous pregnancies
o Menopause age is 51 on average
o Chronological order
o Age of menarche, regular cycles now, length of period, cycle length, heavy periods (how many pads and or tampons do you use in a day, how soaked is the pad, clots - 4 to 5 pads or tampons a day or normal), pain, whine. Is the pain (during period or not during), intermenstrual bleeding, post coital bleeding (ask if they are sexually active), dyspareunia (superficial or deep), post -menopausal bleeding, smear tests (ask if normal and previous smear results), uro-gynae symptoms
o IMB, PMB, PCB - inter, post coital, post -menopausal
o 5/28 = 5 days bleeding in a 28 -day cycle
o Menorrhagia = does the woman think her periods are too heavy
What do you do in a vaginal exam?
o Abdominal exam - ALWAYS ON THE RIGHT
o “Lie flat and ankles together and let your legs go floppy”
o Outer vulval inspection
o Part labia and insert 2 fingers in the vagina to under the cervix
o Left hand on top of tummy - all fingers pointing same direction
o Ballot uterus
o Examine adnexa – stroke on each side of the cervix
· N.B. Cusco’s and speculum require a ‘horse and rider approach’ – “ankles together and let your legs go floppy”
