Gynae History taking

Question 1

menstrual cycle questions

Answer 1

age at menarche
first day of bleeding of last cycle
lenght of cycle
duration
amount - flooding, clots
dysmenorrhea - onset/duration / type of pain / medication
premenstrual symptoms

Question 2

types of abnormal bleeding

Answer 2

intermenstrual
post coital
post-menopausal

Question 3

cervical screening questions

Answer 3

laast cervical screening for HPV typing
HPV vaccination
any abnormalities/treatment

Question 4

other questions to ask about

Answer 4

menopause - age, symptoms, therapy
contraception - satisfaction/side effects
sexual history - gender, dyspareunia, discharge, STIs
urinary and bowel symptoms - frequency, incontinence

Question 5

obstetric history questions

Answer 5

pregnancies
number and outcome of pregnancies
obstetric complicataions
fertility issues

Question 6

breast examination

Answer 6

mammography histroy
recent changes - site, duration, relationship to cycle, symptoms, constant or changing
family history of breast disease/ovarian cancers
previous breast problems/investigation

Question 7

general history questions

Answer 7

previous gynae surgeries, investigation, diagnoses, treatment

Question 8

steps before conducting pelvic examination

Answer 8

explain procedure and gain consent
ask the woman to empty her bladder
must have a chaperone present

Question 9

steps of pelvic examination

Answer 9

abdominal palpation - identify masses, pain, tenderness, rebound
speculum examination - lubricate speculum, draw knees up
bimanual examination

Question 10

how cervical screening is conducted

Answer 10

cells are collected from around the cervical os and endocervical at the transformation zone, with a cervical sampler
if HPV is detected - reflex liquid based (LBC) cytology from the thin prep sample
if positive LBC - refer for colposcopy