Gynaecology - History and physical exam

Question 1

Outline Gynaecological history

Answer 1

HPI:
- Symptoms
- Associated symptoms: Pain, vaginal discharge, AUB, Abdominal mass and compression symptoms, urinary and bowel symptoms, vaginal and uterine prolapse

Menstrual history:
- LMP/ PMP
- Menarche
- Cycle length, regularity, flow, volume
- Dysmenorrhea, IMB, PCB

Past gynaecological history
- Previous Gyn conditions and treatment, e.g. STDs and PID, endometriosis, pelvic mass
- Previous Gyn surgeries/procedures, e.g. uterus, ovaries, fallopian tubes, cervix
- Previous pregnancies and outcomes: GxPx, AN/IP/PN complications
- Last gyn exam
- Last smear and result
- Contraception

Past medical and surgical history

Drug history and allergies

Social history:
- Smoking, alcohol, illicit drug use: routinely asked!
- Marital status: single, married, divorced, separated or widowed?
- Home and family situation: social support? Financial situation?
- Occupation: occupation of pt and husband? Plans for pregnancy and postpartum arrangement?

Question 2

Outline general gynaecological exam

Answer 2

Question 3

Pelvic exam

Indications

Answer 3

Question 4

Pelvic exam

Outline setting and steps for speculum exam

Answer 4

Question 5

Cervical smear

Process
Steps
Contraindications

Answer 5

Question 6

Vaginal swabs

Indications
Types
Process

Answer 6

Question 7

Bimanual exam

Steps
Features to ilicit

Answer 7