Gynecological history

Question 1

History of presenting complaint

Answer 1

1. Onset - acute or gradual
2. Duration - how long did the symptoms last
3. Severity - impact on daily life?
4. Course - improving or worsening
5. Cyclical - relationship to menstrual cycle
6. Intermittent or continuous
7. Associated features - fever/malaise
8. Previous episode?

Question 2

Key gynae symptoms

Answer 2

1. Abdominal / pelvic pain
2. Post coital vaginal bleeding
3. Inter menstrual vaginal bleeding
4. Post menopausal bleeding
5. Abnormal vaginal discharge
6. Dyspareunia
7. Vulval skin changes and itching

Question 3

causes of post coital bleeding

Answer 3

1. cervical ectropian
2. Infection/STI
3. Vaginitis
4. Cervical cancer

Question 4

intermenstrual bleeding

Answer 4

1. STI
2. Malignancy - cervical/endometrial cancer
3. uterine fibroids
4. Endometriosis
5. Mirena coil
6. Pregnancy

Question 5

Characteristics of vaginal discharge

Answer 5

1. volume
2. colour - green, yellow or blood stained
3. consistency - thick or watery
4. fish like smell in bacterial vaginosis

Question 6

Causes of post menopausal bleeding

Answer 6

1. Cervical or endometrial cancer
2. HRT
3. Vaginal atrophy

Question 7

Vulval skin changes and itching causes

Answer 7

1. infections such as candida/bacterial vaginosis and STI
2. Vaginal atrophy can lead to itching and bleeding of vagina
3. Lichen sclerosis - white patches on vulva

Question 8

Other relevant symptoms

Answer 8

1. Urinary symptoms - frequency/urgency/dysparunia
2. Bowel symptoms - change in bowel habits /pain with defecation
3. Fever - PID
4. Unintentional weight loss
5. Abdominal distention - ovarian cancer

Question 9

Menstrual cycle details

Answer 9

1. duration
2. Frequency
3. menstrual blood flow - average is 40 ml ( heavy > 80ml)
4. dysmenorrhea
5. LMP
6. Age at menarche
7. Age at menopause

Question 10

Contraception

Answer 10

1. method of contraception used

2. contraception history int he past

Question 11

Reproductive plans

Answer 11

do u want a fam

Question 12

Screens

Answer 12

1. Cervical smear due/result

2. HPV vaccine

Question 13

Past gynae history

Answer 13

???

Question 14

Past medical history

Answer 14

1. Migraine w aura - oral contraceptive with oestrogen is contraindicated
2. Previous VTE - contraindic
3. Breast cancer
4. Bleeding disorders - Von Willebrand’s disease