History and examination in obstetrics and gyaenacology

Question 1

What is menorrhagia?

Answer 1

Very heavy bleeding

Question 2

What may patients describe when having a prolapse?

Answer 2

—Something coming down or feel a bulge. Get worse as days go on. Ask if need to split vaginal walls to empty bladder

Question 3

How is pelvic pain assessed?

Answer 3

—SOCRATES. Vaginal discharge and bleeding

Question 4

What should you ask when someone has early pregnancy bleeding?

Answer 4

—Was pregnancy planned or unplanned. Ectopic pregnancy

Question 5

What is involved is gynae examination?

Answer 5

—Intimate examination – sensitivity!

—General—

—Abdominal

—PV

—Speculum – Cuscos (together)/Sims (to view walls separately)

Question 6

Whta is involved in a vaginal examination?

Answer 6

—Position of uterus- 80% anteverted. 20% retroverted

—Size of uterus

—Mobility of uterus- Fixed may be due to endometriosis or scaring

—Adnexal masses

—Tenderness/cervical excitation

Question 7

What are the types of speculum?

Answer 7

Question 8

What is involved in a gyanae history?

Answer 8

—Same as any other history

—Additional information which must be included

—Sexual history

—Obstetric history

Question 9

What should not be forgotten to ask about when speakign to a female when relevant?

Answer 9

—LMP- When did they finish period

—Cycle

—Contraception/sexually active- Have convo as to why not if not wanting to be pregnant

—Last smear- 25-64

Question 10

What dop you need to ask in past obstetric history?

Answer 10

—All previous pregnancies and outcomes

—Date

—Type of delivery

—LB/SB

—Weight and sex of baby

—Any problems encountered during pregnancy/delivery/postnatally

Question 11

What is involved in an obstetric exmaination?

Answer 11

—General examination including BP

—Abdominal examination

—FH

—Urine

Question 12

What is involved in measuring fundal height?

Answer 12

Mother semi recumbent with empty bladder

Palpate fundus with 2 hand

Secure tape measurement down at top of fundus

Measure to top of symphsis pubis

Measure along longitudinal axis of measurement

Question 13

What are these lies of fetus called?

Answer 13

Question 14

What is fifths palpable?

Answer 14

The head is divided into fifths (each about 2 cm in length) and descent into the pelvis is described as ‘fifths palpable’.

When only two-fifths of the fetal head is palpable, the widest part has descended into the pelvis and therefore the head is engaged.