History Taking in OBGYN Flashcards
list the important things to ask about in a gynae Hx
LMP
cycle
contraception/sexual activity
last smear + result
what is menorrhagia?
heavy periods
how do you assess menorrhagia?
- How often they have to change
- What kind of protection and level
- What is it like at night
- Are pads soaked through
Also ask if the woman is passing clots. You also need to find out how it is affecting her life, for example does she avoid leaving the house on particularly bad days. Additionally, does she work in an all-male environment which makes flooding even more embarrassing. Does she have to set alarms to get up at night and change her pads?
types of prolpse
uterocervical
cystocele
rectocele
how will women often describe a prolapse?
something coming down
what may women have to do to a prolapse in order to urinate and defaecate?
splint
what doe you need to determine about pelvic pain?
relation to mensturation
why may an ectopic pregnancy cause shoulder tip pain?
blood irritating the diaphragm
what types of contraception increase the risk of ectopic pregnancy?
coil
POP
aspects of a vaginal exam
- Position of uterus
- Size of uterus
- Mobility of uterus
- Adnexal masses
- Tenderness/cervical excitation
what is parity?
number of deliveries after 24 weeks
what questions should you ask in past obstetric hx?
o Previous pregnancies and outcomes o Date o Type of delivery o LB/SB o Weight and sex of baby o Any problems encountered during pregnancy/delivery/postnatally
how would you present an examination of the pregnant abdomen?
The abdomen is distended compatible with pregnancy. The fundal height is X which is/is not in keeping with gestation. The lie is longitudinal/oblique/transverse. The presentation is cephalic/breech (if transverse back up/down). Head is X/5 palpable. Foetal heart is heard, rate = X bpm. Ideally over anterior shoulder at 110-160bpm.
where is foetal heart best heard?
anterior shoulder
