Hx and Ex

Question 1

What specific menstrual questions should be asked? (10)

Answer 1

• How often?
• Days per cycle
• Regular/irregular
• Pain before or after bleeding
• Intermenstrual bleeding (IMB)
• Post coital bleeding (PCB)
• Vaginal discharge?
• PMT?
• Last menstrual period (LMP)
• Post menopausal bleeding?

Question 2

Urinary tract Hx questions? (7)

Answer 2

• Frequency (normal = 4-7 times per day)
• Nocturia
• Urgency
• Enuresis (involuntarily urination)
• Dysuria?
• Hametaria
• Dragging sensation?

Question 3

Sexual/contraceptive questions? (3)

Answer 3

• Sexually active
• Dyspareunia (pain during intercourse). Is it superficial or deep, during or delayed
• Current/past contraceptive use

Question 4

What question would you ask in relation to screening?

Answer 4

Cervical smear -

• Last one? (should be every 3 years from 25-49, every 5 years from 50-64)
• Any abnormal smears?

Question 5

What PMH questions would you ask?

Answer 5

• Obstetric Hx (including miscarriages)
• Previous operations
  DVT, DM, heart disease, HTN, jaundice

Question 6

Family history questions?

Answer 6

• Breast cancer
• Ovarian cancer
• DM
• Venous thrombosis
• Heart disease
• HTN

Question 7

What specific allergies should be asked about?

Answer 7

Penicillin and Latex

Question 8

What aspects should be noted in a breast examination?

Answer 8

• 4 breast quadrants + axilla palpated
• Lumps
• Irregularities
• Tethering
• Nipple discharge or asymmetry

Question 9

What elements are examined in a Digitial Bimanual examination (DBE)?

Answer 9

• Uterus
• Cervix - orientation
• Adnexa (lateral to uterus = tubes and ovaries)
• Pouch of Douglas