Gynaecolgical Assessment

 

Emergency

 

Hx

Ex

Ix

Mx

 

Index

 

 

  

 

Gynaecological History

 

HPI

PMH

 

Social

 

 

Family

 

 

 

 

  

Gynae History of Presenting Illness (HPI)

 

-  Abdo pain

-  Dysmenorrhoea

-  Fibroids, Mittleschmertz, endometriosis

-  Pre-eclmpsia

-  Menorrhagia

-  Breast lump

-  PV discharge

-  PID

-  Candida, BV, Trichomoniasis

-  PV bleeding

-  Infertility

-  Dyspaernuria

 

Menstrual Hx

-  Menarche = age of commencement of menses

-  Early: precocious puberty

-  Late: delayed

-  Primary amenorrhoea

-  LMP

-  Amenorrhoea: secondary amenorrhoea, pregnancy

-  Regularity

-  Regular: ovulatory

-  Irregular: anovulatory: PCOS

-  Length

-  Cycle: N 28 days +/-

-  Bleeding: N 3-5 days +/-

-  Quantity: N = 80ml +/-

-  Oligomenorrhoea

-  Menorrhagia

-  Pain

-  Mittelschmertz

-  Dysmenorrhoea: endometriosis

-  Menopause: age, S/S, Mx

          

 

 

  

Gynae Past Medical History (PMH)

 

-  PV discharge: change of, increase, odour, color

-   

-  PV bleeding

-  Previous episodes

-  Obstetric Hx

-  TOP

-  GxPx

-  Pap smears: last one, result, frequency

-  Sexual Hx

-  PID

-  UTI

-  Surgery (Gynae +)

-  Laparoscopic vs laparaotmy

-  Dx laparoscopies

-  Hysterectomies +/- oophorectomy

-  Endometrial ablations

-  D&C

      

 

 

  

Gynae Social & Personal History

 

-  Smoking

-  Sexual Hx

 

 

 

  

Gynae Family History

 

-  Cancer

-  BRCA1/2: breast, ovarian

-  HNPCC: uterine, ovarian

-  Cervical

 

 

 

 

 

Gynaecological Examination

 

General

Head

 

Arm

 

Chest

Breast

Abdo

 

Pelvis

Spec

 

Vaginal

Leg

 

 

 

 

 

  

General Gynae Examination

 

-  Mastectomy: breast Ca

-  Age: premenarche, menstrual, perimenopausal, postmenopausal

 

 

 

 

  

Gynae Head & Neck Exam

 

-   

 

 

 

 

  

Gynae Upper Limb Exam

 

-   

 

 

 

  

Gynae Chest Exam

 

-  Breast exam

-  Mastectomy: breast Ca

 

 

 

 

  

Gynae Abdominal Exam

 

-  Abdo pain: ectopic, PID, Mittleschmertz, dysmenorrhoea

 

 

 

 

  

Gynae Pelvic Exam

 

-  Vaginal exam (VE) & Bimanual

-  Cervical motion tenderness: PID

-  Adnexal mass: ectopic, ovarian cysts, tubo-ovarian abscess (PID)

-  Speculum exam

-  Vaginal discharge  

-  Pelvic Organ Prolapse Quantification (POP-Q): prolapse

 

 

 

  

Gynae Lower Limb Exam

 

-   

 

 

 

 

Gynaecological Investigations

 

Path

Imaging

Proc

Micro

 

 

 

 

 

Gynaecological Management

 

General

 

Meds

Surgery

Proc

 

Royal Womens Hospital Clinical Practice Guidelines (RCH CPG)

Royal College of Obstetricians (RCOG) Green Top Guidelines

RANZCOG Website