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12 Cards in this Set

  • Front
  • Back
Key History -
Pre- vs. postmenopausal
duration
amount
menstrual history
LMP
associated discharge
pelvic or abdom pain
urinary Sxs
trauma
meds (esp. warfarin, OCPs)
h/o easy bleeding or bruising
h/o abnormal pap smears
Key PE -
VS
abdominal exam
complete pelvic exam
17 y/o F
presents with prolonged, excessive menstrual bleeding occurring irregularly over the past 6 months

What is Differential?
Dysfunctional uterine bleeding
coag d/o (von Willebrand's)
cervical cancer
molar pregnancy
hypothyroidism
diabetes mellitus
17 y/o F
presents with prolonged, excessive menstrual bleeding occurring irregularly over the past 6 months

What is Workup?
Pelvic exam
urine hCG
cervical cultures, pap smear
CBC, ESR, glucose
PT/PTT
prolactin, FSH/LH
TSH
US - pelvis
61 y/o F
presents with profuse vaginal bleeding over the past month.
LMP was 10 years ago.
H/O HTN and DM
nulliparous

What is Differential?
Endometrial cancer
cervical cancer
atrophic endometrium
endometrial hyperplasia
endometrial polyps
atrophic vaginitis
61 y/o F
presents with profuse vaginal bleeding over the past month.
LMP was 10 years ago.
H/O HTN and DM
nulliparous

What is Workup?
Pelvic exam
pap smear
endometrial Bx
US - pelvis
endometrial curettage
colposcopy
hysteroscopy
45 y/o G5P5 F
with postcoital bleeding
cigarette smoker
takes OCPs

What is Differential?
Cervical cancer
cervical polyp
cervicitis
trauma (cervical laceration)
45 y/o G5P5 F
with postcoital bleeding
cigarette smoker
takes OCPs

What is Workup
Pelvic exam
pap smear
colposcopy and Bx
28 y/o F
8 weeks pregnant
presents with lwr abdom pain and vaginal bleeding

What is Differential?
Spontaneous abortion
ectopic pregnancy
molar pregnancy
28 y/o F
8 weeks pregnant
presents with lwr abdom pain and vaginal bleeding

What is Workup
Pelvic exam
urine hCG
US - pelvis
CBC, PT/PTT
quantitative serum hCG
32 y/o F
presents with sudden onset of left lower abdom pain that radiates to scapula and back and is associated with vaginal bleeding.
LMP was 5 weeks ago.
H/O PID and unprotected intercouse

What is Differential?
Ectopic pregnancy
ruptured ovarian cyst
ovarian torsion
PID
32 y/o F
presents with sudden onset of left lower abdom pain that radiates to scapula and back and is associated with vaginal bleeding.
LMP was 5 weeks ago.
H/O PID and unprotected intercouse

What is Workup?
Pelvic exam
uring hCG
cervical Cx
US - pelvis
quantitative serum hCG