TAILIEUCHUNG - The gynaecological history and examination

When interviewing a patient to obtain her history, the consultation should ideally be held in a closed room with no one else present. Enough time should be allowed for the patient to express herself, and the doctor's manner should be one of interest and understanding. It is important that a template is used for history taking, as this prevents the omission of important points. A sample template is given on page 2. | Contents Hl. Ten Teachers Acknowledgements vii Commonly used abbreviations viii 1. The gynaecological history and examination 1 2. Embryology and anatomy 6 3. Normal and abnormal sexual development and puberty 21 4. The normal menstrual cycle 32 5. Disorders ofthe menstrual cycle 43 6. Fertility control 59 7. Subfertility 76 8. Disordersof early pregnancy 89 9. Benign disease ofthe uterus and cervix 103 10. Endometriosis and adenomyosis 110 11. Benign tumours of the ovary 12. Malignant disease of the uterus and cervix . 13. Carcinoma of the ovary and Fallopian tube 143 14. Conditions affecting the vulva and vagina 156 15. Infections in gynaecology 166 16. Urogynaecology 188 17. Uterovaginal prolapse 200 18. Menopause 207 19. Psychological aspects ofgynaecology 218 Appendix 1 Common gynaecological procedures 232 Appendix 2 Medico-legal aspects of gynaecology 236 Index 239 Chapter 1 The gynaecological history and examination History 1 Investigations 5 Examination OVERVIEW A careful detailed history is essential before the examination of any patient In addition to a good general history focusing on the history of the presenting complaint will allow you to customize the examination to elicit the appropriate signs and make an accurate diagnosis. History When interviewing a patient to obtain her history the consultation should ideally be held in a closed room with no one else present. Enough time should be allowed for the patient to express herself and the doctor s manner should be one of interest and understanding. It is important that a template is used for history taking as this prevents the omission ofimport-ant points. A sample template is given on page 2. Examination It is important that the examiner smiles introduces her himself by name and if appropriate asks the patient s name. A handshake often helps to put the patient at ease. Important information about patients can be obtained by watching them walk into the examination room poor mobility may affect .

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