Diagnostic Tests for Female genital disorders
Female genital disorders Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Female genital disorders:
- Home STD Testing
- Menopause: Related Home Testing:
- Vaginal Health: Home Testing:
- Sexuality & Libido: Home Testing:
- Liver Health & Hepatitis: Home Testing
- Breast Cancer: Related Home Tests:
Female genital disorders Diagnosis: Book Excerpts
Diagnostic Tests for Female genital disorders: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the diagnostic tests for Female genital disorders.
MENORRHAGIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Routine studies include a CBC, sedimentation rate, urinalysis, pregnancy test, chemistry panel, ANA titer, VDRL test, coagulation profile, thyroid profile, and flat plate of the abdomen. A Pap smear and vaginal smear and culture should be done.
If these tests are negative, referral to a gynecologist should be made before undertaking expensive tests such as pelvic ultrasound or CT scan of the abdomen and pelvis. Some clinicians will probably ignore this advice. A gynecologist will often be able to resolve the diagnostic dilemma with a good pelvic examination. Laparoscopy, culdocentesis, endometrial biopsy, and dilation and curettage are just a few of the diagnostic tools at his disposal.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Menorrhagia:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
When the patient’s condition permits, obtain a history. Determine her age at menarche, the duration of menstrual periods, and the interval between them. Establish the date of the patient’s last menses, and ask about recent changes in her normal menstrual pattern. Have the patient describe the character and amount of bleeding. For example, how many pads or tampons does the patient use? Has she noted clots or tissue in the blood? Also ask about the development of other signs and symptoms before and during her period.
Next, ask if the patient is sexually active. Does she use a method of birth control? If so, what kind? Could the patient be pregnant? Be sure to note the number of pregnancies, the outcome of each, and any pregnancy-related complications. Find out the dates of her most recent pelvic examination and Papanicolaou smear and the details of any previous gynecologic infections or neoplasms. Also, be sure to ask about previous episodes of abnormal bleeding and the outcome of treatment. If possible, obtain a pregnancy history of the patient’s mother, and determine if the patient was exposed in utero to diethylstilbestrol. (This drug has been linked to vaginal adenosis.)
Be sure to ask the patient about her general health and medical history. Note particularly if the patient or her family has a history of thyroid, adrenal, or hepatic disease; blood dyscrasias; or tuberculosis because these may predispose the patient to menorrhagia. Also, ask about the patient’s past surgical procedures and recent emotional stress. Find out if the patient has undergone X-ray or other radiation therapy, because this may indicate prior treatment for menorrhagia. Obtain a thorough drug and alcohol history, noting the use of anticoagulants or aspirin. Perform a pelvic examination, and obtain blood and urine samples for pregnancy testing.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Menorrhagia:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
When the patient’s condition permits, obtain a history. Determine her age at menarche, the average duration of menstrual periods, and the interval between them. Establish the date of the patient’s last menses, and ask about any recent changes in her normal menstrual pattern. Have the patient describe the character and amount of bleeding. For example, how many pads or tampons does the patient use? Has she noted clots or tissue in the blood? Also ask about the development of other signs and symptoms before and during the menstrual period.
Next, ask if the patient is sexually active. Does she use a method of birth control? If so, what kind? Could the patient be pregnant? Be sure to note the number of pregnancies, the outcome of each, and any pregnancy-related complications. Find out the dates of her most recent pelvic examination and Papanicolaou smear and the details of any previous gynecologic infections or neoplasms. Also, be sure to ask about any previous episodes of abnormal bleeding and the outcome of any treatment. If possible, obtain a pregnancy history of the patient’s mother, and determine if the patient was exposed in utero to diethylstilbestrol. (This drug has been linked to vaginal adenosis.)
Be sure to ask the patient about her general health and medical history. Note particularly if the patient or her family has a history of thyroid, adrenal, or hepatic disease; blood dyscrasias; or tuberculosis because these may predispose the patient to menorrhagia. Also, ask about the patient’s past surgical procedures and any recent emotional stress. Find out if the patient has undergone X-ray or other radiation therapy, because this may indicate prior treatment for menorrhagia. Obtain a thorough drug and alcohol history, noting the use of anticoagulants or aspirin. Perform a pelvic examination, and obtain blood and urine samples for pregnancy testing.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Menorrhagia:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
A. Assess vital signs and the patient’s general appearance. Signs of impending shock (e.g., hypotension and tachycardia) are likely related to pregnancy, particularly in the younger age group, but they can be related to trauma, sepsis, or cancer.
B. Pallor not associated with hypovolemia can be found with chronic blood loss associated with anovulatory cycles, leiomyoma, blood dyscrasia, or malignancy (Chapter 16.1).
C. Fever, leukocytosis, and pelvic tenderness are usually found in acute PID (Chapter 2.6).
D. Pelvic masses found on physical examination point toward abscess, ectopic pregnancy, or malignancy.
E. Signs of thyroid disease (e.g., rapid or slow pulse, reflex changes, hair changes, and thyromegaly) can be associated with menstrual abnormalities.
F. Excessive bruising can indicate nutritional deficiency, eating disorder, trauma, abuse, medication overuse, or coagulopathy (Chapter 15.3).
Testing
A. A baseline complete blood count and serum pregnancy test are essential in most pre- and perimenopausal women.
B. A bleeding disorder should be excluded with a platelet count, a prothrombin time, a partial thromboplastin time, and a bleeding time.
C. Screening for sexually transmitted diseases and thyroid dysfunction, particularly in those of childbearing age, is important.
D. Any nonpregnant woman with irregular bleeding and a pelvic mass requires evaluation with ultrasound, computed tomography (CT), or laparoscopy.
E. Endometrial sampling is recommended before initiating hormone therapy in women aged more than 30 years or in those older than 20 years with prolonged bleeding. Long-term estrogen stimulation in anovulatory patients can result in endometrial hyperplasia, which can result in endometrial carcinoma. This procedure is best done on the first day of menses to avoid an unexpected pregnancy. In the perimenopausal or postmenopausal woman, amenorrhea preceding abnormal bleeding suggests endometrial carcinoma. It is useful to obtain a transvaginal ultrasound prior to the endometrial biopsy because biopsy is often unnecessary if the endometrial stripe is less than 5 mm thick.
Diagnostic assessment (3)
Menorrhagia is defined as excessive menstrual flow. The definition of excessive varies widely among patients but “different” and “worrisome” to the patient appear to be important historical features. When excessive bleeding is regular, pregnancy and systemic illness must be excluded. Of menorrhagia, 90% of cases have no obvious cause and it is thought to be anovulatory or dysfunctional. Dysfunctional bleeding is usually not preceded by premenstrual (molimenal) symptoms. It is seen most frequently at the extremes of the reproductive years, after menarche and before the onset of menopause. Pregnancy must always be excluded as a cause in women of childbearing age. Excessive estrogen stimulation that occurs during anovulatory cycles can lead to endometrial hyperplasia and to carcinoma. Endometrial biopsy is indicated for most nonpregnant women with prolonged, irregular bleeding. Abnormal bleeding following amenorrhea in menopause is endometrial carcinoma until proved otherwise. Any pelvic mass occurring in the context of menorrhagia ought to be evaluated with ultrasound, CT, or magnetic resonance imaging. If confusion still exists, laparoscopy or hysteroscopy with saline infusion may be indicated.
References
1. Rosenfield J. Treatment of menorrhagia due to dysfunctional uterine bleeding. Am Fam Physician 1996;53:165–172.
2. Smith CB. Pinpointing the cause of abnormal uterine bleeding. Women’s Health in Primary Care 1998;1(10):835–844.
3. Nelson AL. A practical approach to dysfunctional uterine bleeding. Fam Prac Recertification 1997;19(8):14–39.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Menorrhagia:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
When the patient's condition permits, obtain a history. Determine her age at menarche, the duration of menses, and the interval between them. Establish the date of the patient's last menses, and ask about recent changes in her normal menstrual pattern. Have the patient describe the character and amount of bleeding. For example, how many pads or tampons does the patient use per period? Has she noted clots or tissue in the blood? Also ask about the development of other signs and symptoms before and during her menses.
Next, ask if the patient is sexually active. Does she use a method of birth control? If so, what kind? Could the patient be pregnant? Be sure to note the number of pregnancies, the outcome of each, and any pregnancy-related complications. Find out the dates of her most recent pelvic examination and Papanicolaou smear and the details of any previous gynecologic infections or neoplasms. Also, be sure to ask about previous episodes of abnormal bleeding and the outcome of any treatment. If possible, obtain a pregnancy history of the patient's mother, and determine if the patient was exposed in utero to diethylstilbestrol. (This drug has been linked to vaginal adenosis.)
Be sure to ask the patient about her general health and medical history. Note particularly if the patient or her family has a history of thyroid, adrenal, or hepatic disease; blood dyscrasias; or tuberculosis because these may predispose the patient to menorrhagia. Also, ask about the patient's past surgical procedures and recent emotional stress. Find out if the patient has undergone X-ray or other radiation therapy, because this may indicate prior treatment for menorrhagia. Obtain a thorough drug and alcohol history, noting the use of anticoagulants or aspirin. Prepare the patient for a pelvic examination, and obtain blood samples and urine specimens for pregnancy testing.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
The first step in effective treatment for vulvovaginal candidiasis is correct diagnosis to rule out bacterial vaginitis and establish species of...
Appropriate treatment for vulvovaginal candidiasis depends on a variety of factors including severity of symptoms, species of yeast and patient...
Sexual contact can sometimes result in problems. An unwanted pregnancy or sexually transmitted diseases may be some of those consequences. But by...
Stress takes its toll by making us anxious, depressed and not able to function as fully as we'd like. What many don't know is that stress can...
See full list of 4 related videos
» Next page: Diagnosis of Female genital disorders
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
