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Are there abnormalities on pelvic examination? A tubo-ovarian mass on pelvic examination should suggest salpingo-oophoritis, endometriosis with a chocolate cyst, or ectopic pregnancy. Perhaps the uterus is abnormal, in which case one should suspect ... DIAGNOSTIC WORKUP
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Is it purulent? A purulent vaginal discharge suggests nonspecific bacterial vaginitis and gonorrhea.
Is it frothy and yellow? This type of discharge is very often due to trichomoniasis vaginitis.
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Dysmenorrhea, or painful menstruation, is one of the most common gynecologic complaints. It is divided into two broad categories: Primary dysmenorrhea refers to severe uterine cramping during ovulatory menses and in the absence of demonstrable... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vaginal discharge is a common complaint that is often accompanied by concerns about the presence of a sexually transmitted disease. Candida may present with extremely intense, often unbearable itch. Whenever one sexually transmitted disease is identified, a... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The pubertal vaginal flora is primarily lactobacillus, and the vagina has an acidic pH with a thick, estrogenized epithelium acting as a protective mechanism. The prepubertal vagina is less estrogenized and has a thinner epithelium, predisposing it to irritation. Any complaint of a... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Visualizing the parts of the female reproductive system (see figure below), one can systematically formulate a differential diagnosis of this common malady.
DYSMENORRHEA
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... Again, the female genital tract can be infected by all sizes of organisms, thus a useful method for recalling the causes of a purulent vaginal discharge is to work from the smallest to the largest organism. Thus, we begin with herpes progenitalis and
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... Dysmenorrhea — painful menstruation — affects more than 50% of menstruating women; in fact, it's the leading cause of lost time from school and work among women of childbearing age. Dysmenorrhea may involve sharp, intermittent pain or dull, aching pain. It's usually... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Common in women of childbearing age, physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or profuse due to estrogenic... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Dysmenorrhea — painful menstruation — is the most common gynecologic complaint and a leading cause of absenteeism from school (affecting 10% of high school girls each month) and work (causing about 140 million lost work hours annually).... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Primary fallopian tube cancer is extremely rare and accounts for fewer than 0.5% of all gynecologic malignancies. Because this disease is generally well advanced before diagnosis (up to 30% of such cancers are bilateral with extratubal spread),... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Dysmenorrhea—painful menstruation—affects more than 50% of menstruating women; in fact, it’s the leading cause of lost time from school and work among women of childbearing age. Dysmenorrhea may involve sharp, intermittent pain or dull,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Common in women of childbearing age, a physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Albert A. Meyer
Approach Dysmenorrhea can be defined as a complaint of pain experienced during or immediately before menstruation. Up to 90% of women experience this symptom for some part in their lives (1). Risk factors... History (2) ... Physical examination ... Laboratory testing (3) ... Diagnostic assessment (1)
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... Albert A. Meyer
Vaginal symptoms, especially discharge, are responsible for 10% of all physician visits by women. Each year, approximately 12 million women in the United States are treated for vaginitis (1).
Approach An irritation... History (2) ... Physical examination (4) ... Testing (5) ... Diagnostic assessment
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... Differential Overview
❑ Physiologic discharge
❑ Candida vulvovaginitis
❑ Bacterial vaginosis
❑ Trichomonas vaginitis ... Diagnostic Approach ... Clinical Findings
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... Common in women of childbearing age, physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or profuse due to estrogenic... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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...Vaginal discharge is abnormal except forphysiologic leukorrhea, which occurs during the first few weeksof life and with the onset of puberty. Principal Causes of Vaginal Discharge Prepubertalonset Physiologicleukorrhea Vulvovaginitis Nonspecific ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Dysmenorrhea—painful menstruation—affects more than 50% of menstruating women; in fact, it's the leading cause of lost time from school and work among women of childbearing age. Dysmenorrhea may involve sharp, intermittent pain or dull, aching... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Common in women of childbearing age, physiologic vaginal discharge is mucoid, clear or white, nonbloody, and odorless. Produced by the cervical mucosa and, to a lesser degree, by the vulvar glands, this discharge may occasionally be scant or profuse due to estrogenic... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Visualizing the parts of the female reproductive system (see figure),
one can systematically formulate a differential diagnosis of this common
malady. At the cervix, stenosis, cervical polyps, and other neoplasms
may obstruct the egress of blood and... Pictures
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Again, the female genital tract can be infected by all sizes of
organisms, thus a useful method for recalling the causes of a purulent
vaginal discharge is to work from the smallest to the largest organism.
Thus, we begin with herpes progenitalis and proceed to... Pictures
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...John T. Berger, III, MD
What to Do - Make a Decision, Take Action
Phenytoin is an important medication for the treatment of primary and secondary generalized tonic–clonic seizures, partial seizures, and status epilepticus. Consistent serum concentrations of... Suggested Readings
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