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Are there abnormalities found on the vaginal examination? An enlarged uterus suggests pregnancy, fibroids, retained secundina, hydatiform ... DIAGNOSTIC WORKUP
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Are there abnormalities on pelvic examination? A tubo-ovarian mass on pelvic examination should suggest salpingo-oophoritis, ... DIAGNOSTIC WORKUP
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Is there persistent or recurring abdominal or pelvic pain? The presence of pain with menorrhagia should make one suspect PID, endometriosis, and ectopic pregnancy.
Are there abnormalities on ... 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 ... DIAGNOSTIC WORKUP
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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... 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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Uterine bleeding is abnormal when the pattern (amount and/or duration) is irregular. Menorrhagia indicates regular but excessive uterine bleeding; metrorrhagia indicates irregular and, often, more frequent uterine... 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,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Age of the patient is important when considering the differential diagnosis of abnormal vaginal bleeding. Pregnancy should always be ruled out despite a negative history of... 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
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... As with most hemorrhages from body orifices, vaginal bleeding is best approached by the anatomic method. Thus, the important structures of the female genital tract are cross-indexed with
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... Metrorrhagia — uterine bleeding that occurs irregularly between menstrual periods — is usually light, although it can range from staining to hemorrhage. Usually, this common sign reflects slight physiologic... History and physical examination ... Medical causes ... Other causes ... 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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Abnormally heavy or long menstrual bleeding, menorrhagia may occur as a single episode or a chronic sign. In menorrhagia, bleeding is heavier than the patient’s normal menstrual flow; menstrual... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... In most women, menstrual bleeding occurs every 28 days, plus or minus 4 days. Although some variation is normal, menstrual bleeding at intervals of greater than 36 days may indicate... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Postmenopausal vaginal bleeding — bleeding that occurs 6 or more months after menopause — is an important indicator of gynecologic cancer. But it can also result from infection, a local pelvic... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers
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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... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Dysfunctional uterine bleeding (DUB) refers to abnormal endometrial bleeding without recognizable organic lesions. The prognosis varies with the cause. DUB is the indication for almost 25% of gynecologic surgical procedures. ... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Metrorrhagia—uterine bleeding that occurs irregularly between menstrual periods—is usually light, although it can range from staining to hemorrhage. Usually, this common sign reflects slight... History and physical examination ... Medical causes ... Other causes ... 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,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Abnormally heavy or long menstrual bleeding, menorrhagia may occur as a single episode or a chronic sign. In menorrhagia, bleeding is heavier than the patient’s normal menstrual flow;... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... In most women, menstrual bleeding occurs every 28 days plus or minus 4 days. Although some variation is normal, menstrual bleeding at intervals of greater than 36 days may indicate oligomenorrhea—abnormally infrequent... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Postmenopausal vaginal bleeding—bleeding that occurs 6 or more months after menopause—is an important indicator of gynecologic cancer. But it can also result from infection, a local pelvic disorder,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Patient counseling
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Dysmenorrhea
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... History (2) ... Physical examination ... Laboratory testing (3) ... Diagnostic assessment (1)
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Menorrhagia
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Albert A. Meyer
Approach Menorrhagia, defined as excessive bleeding from the uterus, is a common gynecologic complaint. Each year, 200,000 American women undergo... History (2) ... Physical examination ... Testing ... Diagnostic assessment (3)
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Vaginal Discharge
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach ... History (2) ... Physical examination (4) ... Testing (5) ... Diagnostic assessment
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... Differential Overview
❑ Physiologic discharge
❑ Candida vulvovaginitis
❑ Bacterial vaginosis
... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Ovulatory bleeding
❑ Anovulatory bleeding
❑ Uterine leiomyoma ... Diagnostic Approach ... Clinical Findings
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... In most women, menstrual bleeding occurs every 28 days plus or minus 4 days. Although some variation is normal, menstrual bleeding at intervals of greater than 36 days may indicate oligomenorrhea — abnormally infrequent... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... 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... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Postmenopausal vaginal bleeding — bleeding that occurs 6 or more months after menopause — is an important indicator of gynecologic cancer, but it can also result from... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... 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 ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Vaginalbleeding is physiologic in the neonatal period and during the normalmenstrual cycle. Maternal estrogen stimulates endometrial growthin the fetus, but after delivery, the... Principal Causes of Vaginal Bleeding ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Metrorrhagia—uterine bleeding that occurs irregularly between menses—is usually light, although it can range from staining to hemorrhage. Usually, this common sign reflects slight physiologic... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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.... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Abnormally heavy or long menstrual bleeding, menorrhagia may occur as a single episode or a chronic sign. In menorrhagia, bleeding is heavier than the patient's normal menstrual... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... In most women, menstrual bleeding occurs every 28 days, plus or minus 4 days. Although some variation is normal, menstrual bleeding at intervals of greater than 36 days may... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Postmenopausal vaginal bleeding—bleeding that occurs 6 or more months after menopause—is an important, albeit not a definitive, indicator of gynecologic cancer. It can also result from... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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... 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... Pictures
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...
As with most hemorrhages from body orifices, vaginal bleeding is best
approached by the anatomic method. Thus, the important structures
of the female genital tract are cross-indexed with etiologic categories... Pictures
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... Author:
Anjali Subbaswamy, MD
What to Do - Take Action
DUB is defined as abnormal vaginal bleeding without an identifiable pathologic condition. This is in contrast to abnormal uterine... Suggested Readings
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... Author:
Anjali Subbaswamy, MD
What to do - Make a Decision
OCPsarewidelyavailableandadvocatedforuseintheadolescentpopulation.
They work via several mechanisms of action, but the most important for ... Suggested Readings
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... Leonard J. Levine, MDJonathan R. Pletcher, MD Dysfunctional Uterine Bleeding - BASICS Dysfunctional Uterine Bleeding - description Bleeding beyond the range of normal menses, with normal defined... Dysfunctional Uterine Bleeding - DIAGNOSIS ... Dysfunctional Uterine Bleeding - TREATMENT ... Dysfunctional Uterine Bleeding - FOLLOW UP ... Dysfunctional Uterine Bleeding - bibliography ... Dysfunctional Uterine Bleeding - CODES ... Dysfunctional Uterine Bleeding - FAQ
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