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Are there abnormalities found on the vaginal examination? An enlarged uterus suggests pregnancy, fibroids, retained secundina, hydatiform mole, choriocarcinoma, endometrial carcinoma, or endometrial polyp. An adnexal mass suggests a granulosa cell ... DIAGNOSTIC WORKUP
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Is there a vaginal discharge? The presence of a vaginal discharge should suggest candidiasis, trichomoniasis vaginitis, and bacterial vaginitis.
Is there a rash? The presence of a rash would suggest eczema, herpes simplex, folliculitis, ... 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.
Is it cheesy and associated ... DIAGNOSTIC WORKUP
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Is it tender? A tender vulval or vaginal mass would suggest vulvitis, hematoma, acute bartholinitis, or urethral caruncle.
Is it reducible? A reducible vulval or vaginal mass would suggest pudendal hernia, ... DIAGNOSTIC WORKUP
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... Ask the Following Question:
Is the lesion or are surrounding lymph nodes tender? The presence of tenderness of the lesion or the surrounding lymph nodes would suggest chancroid, lymphogranuloma venereum, herpes genitalis, and carcinoma. On the ... DIAGNOSTIC WORKUP
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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 search... 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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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 sexual activity. Bleeding that occurs before pubertal development of normal... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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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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... 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 as in Table 59 . In all bleeding symptoms, one
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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 bleeding from the endometrium during ovulation... History and physical examination ... Medical causes ... Other causes ... Special considerations
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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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Vulvar lesions are cutaneous lumps, nodules, papules, vesicles, or ulcers that result from benign or malignant tumors, dystrophies, dermatoses, or infection. They can appear anywhere on the vulva and may go undetected until a gynecologic examination. Usually, however, the patient... History and physical examination ... Medical 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, estrogenic stimulation, atrophy of the endometrium,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers
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... Vulvovaginitis is inflammation of the vulva (vulvitis) and vagina (vaginitis). Because of the proximity of these two structures, inflammation of one occasionally causes inflammation of the other. Vulvovaginitis may occur at any age and affects most females at some time. The prognosis is... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Vaginal cancer accounts for approximately 2% of all gynecologic cancers. It usually appears as squamous cell cancer, but occasionally as melanoma, sarcoma, or adenocarcinoma.
Causes and incidence
The exact cause of vaginal... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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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 bleeding from the endometrium during ovulation. However, metrorrhagia... History and physical examination ... Medical causes ... Other causes ... Special considerations
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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 profuse because... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Vulvar lesions are cutaneous lumps, nodules, papules, vesicles, or ulcers that result from benign or malignant tumors, dystrophies, dermatoses, or infection. They can appear anywhere on the vulva and may go undetected until a gynecologic... History and physical examination ... Medical 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 infection, a local pelvic disorder, estrogenic stimulation, atrophy of the endometrium, and... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Patient counseling
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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).
... 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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... Differential Overview
❑ Ovulatory bleeding
❑ Anovulatory bleeding
❑ Uterine leiomyoma
❑ Dysfunctional bleeding
❑ Threatened... Diagnostic Approach ... Clinical Findings
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... Inflammation of the vulva (vulvitis) and vagina (vaginitis) is called vulvovaginitis. Because of the proximity of these two structures, inflammation of one usually precipitates inflammation of the other. Vulvovaginitis may occur at any age and affects most females at... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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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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... Vulvar lesions are cutaneous lumps, nodules, papules, vesicles, or ulcers that result from benign or malignant tumors, dystrophies, dermatoses, or infection. They can appear anywhere on the vulva and may go undetected until a gynecologic examination. Usually, however, the... History ... Physical assessment ... Medical 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 infection, a local pelvic disorder, estrogenic stimulation,... 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 Prepubertalonset Physiologicleukorrhea Vulvovaginitis ... 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 decrease in serum estrogenleads to endometrial sloughing and mild... 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 bleeding from the endometrium during ovulation. However,... 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 occasionally be scant or... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Vulvar lesions are cutaneous lumps, nodules, papules, vesicles, or ulcers that result from benign or malignant tumors, dystrophies, dermatoses, or infection. They can appear anywhere on the vulva and may go undetected until a gynecologic examination. Usually, however, the patient notices... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... 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 infection, a local pelvic disorder, estrogenic stimulation, atrophy of the endometrium,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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... Pictures
... READ EXCERPTS »
...
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 as
in Table 59. In all bleeding symptoms, one must... Pictures
... READ EXCERPTS »
... Marianne Ruby, MDGary A. Emmett, MD Vaginitis - BASICS Vaginitis - description Vaginitis is an inflammatory process of the vagina often caused by infection, but also caused by foreign ... Vaginitis - DIAGNOSIS ... Vaginitis - TREATMENT ... Vaginitis - FOLLOW UP ... Vaginitis - bibliography ... Vaginitis - CODES ... Vaginitis - FAQ
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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...
Despite what many people think, elder women can lead healthy and active sexual lives. But this doesn't mean it will always be easy. Our panel...
Whenever you go to a hospital or clinic for a major procedure or diagnostic test, one of the many forms you are given to sign is an "informed...