Diese Präsentation wurde erfolgreich gemeldet.
Wir verwenden Ihre LinkedIn Profilangaben und Informationen zu Ihren Aktivitäten, um Anzeigen zu personalisieren und Ihnen relevantere Inhalte anzuzeigen. Sie können Ihre Anzeigeneinstellungen jederzeit ändern.
DR HALIMATUN MANSOR
SPECIALIST
DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
HSNZ
 Gynaecology history and examination are a
modification of a standardized history taking
design for
 elucidation of the ...
 Depending on the presenting complaint
 Age of menarche/menopause
 Marital status- infertility
 LNMP
 Length of menst...
 Abnormal bleeding
 Intermenstrual
 Postcoital
 Postmenopausal
 Abnormal PV discharge
 Color, pruritus, offensive od...
 Sexual history
 Dyspereunia
 Contraception
 Previous STD
 Hormonal therapy
 Oral / injectable
 HRT
 Menopausal symptoms
 Pain
 Onset, duration , nature , site
 Relation to menstrual cycle
 Symptoms of prolapse, uncon...
 Urinary problems
 Incontinence, (stress or urge)
 Frequency, nocturia or dysuria
 Other systemic review
 Past obstet...
 Social history
 Smoking, alcohol consumption
 Drug history
 Always begin with
 Inspection
 Palpation
 Purcussion
 Auscaltation
 Genaral examination
 Specific examination
 Inspection of genitalia and urethral meatus
 Evidence of estrogen deficiency, prolapse or
abnormal masses
 Presence of...
 Speculum Examination
 Inspection of vagina and cervix
 Taking of cervical cytology or microbiology swab
 Assess utero...
13
Candidiasis Strawberry cervix: Trichomonas
Bacteria vaginosis
Herpes Simplex
Actinomyces
infection
Atrophic
cervicitis
Stage IV Complete
eversion
 Perform bimanual examination
 Assess uterine
size, shape, ante/retroverted, mobility of uterus
 Tenderness- cervical m...
Imperforate hymen
Differential diagnosis
Revise/Prioritise diagnosis
Investigations
Treatment / Management
 Ultrasound
 PAP Smear for cervical screening
 Colposcopy procedure
 Cheap
 Acceptable
 Good sensitivity and specificity
 Achieved of screening must be 70-80%
23
Cervical Biopsy
Exfoliative cytology test
cells collected are from normally shedding
epithelium .
collected using spatu...
24
 Initially using vaginal pool smears to
study hormonal status .
 Found cancer cells on a slide containing
a specimen ...
25
1. Approximately 80% of
cells sample containing
important diagnostic
imformation is removed with
sampling devices.
2. F...
27
 Sampling
Scanty cells
Blood, mucous, pus
Mainly endocervical cells *
 Preparation
Too thick due to poor spreading
Ai...
VIA : Visual inspection with acetic acid.
VILI : Visual inspection with Lugol’s iodine.
28
 A tool for screening as well as treatment of
cervical pathology especially at preinvasive
and early stage
 Need trainin...
smooth featureless covering of the cervix
Low grade lesion in a satellite pattern
Approach to gynaecology patient
Approach to gynaecology patient
Approach to gynaecology patient
Approach to gynaecology patient
Approach to gynaecology patient
Approach to gynaecology patient
Approach to gynaecology patient
Approach to gynaecology patient
Approach to gynaecology patient
Nächste SlideShare
Wird geladen in …5
×

Approach to gynaecology patient

4.635 Aufrufe

Veröffentlicht am

Veröffentlicht in: Bildung, Gesundheit & Medizin
  • This program is a must read for anyone suffering from Candida or ones like me who has ever taken antibiotics and is now experiencing any of the many problems that go along with intestinal flora imbalance. I must also add that several people in my church have been following this book and are doing great! ♥♥♥ http://ishbv.com/index7/pdf
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • Unique Yeast Infection System, How to get lasting Candida freedom, Candida Cure e-book Reveals All ●●● http://ishbv.com/index7/pdf
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • After years of suffering from a myriad of symptoms, going from doctor to doctor, with no light at the end of the tunnel, I finally got the relief I dreamed of after following your Yeast Infection No More program... ★★★ http://ishbv.com/index7/pdf
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • How I Cured My Candida, Life-long Sufferer Discovers, Powerful Secret To Yeast Infection Freedom ◆◆◆ http://scamcb.com/index7/pdf
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • About 2 years ago, I developed a severe case of vaginal yeast infection that would not let up. The itching, burning and swelling of my labia were simply unbearable. I have purchased several over-the-counter treatments, including Monistat cream to subside the symptoms. While it worked initially, eventually things wore off and left me with an even worse infection than before. The same goes for the antibiotics I took with the advice of my doctor. I felt horrible. After doing some research online, I guessed I had a yeast infection and purchased your program. The results were almost instantaneous. In less than 7 hours, I felt a tremendous relief. Two weeks later and I became completely free from the unbearable vaginal itching, burning, swelling and discharge. Using your methods, I have kept my chronic yeast infection at bay ever since. No more drugs or OTC�s for me. ♣♣♣ https://tinyurl.com/y3flbeje
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier

Approach to gynaecology patient

  1. 1. DR HALIMATUN MANSOR SPECIALIST DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY HSNZ
  2. 2.  Gynaecology history and examination are a modification of a standardized history taking design for  elucidation of the presenting problems,  concluding provisional and differential diagnosis  Planned for further management
  3. 3.  Depending on the presenting complaint  Age of menarche/menopause  Marital status- infertility  LNMP  Length of menstruation and cycle  Frequency and regularity of cycle  Menstrual loss , presence of clots and flooding  Duration of dysmenorrhea and relation to period
  4. 4.  Abnormal bleeding  Intermenstrual  Postcoital  Postmenopausal  Abnormal PV discharge  Color, pruritus, offensive odour
  5. 5.  Sexual history  Dyspereunia  Contraception  Previous STD  Hormonal therapy  Oral / injectable  HRT
  6. 6.  Menopausal symptoms  Pain  Onset, duration , nature , site  Relation to menstrual cycle  Symptoms of prolapse, unconfortable lumps in vagina
  7. 7.  Urinary problems  Incontinence, (stress or urge)  Frequency, nocturia or dysuria  Other systemic review  Past obstetric and gynaecology history  Past medical and surgical history
  8. 8.  Social history  Smoking, alcohol consumption  Drug history
  9. 9.  Always begin with  Inspection  Palpation  Purcussion  Auscaltation  Genaral examination  Specific examination
  10. 10.  Inspection of genitalia and urethral meatus  Evidence of estrogen deficiency, prolapse or abnormal masses  Presence of abnormal bleeding or discharge
  11. 11.  Speculum Examination  Inspection of vagina and cervix  Taking of cervical cytology or microbiology swab  Assess uterovaginal prolapse and incontinance
  12. 12. 13 Candidiasis Strawberry cervix: Trichomonas Bacteria vaginosis Herpes Simplex Actinomyces infection Atrophic cervicitis
  13. 13. Stage IV Complete eversion
  14. 14.  Perform bimanual examination  Assess uterine size, shape, ante/retroverted, mobility of uterus  Tenderness- cervical motion, POD, adnexas  Presence of abnormal masses at POD or adnexa  Uterosacral ligament- presence of nodule  Thickness of the rectovaginal space
  15. 15. Imperforate hymen
  16. 16. Differential diagnosis Revise/Prioritise diagnosis Investigations Treatment / Management
  17. 17.  Ultrasound  PAP Smear for cervical screening  Colposcopy procedure
  18. 18.  Cheap  Acceptable  Good sensitivity and specificity  Achieved of screening must be 70-80%
  19. 19. 23 Cervical Biopsy Exfoliative cytology test cells collected are from normally shedding epithelium . collected using spatulas or brushes. Specimen is fixed, stained and studied for morphology under microscope.
  20. 20. 24  Initially using vaginal pool smears to study hormonal status .  Found cancer cells on a slide containing a specimen from a woman's uterus.  Dr. George Papanicolaou reported the usefulness of the technique for detecting neoplastic cervical cells in 1941.  late 1940s to early 1950s, Pap smear became widely used as a screening technique. Dr. George Nicholas Papanicolaou
  21. 21. 25 1. Approximately 80% of cells sample containing important diagnostic imformation is removed with sampling devices. 2. False negative rate at least 20% (mainly due to sampling error). 3. Sampling is a factor in up to 90% of false negative pap smear. ( JosephMG. Diagn Cytopathol 1991;7(5):477) 4.Up to 40% of all Pap smears are compromised by blood, mucus and inflammation. (Davey DD.Arch Pathol Lab Med 1992;116:90)
  22. 22. 27  Sampling Scanty cells Blood, mucous, pus Mainly endocervical cells *  Preparation Too thick due to poor spreading Air drying artifact
  23. 23. VIA : Visual inspection with acetic acid. VILI : Visual inspection with Lugol’s iodine. 28
  24. 24.  A tool for screening as well as treatment of cervical pathology especially at preinvasive and early stage  Need training and practice  Available
  25. 25. smooth featureless covering of the cervix
  26. 26. Low grade lesion in a satellite pattern

×