By Cecilia Bottomley
A 24-year-old girl is referred from the emergency division with surprising onset of left iliac fossa ache and also you are the medic on duty...
100 circumstances in Obstetrics and Gynaecology provides a hundred as a rule visible obstetric and gynaecological situations. The patient's heritage, exam and preliminary investigations are provided in addition to questions about the prognosis and administration of every case. the reply contains a special dialogue on each one subject, offering a vital revision reduction in addition to a pragmatic advisor for junior clinicians.
Making medical judgements is likely one of the so much difficult and tough components of teaching to turn into a physician. those situations will train medics and clinical scholars to acknowledge vital obstetric and gynaecological stipulations and aid them increase their diagnostic and administration talents.
Read or Download 100 Cases in Obstetrics and Gynaecology (A Hodder Arnold Publication) PDF
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Additional info for 100 Cases in Obstetrics and Gynaecology (A Hodder Arnold Publication)
For the last 18 months pain has also occurred in between periods. The pain is dull and constant across the lower abdomen. Her periods are regular and there is no menorrhagia, intermenstrual or postcoital bleeding. There is no other significant medical history. She has been married for 2 years and has deep dyspareunia which makes her interrupt intercourse. She does not use any contraception, as they are keen to start a family. She has never been pregnant in the past. Examination There is generalized lower-abdominal tenderness, particularly in the suprapubic area but no masses are palpable.
1. Endometrial biopsy report: the specimen shows atrophic endometrium with no evidence of inflammation, hyperplasia or malignancy. 1 Transvaginal ultrasound scan. Questions • What is the likely diagnosis? • How would you manage this patient? 27 100 Cases in Obstetrics and Gynaecology ANSWER 11 Postmenopausal bleeding is considered to be caused by endometrial cancer until proven otherwise. However, only 10 per cent of women with postmenopausal bleeding are diagnosed with endometrial cancer. Causes of postmenopausal bleeding • • • • • • Endometrial cancer Endometrial/endocervical polyp Endometrial hyperplasia Atrophic vaginitis Iatrogenic (anticoagulants, intrauterine device, hormone-replacement therapy) Infective (vaginal candidiasis) In this case the endometrium is Ͻ5 mm on ultrasound, which effectively excludes an endometrial malignancy or polyp.
Case 1 Intermenstrual bleeding, p 2. Plate 2 Fig. 2 Findings at laparoscopy. Case 15 Pelvic pain, p 37. Plate 3 Fig. 1 Hysteroscopy. Case 17 Heavy periods, p 43. Plate 4 Fig. 1 Hysteroscopy findings. Case 22 Postmenopausal bleeding, p 55. Plate 5 Fig. 1 Laparoscopy findings. Case 23 Pelvic pain, p 58. Plate 6 Fig. 2 Laparoscopy findings. Case 23, Pelvic pain, p 59. Plate 7 Fig. 2 Laparoscopy findings. Case 41 Bleeding and pain in early pregnancy, p 99. General gynaecology CASE 14: RECURRENT MISCARRIAGE History A 34-year-old woman is referred from the emergency room with vaginal bleeding at 6 weeks and 5 days’ gestation.
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