O & G Scenarios

Gynaecology Scenarios

Child and Adolescent gynae

• 'Her periods have started early'
• 'She still hasn't started her periods'
• 'Can you tell if she is a boy or girl?' (ambiguous genitalia)
• 'She is a little slow developing' (delayed puberty)
• 'She has had a smelly discharge' (vaginal discharge, retained FB)

Vulvovaginal conditions

• 'There's been this funny discharge' *
• 'It itches /there are lumps down there' (vulvovaginitis and other superficial lesions) *
• 'I lost my tampon'
• 'I feel there is a lump down below' (prolapse)

Menstrual conditions

• 'My periods are heavy' *
• 'My periods are irregular' *
• 'My periods have stopped' *
• 'My periods are painful' *
• 'I start bleeding after sex'

Other important problems

'I had unprotected sex last night and worried I have caught something' (STDs) *
'I've been getting pain' (acute and chronic pelvic pain) *
'Sex is painful' (dysparenunia)
'Is all this hair normal?' (hirsuitism)
Abnormal PV tenderness or mass / abnormal mass on ultrasound
Embarrassing accidents (incontinence)

Post-menopausal symptoms

'What can I do about these hot flushes?' (Managing the climacteric) *
'Why have I started bleeding again?' (post-menopausal bleeding)*

Obstetric Scenarios

Overview

• What happens at the initial visit and follow-up visits *
• 'I am thinking of having a baby, what should I do first?' *
• 'We are having trouble getting pregnant'

Early pregnancy issues

• 'How far along am I' 'When is baby due?' (Dating the pregnancy by symptoms and ultrasound) *
• 'There as been some bleeding' (early pregnancy) *
• 'I lost my baby, what should I do?' (miscarriage) *
• 'I want to end my pregnancy' (termination)

Preventative health care

• 'What should I eat? What can't I do? 'When should I stop having sex' *
• 'What medications are OK during pregnancy' *
• Can I still take my medications for........' *
• 'When can I start having sex' 'What should I use for contraception?' *
• 'Is this normal for my pregnancy.......' *

Late Pregnancy issues

• 'I can't feel baby kicking'
• 'Your blood pressure is high' *
• 'You have sugar in your urine' *
• Identifying problems on abdominal examination *
• Common minor problems in pregnancy *
• Large for dates *
• Small for dates *
• 'Something's wrong with the scan'
• 'The baby is in the wrong position'
• 'Baby's blood type is different from yours'
• Important problems seen on third trimester ultrasound *
• Major co-existing medical conditions during pregnancy
•  *Pre-eclampsia / Eclampsia *
• 'My water's have broken
• Placental abruption *
• 'It's too early' (preterm labour)
• 'Baby is late' (postdates)