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2.1
Pelvic Examination
Manual Pelvic Examination (procedure)

Images

WIKIDATA, CC BY-SA 4.0
WIKIDATA, Public Domain

Presentation

Occult cervical pathogens may be present in these patients. Copyright 2010 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]

Entire Body System

  • Pathologist

    Pap smear — liquid-based technology Originally the Pap test consisted of using a small wooden spatula to sample the outermost cell layer of the cervical os (the opening to the womb inside the vagina), then smearing the sample onto a glass slide for a pathologist [womentowomen.com]

    Now use Bethesda system (2001) which incorporates important changes: -Pap smear analysis considered medical consult -Pathologist responsible for making dx -Referring physician provides hx -Must have a statement of adequacy Recs regarding f/u made by pathologist [quizlet.com]

    Sometimes, pathologists practice both anatomical and clinical pathology, a known as general pathology. [wikivisually.com]

  • Weight Loss

    Symptoms include jaundice, abdominal pain, nausea, vomiting, and weight loss. [cancer.gov]

Gastrointestinal

  • Abdominal Pain

    Lower abdominal pain was the most common symptom (90.0%) reported by these patients. All of the patients with PID reported either lower abdominal pain or dyspareunia in the medical history compared with 97 (56.1%) of those without PID. [ncbi.nlm.nih.gov]

    Patients with the chief complaint of vaginal bleeding or lower abdominal pain less than 16 weeks and positive HCG will be considered for this non-inferiority-designed clinical trial. [clinicaltrials.gov]

    Lower abdominal pain : type of pain arising from the urinary system. Last updated 01.04.2016 [netdoctor.co.uk]

  • Lower Abdominal Pain

    Lower abdominal pain was the most common symptom (90.0%) reported by these patients. All of the patients with PID reported either lower abdominal pain or dyspareunia in the medical history compared with 97 (56.1%) of those without PID. [ncbi.nlm.nih.gov]

    Patients with the chief complaint of vaginal bleeding or lower abdominal pain less than 16 weeks and positive HCG will be considered for this non-inferiority-designed clinical trial. [clinicaltrials.gov]

    Lower abdominal pain : type of pain arising from the urinary system. Last updated 01.04.2016 [netdoctor.co.uk]

  • Constipation

    If there is an impression that the bimanual examination is not adequate because of constipated stool in the rectum and lower colon, the patient should be instructed to take an enema and return for another examination. [ncbi.nlm.nih.gov]

    This causes severe constipation or blockage of the large intestine. Constipation is when stool becomes hard, dry, and difficult to pass and bowel movements occur less often than normal. [cancer.gov]

  • Abdominal Bloating

    Out of a mixture of "fear and embarrassment," many women won't volunteer to their internist their struggles with pain during sex, incontinence, abdominal bloating or spotting, said Rabin, head of urogynecology at the Long Island Jewish Medical Center [latimes.com]

Skin

  • Blister

    Ulcerations, bumps, sores, blisters, or vesicles on the external genitalia may be signs of a sexually transmitted disease. [medical-dictionary.thefreedictionary.com]

Workup

Diagnostic workup however is needed to ascertain the underlying cause of the anemia. (1-5) History and physical examination Diagnosis begins with a detailed history and physical examination. [news-medical.net]

[…] included conditions (including but not limited to abnormal bleeding, pelvic pain, incontinence, and infertility); quality of life KQ 2: Sensitivity, specificity, likelihood ratios, positive and negative predictive values KQ 3: Unnecessary diagnostic workup [uspreventiveservicestaskforce.org]

Current standard of care requires further workup of any abnormality found on Pap. -this usually consists of screening for HPV, colposcopy, and bx of cervical samples. Decreases the incidence and mortality of cervical CA. [quizlet.com]

Available evidence reports false-positive rates for ovarian cancer of 1.2% to 8.6% and false-negative rates of 0% to 100%. 4 Pelvic examination screening also could result in unnecessary diagnostic workup and treatment. [doi.org]

Colonoscopy

  • Polyps

    The anal canal and rectum can also be examined for any polyps, or other lesions at this time. After the rectovaginal exam, the patient will be allowed clean off any excess lubricant and get dressed. [medical-dictionary.thefreedictionary.com]

    The cervix should be examined for contour, amount of erosion, shape of the os (patulous, scarred, parous, nonparous), discharge, lacerations, polyps, neoplasias, and lesions (eg, warts). [emedicine.medscape.com]

    During the exam, the doctor looks for signs of certain conditions, such as yeast infections, genital warts, genital herpes, pelvic inflammatory disease, uterine fibroids, cervical polyps and ovarian cysts. [livescience.com]

Treatment

METHODS: The SNAP-IT (Smooth National Adaptation and Presentation of Guidelines to Improve Thrombosis Treatment) method was used to determine whether the ACP guideline was consistent with CTFPHC standards and could be adapted or adopted. [ncbi.nlm.nih.gov]

Your doctor might suggest additional diagnostic testing or treatment. How you prepare You don't need to do anything special to prepare for a pelvic exam. [mayoclinic.org]

No studies evaluated the effectiveness of early diagnosis and treatment of screen-detected, asymptomatic gynecologic conditions compared with the diagnosis and treatment of symptomatic gynecologic conditions. 4 It is also unknown whether performing screening [doi.org]

If an STI or pelvic in ammatory disease (PID) is confirmed and she still wants an IUD, it may be inserted as soon as she finishes treatment, if she is not at risk for reinfection before insertion. 1. [fphandbook.org]

Prognosis

Acute myeloid leukemia with myelodysplasia-related changes usually occurs in older adults and has a poor prognosis. [cancer.gov]

Epidemiology

[…] impact of our findings, we think there is a pressing need for improving patient counseling concerning this exam,” said senior author Miriam Kupperman, PhD, MPH, a UCSF professor in the departments of Obstetrics, Gynecology and Reproductive Sciences, and Epidemiology [ucsf.edu]

“Stories are very powerful, but they are the antithesis of epidemiological evidence,” Sawaya said. “The focus should be on symptoms, and on how to keep people healthy, not to turn healthy people into patients.” [khn.org]

More information on the burden and epidemiology of the numerous gynecologic conditions potentially detected by pelvic examination is available in Table 1 of the accompanying systematic evidence review. 2 Scope of Review The USPSTF commissioned a systematic [uspreventiveservicestaskforce.org]

More information on the burden and epidemiology of the numerous gynecologic conditions potentially detected by pelvic examination is available in Table 1 of the accompanying systematic evidence review. 4 The USPSTF commissioned a systematic review to [doi.org]

The amount of epidemiologic and physiologic information about contraceptives has grown enormously, and the methods have evolved toward safer formulations; today's oral contraceptives, for example, contain much lower doses of contraceptive hormones than [guttmacher.org]

Prevention

It has been suggested that to address every preventive service recommended by the U.S. [aafp.org]

Perdue, MPH US Preventive Services Task Force USPSTF Recommendation: The Screening Pelvic Examination US Preventive Services Task Force; Kirsten Bibbins-Domingo, PhD, MD, MAS; David C. Grossman, MD, MPH; Susan J. Curry, PhD; Michael J. [jamanetwork.com]

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