Table of Contents IntroductionPresenting complaintHistory of presenting complaintMenstrual historyObstetric history – GMCSexual historyContraception and cervical smear historyRest of history as normalTest your knowledge with a few questions!Time to try some OSCE stations… Introduction Wash handsIntroduce selfAsk Patient’s name, DOB and what they like to be calledExplain and obtain consent Presenting complaint Determine symptoms which brought patient in History of presenting complaint Explore every symptomTimeframesSymptom-specific questions (see exploring symptoms)Relevant systems reviews (see systems review)GeneralGynaecological (The 4 P’s)Gastrointestinal (∆∆ IBS, malignancy, appendicitis, diverticulitis etc.)Urological (∆∆ UTI, incontinence etc.) The 4 P’s PV bleeding: menorrhagia, intermenstrual, post-coital, post-menopausal PV discharge Pain: pelvic, dysmenorrhoea, dyspareunia Pregnancy (chance of pregnancy) Menstrual history 1st day of last menstrual periodMenarche (usually 12-13 years) ± menopause (usually 48-55 years)Regularity and cycle length (range from 21-35 days)Duration of periods (range from 3-7 days) Character of periods (heaviness, number of pads per day, flooding, pain) Obstetric history – GMC Gravida and paraGravida/gravidity = pregnanciesPara/parity = birth of fetuses over 24 weeks, regardless if born alive or notMiscarriages, ectopic pregnancies and terminationsStageTreatmentComplicationsChildren (living)NumberAgesBirthweightsType of deliveriesPrevious problems during pregnancy/delivery Sexual history PartnersCurrent partner (male/female, relationship duration)Previous partners (last three or all in last 6 months), high-risk encountersIntercourse: type, pain/discomfort, contraception usedSubfertility Contraception and cervical smear history Contraception: current use, previous methodsCervical smears: date of last smear, results Rest of history as normal PMHx: including previous abdominal surgeryDHx: including HRT/hormones, over-the-counter remedies, allergiesFHx: breast/bowel/ovarian cancerSHx Test your knowledge with a few questions! A 45 year old female presents pelvic pain. What is in your gynaecological differential diagnosis and which clinical features would help differentiate these causes? Oops! This section is restricted to members. How would you classify PV bleeding? List three causes of each. Oops! This section is restricted to members. Time to try some OSCE stations… Pelvic pain IPelvic pain IIAbdominal pain during pregnancyVaginal dischargeFind lots more here