Gynecology Case 1

History
Paula Johnston is a 26 year old accountancy student who comes to you complaining of absence of menstruation for a period of 4 months.

 What is the presenting complaint?

 Presenting Complaint


 * Oligomenorrhoea - this is the absence of menstruation for a period between 6 weeks and 6 months. Amenorrhoea is the absence of periods for over six months

'''The etiology of oligomenorrhoea is extensive. You make it easier for yourself by narrowing it down to specific organ systems. Dysfunction of which organ systems and organs can cause oligomenorrhoea?'''

 Etiology


 * Endocrine System
 * Hypothalamus
 * Pituitary Gland
 * Thyroid Gland
 * Pancreas
 * Adrenal Gland
 * Reproductive/Endocrine System
 * Ovaries

'''Verbally practice your history taking from a patient with oligomenorrhoea. What information will you try to attain from the patient?'''

 Full History and Responses


 * History of Presenting Complaint
 * Onset:         4 months ago
 * Periodicity:   Constantly no periods
 * Duration:      4 months
 * Has this happened before?         No


 * Menstrual History (normal)
 * Menarche:         12 years old
 * 1st day of last menstrual period:         4 months ago
 * No. of days bleeding:         3
 * Frequency:         26-30 days
 * Regularity:        Irregular
 * Bleeding between periods:         No
 * Bleeding after intercourse:       No
 * Nature of periods - clots?         No
 * Heavy?         Light
 * Flooding?         No


 * Past Gynecological History
 * Gynecological symptoms:         None
 * Gynecological diagnoses:         None
 * Gynecological surgery:         None
 * Abnormal smears:         None


 * Past Obstetric History
 * No. of children:         None
 * No. of pregnancies:         None


 * Drug History
 * Prescribed Medications:         None
 * Non-prescribed medications:         None
 * Recreational drugs:         None


 * Family History
 * Medical Conditions:        None
 * Gynecological conditions:         Premature Menopause (Mother at 37; Sister at 35)
 * Malignancies:         None


 * Social History
 * Support Network:         Extensive
 * Smoking:         No
 * Alcohol:         No