Pt interview questions
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Help!
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| 23yo obese, amenorrhea 6mos, facial hair. What are key questions to ask? | anovul: if periods nmlly regular, sex active, contraception, prolactin: HA/visual, milk discharge, thyroid: hot/cold, palpitations, hirsut: hair new?
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| 23yo obese, amenorrhea 6mos, facial hair. What tests order? | UPT, LH/FSH ratio, TSH, prolactin, testosterone, DHEAS, 17OHP
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| 23yo obese, amenorrhea 6mos, facial hair. What's difftl | anovul: PCOS, thyroid, preg, [hi prolactin, ovarian/adrenal malig, premature ovarian failure], hirsutism: PCOS, Cushings, adrenal or androgen secreting tumor, CAH
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| 23yo hirsutism. What are key questions to ask? | new (if PCOS since menarche)? Periods regular? Deepening of voice? h/o glucose intolerance (Cushings)? h/o hypotension (CAH)?
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| 23yo hirsutism. What tests order? | dexamethasone suppression test, DHEA, testosterone, LH/FSH ratio
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| 23yo hirsutism. What's difftl | Cushings, PCOS, adrenal tumor or androgen secreting tumor, CAH
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| 48 yo irreg periods. What are key questions to ask? | previously regular? Hot flashes/NS/palitations? Emotional lability? Breast discharge? Vaginal dryness or pain during intercourse?
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| 48 yo irreg periods--tests order? | UPT, LH/FSH, TSH, prolactin, testosterone, DHEAS, 17OHP, CBC
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| 48 yo irreg periods--difftl? | menopause, hyperprolactin, PCOS, thyroid, preg
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| 33 yo no period, recently gave birth--key questions to ask | previously regular? Blood loss during delivery? D&C? contraception? Problems breast feeding (Sheehans) Thyroid sympt (cold intolerance, hair loss)
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| 33 yo no period, recently gave birth--tests | UPT, LH/FSH, TSH, prolactin, progesterone stimulation test (Sheehan should bleed, Asherman wouldn't)
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| 33 yo no period, recently gave birth--difftl | Preg, Sheehans, Asherman [hyperprolactin, PCOS, ovarian/adrenal malig, premature ovarian failure]
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| 25yo irreg, heavy menses--key questions | how long? Still having menses and bleeding in bw or completely irreg? dysmenorrhea? Pain on intercourse or constipation? Anemia sympt (dizziness)
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| 25yo irreg, heavy menses--tests | UPT, LH/FSH, TSH, prolactin, progesterone stim test, CBC (anemia)
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| 25yo irreg, heavy menses--ddx | anovulatory cycles, endometriosis, dysfxnl uterine bleeding, [also molar preg/ectopic if nmlly regular this 1x irreg, endometrial hyperplasia/cancer, if regular cycles + inbw bleeding could be polyps or submucosal fibroids]
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| 30yo dysmenorrhea, menorrhagia--key questions | pain on intercourse? Constipation? [endometriosis] coag--always had heavy periods? Other bleeding problems in her or her family? Anemia sympt?
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| 30yo dysmenorrhea, menorrhagia--tests | pelvic US, coag studies, CBC
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| 30yo dysmenorrhea, menorrhagia--ddx | fibroids, endometriosis/adenomyosis
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| 35 yo breast mass--key questions | painful? Growing? Changes w cycle? h/o of similar
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| 35 yo breast mass--tests | once examine either breast US or bx
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| 35 yo breast mass--ddx | fibroadenoma, fibrocystic disease, [cancer]
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| 35yo pelvic pain--key questions | how long? Assoc w menses? Dysuria? F/C? discharge? Constipation? Anything like this prev?
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| 35yo pelvic pain--tests | UPT, STD w/u, UA/Ucx, pelvic US,
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| 35yo pelvic pain--ddx | STD, PID, pyelo, fibroids/adenomyosis/endometriosis, constipation, ectopic preg
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| 40yo vulvar ulcer--key questions | painful? Pustule before hand? F? rashes or lesions elsewhere? h/o STD or STD in partner? Discharge?
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| 40yo vulvar ulcer--tests | GC/CC, wet mount, KOH, RPR
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| 40yo vulvar ulcer--ddx | syph, chancroid, HSV, granuloma inguinale, donovanosis
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| 25yo dysuria, F--key questions | F/C/NS? Back pain? Discharge?
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| 25yo dysuria, F--tests | UA, Ucx, check for CVA tenderness
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| 25yo dysuria, F--ddx | pyelo, PID, UTI, urosepsis
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| 22yo vag discharge--key questions | color? How long? Consistency? Itchy? Dysuria? Pain?
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| 22yo vag discharge--tests | GC/CC, wet mount, KOH
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| 22yo vag discharge--ddx | GC/CC, candida, bac vaginosis, trichomonas, cervicitis, physiologic,
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| 65yo womb dropping--key questions | how long? Problems urinating? BM? Constipation? Ever discharge or bleeding?
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| 65yo womb dropping--tests | physical exam, examine while straining
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| 65yo womb dropping--ddx | vaginal prolapse, uterine prolapse, cancer (cervix, uterus)
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| 60yo vaginal bleeding--key questions | how long/how much? Hematuria? Any lesions/ulcers? Abd bloating? Pelvic pain? masses?
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| 60yo vaginal bleeding--tests | endometrial biopsy, pelvic US, bx any visible lesions, colpo? CBC (Anemia
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| 60yo vaginal bleeding--ddx | uterine cancer, cervical cancers, vulvar lesion/cancer
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| 50yo WWE--key questions | LMP? Menopause? Any bleeding or bleeding bw cycles? Pelvic pain? Other problems
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| 50yo WWE--tests | mammo q1yr, pap, Dexa?
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