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Flashcards in DIFFERENTIAL DIAGNOSIS Deck (23):
1

What is the differential diagnosis for acute pelvic pain?

Gynaecological:
Pelvic inflammatory disease
Tubo-ovarian abscess
Ectopic pregnancy
Miscarriage
Malignancy
Ovarian cyst
Fibroid necrosis
Ovulation pain

Non-gynaecological:
UTI
Renal calculi
Appendicitis

2

What is the differential diagnosis for chronic pelvic pain?

Gynaecological:
Adenomyosis
Endometriosis
Adhesions
Malignancy

Non-gynaecological:
Diverticulitis
Irritable bowel syndrome

3

What is the differential diagnosis for superficial dyspareunia?

Congenital vaginal atresia
Infection: vulvovaginitis
Post-surgery: pelvic floor repair, FGM
Vulval disease: Bartholin's cyst, carcinoma
Psychosexual: vaginismus
Atrophic changes

4

What is the differential diagnosis for deep dyspareunia?

Congenital vaginal atresia
Infection: PID
Post-surgery: pelvic floor repair
Endometriosis
Fibroids
Ovarian cyst/tumours
Psychosexual: vaginismus

5

What is the differential diagnosis for abdominal swelling?

Gynaecological:
Ovarian cyst
Pregnancy
Fibroid uterus
Malignancy

Non-gynaecological:
Full bladder
Ascites
Malignancy
Constipation or ileus

6

What is the differential diagnosis for vaginal discharge?

Physiological - eg vestibular gland secretions

Infection - STDs (Chlamydia, Trichomonas, Gonorrhea); Candida, Bacterial vaginosis

Inflammatory - Allergy, atrophic changes, postop granulation tissue

Malignancy

Foreign body - retained tampon/condom

Fistula - Bowel, bladder, ureter

7

What are the obstetric causes of abdominal pain in the 2nd or 3rd trimesters?

Labour
Placental abruption
Symphysis pubic dysfunction
Ligament pain
Pre-eclampsia/HELLP syndrome
Acute fatty liver of pregnancy

8

What are the gynaecological causes of abdominal pain in the 2nd or 3rd trimesters?

Ovarian cyst rupture/torsion/haemorrhage

Uterine fibroid degeneration

9

What are the gastrointestinal causes of abdominal pain in the 2nd or 3rd trimesters?

Constipation
Appendicitis
Mesenteric adenitis
Gallstones/cholecystitis
Pancreatitis
Peptic ulcer disease

10

What are the genitourinary causes of abdominal pain in the 2nd or 3rd trimesters?

Cystitis
Pyelonephritis
Renal stones/renal colic

11

What is the most likely diagnosis in a pregnant woman in the 2nd or 3rd trimester based on clinical features?

Intermittent pain, usually regular in frequency, associated with uterine tightenings. Vaginal examination shows cervical change

Labour

12

What is the most likely diagnosis in a pregnant woman in the 2nd or 3rd trimester based on clinical features?

Mild to severe pain, more commonly associated with vaginal bleeding. Tender uterus to palpation and can be irritable or tense. Might be symptoms of pre-eclampsia.

Placental abruption

13

What is the most likely diagnosis in a pregnant woman in the 2nd or 3rd trimester based on clinical features?

Pain is usually low and central in abdomen just above the symphysis pubis, which is tender on palpation.

Symphysis pubis dysfunction

14

What is the most likely diagnosis in a pregnant woman in the 2nd or 3rd trimester based on clinical features?

Epigastric or right upper quadrant pain, associated with nausea and vomiting, headache and visual disturbances.

Pre-eclampsia or HELLP

15

What is the most likely diagnosis in a pregnant woman in the 2nd or 3rd trimester based on clinical features?

Epigastric or right upper quadrant pain, associated with nausea, vomiting, anorexia and malaise.

Acute fatty liver of pregnancy

16

What is the most likely diagnosis in a pregnant woman in the 2nd or 3rd trimester based on clinical features?

Unilateral pain, which is intermittent and might be associated with vomiting

Ovarian cyst

17

What is the most likely diagnosis in a pregnant woman in the 2nd or 3rd trimester based on clinical features?

Pain is localised centrally and constant. On palpation, mass is noted which is tender.

Fibroid

18

What is the difference between small for gestational age and intrauterine growth restriction?

SGA: fetus is small for expected size at certain gestation, but continues to grow at a normal rate

IUGR: fetus is small or normal sized for expected size at a certain gestation, but the growth rate slows down as the pregnancy advances

19

What are the causes of increased liquor volume?

Diabetes

Fetal abnormality

Multiple pregnancy

Fetal infection

20

What are the causes of decreased liquor volume?

Ruptured membranes

Fetal abnormality

Aneuploidy

IUGR

Fetal infection

Maternal drugs eg atenolol

21

What are some causes for fetus being small for gestational age (as opposed to IUGR)?

Alcohol

Drugs

Smoking

22

What are the causes of symmetrical (growth of the head is not spared) IUGR?

Chromosomal abnormalities such as trisomy 21, 18 and 13

Fetal alcohol syndrome

Intrauterine infections (i.e CMV, rubella, toxoplasmosis)

23

What are the causes of asymmetrical (growth of the head is spared) IUGR?

Multiple gestations

Maternal malnutrition

Hypertension and pre-eclampsia

Clotting problems: Anti-phospholipid syndrome and hereditary thrombophilia

Diabetes mellitus

Renal or cardiac disease)