G-21

Gynaecology casecase :-06

Mrs X, 41 years

Complaints Intermenstrual bleeding PV for 3 months,

post coital bleeding for 3 months,

Menorrhagia for 3 months.

O/H MS 22 years, P3 L3, all full-term vaginal

delivery. TL not done. No history of any
hormonal contraceptive use.
M/H LIMP: 28/08/2020, PMC: 4-5 daysflow/ 28
days interval/ passage of clots,
intermenstrual bleeding for 3months, which
is heavy with passage of clots.

P/H and F/H Nothing suggestive

General examination Average built, BP: 120/70mmHg, pulse:
80/min, Pallor +, no icterus, no
ymphadenopathy, no thyromegaly.
Systemic RS, CVS: NAD
examination

Gynaecological p/a: ut not palpable, p/s: erosion present all

examination around external os, punctate
bleeding points
present,
Investigations Pap smear shows HSIL,
swede's
Colposcopy showed
score of 6,
colposcopy guided
biopsy showed HSIL

AShot
Bysakshi
n On sE'us
CERVIX
 12

Department of Obstetrics and GynacologBY

Case No.:-12

44 yrs old female patient

C/O Malodorous vaginal discharge since 1 month
C/O Intermittentitching on private part
M/H Monarche age 11 yr
Prac-3/30 days reg with avg flow
O/H Para 1 live 1
Uses OCP for contraception
P/H Nosignificant history
O/E GCfair
Afeb
PR-72/mini reg
RS-NAD
CVS-NAD

P/A-soft
P/s-Cz healthy
Grey and fronthy, discharge+
Fishy odour+
Fx clear
P/V-ut NS, AV,

Dacterlal
AShot
vagi on OnePlus
By sakshii
 G-13 HIYsyes Ag
snldeuo uo jous
GynacologY

and
Obstetrics

Department
of
Case No.:- 13

female patient
old
30yrs since 5 yrs
Menses
Irregular
C/O Married since
5 yrs
O/H Nalligravida
LMP-2 months back
flowN
M/H Pracs-5/30-60days
irregular with average

H/O DM to mother +
O/H GC moderate, Obesity ++

0/E
Acne + Hirsuitism +
PR-80/min reg
BP-120/70
Syst -NAD
P/A-Soft, NT
P/S-CX and vg healty
P/V uterus normal size, AV, Fx clear

PO
 LYSyes Ag
snIdauouo10us

G-24

Gynaecology caseCase:- 09

Mrs X, 42 years.

Menorrhagia
since 6 months. Frequency of
Complaints lower
since 3 months, dysuria, pain
micturition

abdomen since 2 months, dull aching.

No
P1: FCH/ 7 years/ FT LSCS.
O/H MS 15 years, P1 L1, use.
contraception
history of hormonal
25-28 days
M/H LMP: 16/8/2020, PMC: 7-8 days flow,
interval/ passage of clots/ 4-5 pads a day/
treatment from
dysmenorrhea. Took symptomatic
family physician irregularly.
P/H and F/H k/c/o type 2 DM, on OHA since 7 years
Hypertensive since 4 years on amlodepine.

General Obese, BP: 140/90 mmHg, p: 88/min, pallor ++, no

examination oedema feet.
Syst examination RS, CVS NAD

Gynaecological p/a: 14 weeks size mass,

arising from pelvis,
examination uniform, mobile from side to side, restricted
mobility in above downwards.
P/s: Cx vagina healthy, Cx directed
posteriorly
p/v: uterus 14 weeks size,
anteverted, mobile, a
globular mass arising from anterior
b/l fornix free. wall (4 X 4 cm)
Investigations Hb 7.8g/dl

B.ROID
 G-16

Gynaecological short case

Case No.:- 01

28yrs/Female
Complaints C/O White discharge pv on & off since two month
C/o itching over
private parts 2 months
P/H H/O Diabetes
Mellitus++ on Oral
Hypoglycemic drugs
O/H Para 2 Live 2 TL done
P/O NO H/O HT/TB
O/E
GCM
Afebrile
PR-r
reg
RS
NAD
CVS NAD
P/A
Soft
P/S
Thick
curdy white discharge ++
Adherent to vaginal wall
PV Uterus normal size
A/V
Removal of white
flaps leaves multiple
oozers on
Adnexa free vagina

AShot on OnePlus
By sakshii
DI IS
 ase

Case No. 02

58 yrs old
patient came
Complaints C/O
Postmenopausal bleeding since 2 months
C/O Foul smelling discharge since 2
months
C/o Dull aching pain in lower abdomen since 1 month
M/H Attained menarche at 11 yrs of age
Attained menopause 3 yrs ago
PMC 4-5/28-30 days slightly heavy flowW
O/H Nullipara married at 23 yrs age
Investigated for infertility anid K/O PCOSs
Had ovulation induction conception

Past Medical k/c/o DM since 35 years k/c/o HTN since 47 yrs age
History
o/E GC Moderate

Obese, hirsuitism+
Bp 140/90
Pallor +
RS/ CVS NAD
palpable
P/A SOFT, no
mass palpable, liver spleen not
Cx and Vg healthy
P/S
with infected blood infected tissum
bleeding through os,mixed
smelling
Adnexa free, nontender
Uterus bulky, A/V; B/L
P/V
 Gr-30
Department of Obstetrics and Gynaecology
Case No.:-14

30yrs old female patient

C/o Excessive bleeding pv since 1 yr
C/O Dysmenorrhoea since 1 yr
O/H Married life 7 yrs. P1 L1 5yrsFTND
M/H LMP-15 days back. PMG 8-10/30 days reg with flow
with passage of clots
P/H Not significant
O/E GCfair, Afeb, PR-96/min, BP-11/80
Pallor+, syst-NAD
P/A, mass of around 16 wks, irregular firm, mobile,
NT,arising from pelvis
P/S Cx and vg healthy mobile, Fx
P/V Uterus 16 wks, Irregularly enlarged, firm
clear

RBROID
 53

Department of Obstetrics and Gynaecology

Case No.:-15

27yrs old female patient

C/o Itchingover pvt partssince1month
C/o Foulsmellingdischarge pv+c/odysuria+
M/H LIMP-8days back
O/H P212, TL done
P/H Not significant
O/H GC fair
Afeb
PR-72/min
PS-NAD
CVS-NAD
P/A-soft
P/S-multiple, small, bright red punctuate lesion
seen on cervix and vagina.
Yellowish green frothy discharge+
P/V- uterus n size, AV, fx clear

TRICHOMONAS
VAGINITIS
 Department of Obstetrics and G
Mrs X, 32 years.

Complaints Infertility of 6 years, white discharge per vagina for 5

6 years, pain lower abdomen 3 years (dull aching),
dyspareunia, dysmenorrhea since 1 year.
O/H MS:8 years, trying to conceive since 6 years, husband
factory worker, stay together, normal conjugal life,
since one year she is experiencing dyspareunia.
Nuclear family. Husband takes alcohol occasionally.

M/H LIMP: 14/08/2020, 2-3 days flow, average flow, 28

days interval, dysmenorrhea +. Menarche at the age
of 12.

P/H and F/H Nothing suggestive.

General Average built, height: 148 cm, weight 59 kg, BP:

examination 120/70, pulse: 90/minute, no pallor

Systemic RS CVS: NAD

examination

P/a: lower abdomen tenderness, in both the iliac

Gynaecological
examination fossa.

P/s: greyish white vaginal discharge, cervical erosion

present. PAP smear and vaginal and cervical swab
taken.
p/v: ut normal size, anteverted, cervical motion
tenderness present.
HSG: b/lhydrosalpinx, HSA: total sperm count 4
Investigations
million/ejaculate.
 -7

Department of Obstetrics and Gynacology

Case No.:-07

A 15 yrs old Female patient

Complaints H/O Primary amenorrhea i.e. not attained menarche
Cyclic pain in lower abdomen monthly since 4-5
months
C/O Abdominal distention+
C/O Retention of urine since 1day+
O/H unmarried
M/H Not attained menarche
hist
P/O No h/o TB/DM/past medical or surgical
O/E GC-mod
Afebrile, pallor +
Pulse reg 100/min
No icterus/LN pathy/clubbing/odema feet
Secondary sexual characters well developed.

RS Nad
CVS Nad

P/A soft
arising from
Vague mass cystic in consistency
restricted mobility
hypogastrium upto umblicus,
Tenderness+
Tense, bulging, purplish hymen
+

L/E
P/V Not done

CRYPTOMENORRHEA
- imperforate hymen
-

transverse vaginal septum

 G-40

Department of Obstetrics and Gynaecology

Mrs X, 65 years.

Complaints Something coming out per vagina since 5 years.

Difficulty in micturition since 3 months, able to pass
urine only after reducing the swelling, since three
days there is acute retention of urine, severe pain
abdomen.
O/H MS 45 years, P4 L4, all FTND, home deliveries. LCB
30 years back. TL done.
M/H Postmenopausal since 20 years.

P/Hand F/H Nothing suggestive

General Average built, BP: 130/90mmHg, pulse: 120/minute,
examination

Systemic CVS: tachycardia, RS: nad

examination

Gynaecological p/a: cystic mass palpable of 24 weeks size, tender.

examination
Local examination: cervix seen outside interoitus,
cystocele +, recocele +, vaginal mucosa congested,
oedematous.
Patient catheterised, 2500 cc urine came out,
sediments seen floating in urine,

p/s: swelling reduced, TVL: 8 cm, Aa: +3cm, Ba:

+6cm, C:+4 cm, Ap: +2 cm, Bp: +4 cm.
p/v: uterus small size, retroverted, mobile,
b/lfornices free.
Investigations: Urine microscopy: plenty of pus cells, RBC present.

PROLAPSE
 -2 vouvA

GNITAL TB
epart ner of pbst tris Gocology anc

Mrs X, 31 years.
Complaints
Infertility of 5 years, scanty menses with
menorrhea since oligo
1 year, pain lower abdomen since 1
year, dull aching pain, grey white vaginal discharge
since3 months.
O/H MS 7 years.
Nulliparous.
M/H
LMP: 21/8/2020, 1-2 days flow/at an interval
60 days, dysmenorrhea+ of 45 to
P/Hand F/H h/o contact with tuberculosis patient one year back.
Patient evaluated
for infertility in private hospital.
HAS: normal, HSG:
B/L hydrosalpinx.
General Thin built,
height: 151 cm, weight: 48 kg, BP:
examination
110/70mmHg, pulse: 70/minute, pallor+, no
lymphadenopathy.
Systemic CVS, RS: NAD
examination

Gynaecological p/a: soft, non-tender.

examination
p/s: cervix hypertrophied, erosion all around
os, ut NS, anteverted, mobile,
external
b/a free.
P/v: uterus normal size, mobile, anteverted,
motion tenderness present, adnexa free.
cervical
Investigations ESR: 64, chest x ray: normal, montoux test: 15 mm in
24 hours.

POCO
 -26

GYNAECOLOGY CASE
40 yrs/ Female

Complaints C/O Increased micturition since 1 year off & on

C/O Excessive pain in abdomen during menstruation.

C/o Menorrhagia since 7-8 months.

Since 8 months 5-6/28 days ey ssive flow, H/O passing
clots+

M/H Attained menarche at 12 yr. of age PMC 4-5/26-28 days

avg. flow

O/H Para 3 all FTND A/W, TL done.

P/O No h/o Major medical illness at present.

o/E GC FairAfebrile P-96/ minPallor +

RS/CVS NAD

P/A Soft
P/S CX vagina Healthy
Ut A/V of 10 weeks size
P/V
&Rt lateral
Smooth firm mobile, mass 4x5 cm. in anterior
fornix continuous with uterus.

OSIS
 PROA C epa tm. of uustetrics and GynacologY
Case No.:-03
60yrs/Female
Complaints c/oSomething coming out of vagina since
c/o Frequency of micturition and 5 years
dysuria
H/S/O SUl+
H/O Blood stained discharge+
H/o Of irreducibility +
O/H PSL5
M/H Post
menopausal since 15 years
All FTN
home delivery
P/O H/OProlonged labour+conducted by dais.
0/E K/C/O Bronchial asthma
GC moderate
P-Reg 88/min
BP 110/70
5
VS
Occasional ronchi +
NAD
P/A
Soft
No mass feit
Cerivical descent+
Cystocoele +enterocele+
Rectocoele +
Pelvic floor laxity +
Decubitus5 ulcer on both lips of Cx
P/V SUI+
UCL4
UtR/V N/S-Bulky
Smooth, mobile, non
tender
Bilateral adnexia not
Perineal body intact pulpable, non
tender