List of Contributors |
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ix | |
Preface |
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xiii | |
Section 1: Pelvic Pain |
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1 A 27-Year-Old Woman with Recurrent Visits for Severe Pelvic Pain |
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1 | (3) |
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2 A 25-Year-Old Woman with Deep Dyspareunia |
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4 | (3) |
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3 A 16-Year-Old Adolescent with Ongoing Dysmenorrhea Despite Oral Contraceptive Pill Use |
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7 | (3) |
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4 A 37-Year-Old Woman with Pain at the Lateral Aspect of Her Pfannenstiel Incision |
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10 | (3) |
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5 A 26-Year-Old Woman with Chronic Pelvic Pain and Negative Work-Up |
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13 | (3) |
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6 A 30-Year-Old Woman with Endometriosis with Worsening Pelvic Pain Despite Continuous Oral Contraceptives |
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16 | (3) |
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7 A 47-Year-Old Woman with Severe Menstrual Cramps and Painful Intercourse |
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19 | (4) |
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Section 2: Vaginal Discharge and Sexually Transmitted Infections |
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8 A 28-Year-Old Woman with Metronidazole Allergy and Trichomonas Infection |
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23 | (3) |
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9 A 24-Year-Old Woman with Mucopurulent Cervicitis |
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26 | (3) |
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10 A 27-Year-Old Woman with Trichomonas Requesting a Prescription for Her Partner |
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29 | (3) |
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11 A 33-Year-Old Woman with Multiple Visits for Vaginal Discharge and Itching |
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32 | (4) |
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12 A 24-Year-Old Woman with Trichomonas in the First Trimester of Pregnancy |
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36 | (3) |
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13 A 16-Year-Old Adolescent Requesting Confidential Treatment for Chlamydia Exposure (Understanding State Laws Regarding Minors and Resources) |
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39 | (3) |
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14 A 75-Year-Old Woman Complaining of Greenish Discharge |
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42 | (3) |
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Section 3 Amenorrhea and Abnormal Vaginal Bleeding |
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15 A 32-Year-Old Woman with Friable Cervix |
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45 | (2) |
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16 A 28-Year-Old Woman with Secondary Amenorrhea and Family History of Mental Retardation (Fragile X Premutation) |
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47 | (4) |
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17 A 27-Year-Old Female Runner with Secondary Amenorrhea |
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51 | (3) |
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18 A 38-Year-Old Woman with Secondary Amenorrhea Six Months after Gastric Bypass |
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54 | (3) |
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19 A 25-Year-Old Woman with a Levonorgestrel Intrauterine Device (LNG-IUD), New Onset Spotting, and a Positive Pregnancy Test |
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57 | (2) |
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20 A 30-Year-Old Woman with Irregular Periods (Hypothyroidism) |
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59 | (2) |
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21 A 25-Year-Old Woman with Midcycle Spotting |
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61 | (4) |
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Section 4: Contraception and Abortion |
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22 A 25-Year-Old Woman with No IUD String Visible One Year after Placement (IUD in Uterus) |
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65 | (3) |
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23 A 29-Year-Old HIV-Positive Woman Requesting Oral Contraceptive Pills |
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68 | (3) |
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24 A 42-Year-Old Woman with IUD and Actinomyces on Cervical Cytology |
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71 | (2) |
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25 A 25-Year-Old Woman with a History of Pulmonary Embolism on OCPs Who Desires Contraception |
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73 | (3) |
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26 A Pregnant 22-Year-Old Woman Who Desires Long-Acting Postpartum Birth Control |
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76 | (3) |
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27 A 33-Year-Old G4P4 Unable to Palpate Implant Desiring Removal |
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79 | (3) |
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28 A 24-Year-Old Woman with a Contraceptive Implant Placed Three Weeks Ago Presents with Positive Pregnancy Test |
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82 | (3) |
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29 A 32-Year-Old HIV-Positive Woman Requesting IUD |
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85 | (3) |
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30 A 23-Year-Old Woman Presents Two Hours after Sexual Assault |
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88 | (3) |
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31 A Woman with a BMI of 40 kg/m2 Requests Oral Contraceptive Pills (Efficacy of Contraceptive Methods with Obesity) |
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91 | (4) |
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Section 5: Breast Problems |
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32 A 41-Year-Old Woman with Bilateral Clear Nipple Discharge (Physiologic Discharge) |
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95 | (3) |
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Christine Robillard Isaacs |
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33 A 38-Year-Old Woman with New-Onset, Unilateral Bloody Nipple Discharge |
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98 | (3) |
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34 A 34-Year-Old Newly Pregnant Woman with a Breast Mass |
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101 | (3) |
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35 A 29-Year-Old Woman with Lactational Mastitis and Persistent Fevers and Erythema |
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104 | (3) |
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36 A 45-Year-Old Woman with Unilateral Green Nipple Discharge (Duct Ectasia) |
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107 | (4) |
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37 A 35-Year-Old Woman Who Complains of Cyclic Breast Pain (Idiopathic Mastodynia) |
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111 | (4) |
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Section 6: Cancer Screening and Prevention |
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38 A 22-Year-Old Woman with LSIL on Initial Cervical Cytology |
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115 | (3) |
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39 A 25-Year-Old Woman Who Has Received a Letter from an Aunt Recommending Lynch Testing (Cascade Testing) |
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118 | (4) |
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40 A 30-Year-Old Woman with Positive Margins on LEEP for HSIL |
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122 | (3) |
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41 A 32-Year-Old Woman Whose Paternal Aunt and Grandmother Had Ovarian Cancer |
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125 | (4) |
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42 A 23-Year-Old Woman with HSIL on Cervical Cytology |
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129 | (3) |
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43 A 35-Year-Old Woman with a Strong Family History of Breast Cancer Not Linked to BRCA Mutation |
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132 | (4) |
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44 A 25-Year-Old Woman with LSIL Desiring HPV Vaccination |
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136 | (3) |
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Section 7: Vulvar Disease |
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45 A 55-Year-Old Woman with a White, Itchy Lesion on the Vulva (Lichen Sclerosus) |
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139 | (3) |
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46 A 55-Year-Old Woman with a New Wart (Vulvar High-Grade Squamous Intraepithelial Lesions) |
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142 | (3) |
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47 A 25-Year-Old Woman with Perinea! Pain and Inability to Have Intercourse (Vestibulodynia) |
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145 | (4) |
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48 A 30-Year-Old Woman with New Vulvar Lesions (Condyloma Accuminata) |
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149 | (3) |
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49 A 50-Year-Old Woman with Lichen Sclerosus, Fused Labia, and UTIs |
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152 | (3) |
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50 A 25-Year-Old Woman with Recurrent Candida Vaginitis |
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155 | (3) |
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51 A 35-Year-Old Woman Complaining of a "Knot" in the Vulva (Bartholin's Cyst) |
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158 | (3) |
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Section 8 Infertility |
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52 A Couple with Medicaid and No Conception after Two Years (Cost Conscious Infertility Evaluation) |
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161 | (3) |
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53 A 33-Year-Old Woman with Infertility (Bilateral Hydrosalpinx) |
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164 | (3) |
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54 A 26-Year-Old Woman with Irregular Menses and Infertility |
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167 | (3) |
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55 A 32-Year-Old Woman with a 3 cm Endometrioma and Infertility |
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170 | (3) |
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56 A 32-Year-Old Woman with Recurrent Pregnancy Loss |
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173 | (4) |
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Section 9: Preconception Planning |
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57 A Couple Planning Pregnancy Who Have Just Returned from Brazil (Zika Virus) |
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177 | (4) |
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58 A 26-Year-Old Woman with a History of Depression Planning Pregnancy |
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181 | (3) |
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59 A 25-Year-Old Woman with a History of DVT Presents for Preconception Counseling |
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184 | (3) |
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60 A 25-Year-Old Ashkenazi Jewish Woman Who Desires Pregnancy |
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187 | (3) |
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61 A 40-Year-Old Woman with Chronic Hypertension on Atenolol Planning Pregnancy |
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190 | (4) |
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62 A 30-Year-Old Woman with a History of Diabetes Controlled on Oral Agents Planning Pregnancy |
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194 | (3) |
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Section 10: Pediatric and Adolescent Problems |
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63 A 14-Year-Old Adolescent with a Large Labia |
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197 | (3) |
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64 A 16-Year-Old Adolescent with Acne, Hirsutism, and Irregular Menses |
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200 | (3) |
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65 An Eight-Year-Old Girl with Persistent Vulvar Itching |
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203 | (3) |
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66 A Four-Year-Old Girl with Recurrent Vulvar Discharge and Itching |
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206 | (3) |
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67 A 15-Year-Old with Painful Vulvar Ulcers |
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209 | (4) |
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68 A 15-Year-Old Adolescent Who Is Unable to Use a Tampon |
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213 | (3) |
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69 A Six-Year-Old Girl with Breast Development (Precocious Puberty) |
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216 | (5) |
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70 A 13-Year-Old Adolescent with Primary Amenorrhea and Cyclic Abdominal Pain (Imperforate Hymen) |
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221 | (3) |
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71 A 17-Year-Old Adolescent with Secondary Amenorrhea |
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224 | (3) |
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Section 11: Pelvic Masses and Cysts |
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72 A 53-Year-Old Woman with a 3 cm Dermoid Cyst Noted as an Incidental Finding on CT |
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227 | (3) |
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73 A 60-Year-Old Woman with a 4 cm Simple Ovarian Cyst |
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230 | (3) |
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74 A 25-Year-Old Woman with a 2 cm Simple Asymptomatic Cyst Noted Incidentally on Ultrasound |
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233 | (3) |
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75 A 25-Year-Old Woman with Endometriosis and a 4 cm Endometrioma |
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236 | (3) |
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76 A 25-Year-Old Woman with Abrupt Onset of Pelvic Pain, Nausea and Vomiting, and Adnexal Mass (Torsion) |
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239 | (3) |
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77 A 30-Year-Old Woman with Fever, Abdominal Pain, Vaginal Discharge, and Adnexal Mass (Tubo-Ovarian Abscess) |
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242 | (4) |
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78 A 45-Year-Old Woman with Pelvic Pain One Year after TLH/BSO for Endometriosis (Ovarian Remnant) |
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246 | (3) |
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79 A 21-Year-Old Woman at Five Weeks EGA with Left Lower Quadrant Pain |
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249 | (4) |
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Section 12: Incontinence and Prolapse |
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80 A 30-Year-Old Woman with Postpartum Flatal and Fecal Incontinence |
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253 | (3) |
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81 A 46-Year-Old Woman with Leakage of Urine |
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256 | (4) |
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82 A 48-Year-Old Woman with Microscopic Hematuria and Negative Urine Culture |
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260 | (3) |
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83 A 55-Year-Old Woman with Urinary Urgency and Negative Urinalysis and Culture |
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263 | (3) |
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84 A 30-Year-Old Woman with Frequency, Urgency, Nocturia, and Pressure Relieved by Urination |
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266 | (3) |
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85 A 25-Year-Old Woman with Recurrent Urinary Tract Infections |
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269 | (3) |
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86 An 80-Year-Old Woman with Total Procidentia with Vaginal Irritation |
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272 | (4) |
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Madhurima Krishna Keerthy |
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87 A 60-Year-Old Woman Presenting with Difficulty with Defecation (Posterior Wall Defect) |
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276 | (3) |
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Section 13: Behavioral, Sexual, and Social Health |
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88 A 25-Year-Old Woman with Recurrent STDs (Human Trafficking) |
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279 | (6) |
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89 A 41-Year-Old Woman with Loss of Interest in Having Sex |
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285 | (3) |
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90 A 28-Year-Old Transgender Woman Requesting Well-Woman Visit |
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288 | (3) |
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91 A 35-Year-Old Female-to-Male Transgender Patient with Vaginal Spotting on Testosterone |
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291 | (3) |
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92 A 23-Year-Old Woman Who Reports Inability to Consummate Her Marriage Due to Vaginal Pain (Vaginismus Due to Sexual Abuse) |
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294 | (3) |
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93 A Tearful 32-Year-Old Woman Requesting a Sleeping Aid Two Weeks after Delivery (Postpartum Depression) |
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297 | (4) |
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Enid Yvette Rivera-Chiauzzi |
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Section 14: Menopause and Aging |
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94 A 50-Year-Old Breast Cancer Survivor with Severe Hot Flashes |
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301 | (3) |
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95 A 56-Year-Old Woman with Dyspareunia |
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304 | (3) |
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96 A 60-Year-Old Woman with FRAX® Score Indicating a 10 Percent Probability of Osteoporotic Fracture |
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307 | (4) |
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97 A 45-Year-Old Woman with Menses Every 60-90 Days and Hot Flashes |
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311 | (4) |
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98 A 70-Year-Old Victim of Elder Abuse |
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315 | (3) |
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Index |
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