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PBL 41 INTIMATE PAIN

LO1
-Anatomy of the Female Reproductive System + position of uterus 🍓 Iman

LO2
-Acute Pelvic inflammatory disease and tubo ovarian abscess 🍕 Nafiz
-Pathophysiology of the symptoms(dysparaeunia, redness around external os, suprapubic pain, painful mens) 🍔Fatiha
-Pathophysiology of mucopurulent yellowish discharge 🍪 Pravei
-Left adnexa mass (overview, causes, Etc) 🍰 - ALIA

LO3
-eneocervical swab + chlamydia trachomatis   🍗 SINEHAA
-Treatment & Management of Acute Pelvic inflammatory disease 🍇 Omar
-Contraceptive pills 🍌 Anisha

LO4
-Merci 🥪 - Ji

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A tubo-ovarian abscess is a pocket of pus that forms because of an infection in a fallopian tube and ovary. A tubo-ovarian abscess is most often caused by pelvic inflammatory disease (PID)

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worried about her husband's feeling

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acute pelvic inflammatory disease with tubo-ovarian abscess secondary to chlamydial infection: tubo ovarian abscess= pocket of pus forms because of infections

treated with a course of antibiotics: what type? examples?

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ovaries, fallopian tubes and ligaments securing the female reproductive system

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- HVS: normal vaginal flora

- endocervical: +ve for Chlamydia trachomatis, common organism for STI, need to find source of infection(husband?), what is the complications?

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- mucopurulent yellowish discharge: mucus + pus, indicates infection

- redness around external cervical os: inflammation, might be in relation with dyspareunia, cervicitis?

- uterus is mobile and tender

- left adnexa mass palpated and was tender: no idea if it is benign/malignant, could be found in many conditions, might causing the lower abdomen pain

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- febrile and pulse rate of 100 bpm: indicates infection

- lower abdomen is tender with presence of guarding: inflammation, what organ is involved?

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On examination, she was febrile and her pulse rate was 100 beats / minute. Her lower abdomen was tender with presence of guarding. Other systems were normal.

Vaginal examination revealed a mucopurulent yellowish discharge. There was redness around the external cervical os. Theuterus was normal in size, anteverted, mobile and tender. There was left adnexa mass palpated and it was tender.

High vaginal swab (HVS) showed normal vaginal flora. Endocervical swab was positive for Chlamydia trachomatis.

She was diagnosed as having acute pelvic inflammatory disease with tubo-ovarian abscess secondary to chlamydial infection and was treated with a course of antibiotics.

Mrs. Syasya was worried about her husband’s feelings towards her after this.

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Are there different types of dyspareunia?

The location of the pain can help determine what type of dyspareunia you are experiencing:

Entry pain (intraorbital or superficial dyspareunia): This pain is felt at the entrance to the vagina during initial penetration. Some factors associated with entry pain can be lack of lubrication, injury or infection.

Deep pain (collision dyspareunia): This is pain that occurs in deep penetration and can feel worse in certain sexual positions. You will feel this pain in the cervix or lower abdomen. A medical condition or prior surgery usually causes sexual pain that occurs deeper.

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- pills taken to prevent pregnancy
- a.k.a. birth control pill
- family planning
- what are the effects of taking contraceptive pills? could it be risk factor?

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complained of mild fever: might due to infection

malaise: feeling of discomfort/unease

suprapubic pain: onset? characteristic? what organ might involved?

deep pain during sexual intercourse: a.k.a. dyspareunia

painful menstruation

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Chief complaint: offensive, yellowish per vaginal discharge for 2 months duration

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Chief complaint: offensive, yellowish per vaginal discharge for 2 months duration

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- offensive discharge: foul smell
- yellowish: might indicate infection(could be trichomonas, candida albicans)/STI

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Mrs. Syasya, 30 y/o married lady, para 1

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Mrs. Syasya, 30 y/o married lady, para 1

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- identity of patient : most probably malay, middle age, young, married, successfully delivered a baby
- important for risk factor
- missing: the antenatal history? eventful/uneventful? is the baby healthy?

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Mrs. Syasya, a 30-year-old married lady, para 1, complained of offensive, yellowish per vaginal discharge for 2 months duration. She also complained of mild fever, malaise, suprapubic pain, deep pain during sexual intercourse and painful menstruation. She was on contraceptive pills for family planning