Acute Care and Emergency Gynecology: A Case-Based Approach

Cover......Page 1
Title......Page 3
Contents......Page 5
Contributors......Page 9
Preface......Page 14
Case 1 - A 45-year-old woman with heavy vaginal bleeding......Page 15
Case 2 - A 29-year-old woman with a pelvic mass and altered mental status......Page 18
Case 3 - Acute exacerbation of chronic pelvic pain in a 32-year-old woman......Page 21
Case 4 - A 19-year-old woman with diabetes and hypertension requiring emergency contraception......Page 24
Case 5 - Bleeding, pain, and fever four days after first-trimester termination......Page 27
Case 6 - A 25-year-old woman requesting emergency contraception......Page 31
Case 7 - Persistent trichomonas infection......Page 34
Case 8 - A 42-year-old woman with recurrent unexplained vaginitis symptoms......Page 37
Case 9 - A 30-year-old woman with vaginal itching......Page 40
Case 10 - Sudden-onset left lower quadrant pain in a 21-year-old woman......Page 43
Case 11 - A 35-year-old woman with IUD string not visible......Page 45
Case 12 - A 38-year-old woman with sudden-onset shortness of breath......Page 48
Case 13 - Vaginal bleeding in a 75-year-old woman......Page 51
Case 14 - A 60-year-old woman with severe vulvar itching and an ulcer......Page 55
Case 15 - Urinary retention in a 19-year-old woman......Page 58
Case 16 - Recurrent herpes infection in a 28-year-old woman......Page 61
Case 17 - Vulvar infection and sepsis in a 42-year-old woman......Page 63
Case 18 - A 42-year-old woman with irregular bleeding......Page 66
Case 19 - Persistent HSV in an HIV-positive woman......Page 69
Case 20 - Incidentally discovered vaginal cyst in a 34-year-old woman......Page 72
Case 21 - A 45-year-old woman with an enlarging pelvic mass......Page 74
Case 22 - A 23-year-old woman with pelvic pain and fever......Page 77
Case 23 - A 21-year-old woman with a new sexual partner......Page 82
Case 24 - A 21-year-old woman with persistent pain and fever after treatment for PID......Page 85
Case 25 - Acute vaginal and abdominal pain after defecation in a 79-year-old woman......Page 88
Case 26 - Tachycardia and vaginal bleeding in pregnancy......Page 91
Case 27 - Vaginal spotting at eight weeks’ gestation......Page 94
Case 28 - Heavy bleeding after medical management of a missed abortion......Page 97
Case 29 - Abdominal pain and vaginal bleeding in a 24-year-old woman......Page 100
Case 30 - Unanticipated ultrasound findings at follow-up prenatal visit......Page 103
Case 31 - Early pregnancy spotting and an unusual ultrasound......Page 107
Case 32 - Undesired pregnancy in a 19-year-old woman......Page 110
Case 33 - A pregnant 37-year-old woman with lower left quadrant pain......Page 113
Case 34 - Unruptured advanced ectopic pregnancy......Page 117
Case 35 - A 23-year-old pregnant woman with acute-onset abdominal pain and hypotension......Page 120
Case 36 - A woman with first-trimester vaginal bleeding......Page 123
Case 37 - Midcycle spotting and worsening menorrhagia......Page 127
Case 38 - A 40-year-old woman on tamoxifen therapy with a uterine mass......Page 131
Case 39 - Small mass prolapsing from the cervix found on routine pelvic examination......Page 134
Case 40 - A 35-year-old woman with a painful vulvar mass......Page 136
Case 41 - A 32-year-old woman urgently referred for a cervical mass noted on routine pelvic examination......Page 138
Case 42 - An 18-year-old woman with long-acting reversible contraception and new-onset bleeding......Page 140
Case 43 - Cyclic pain after endometrial ablation......Page 143
Case 44 - Positive hCG in a patient who reports no sexual activity for one year......Page 146
Case 45 - Recalcitrant severe vaginal discharge and odor......Page 148
Case 46 - A 25-year-old woman with a painful vulvar mass......Page 150
Case 47 - Acute abdominal pain two weeks after successful vaginal birth after Cesarean......Page 153
Case 48 - A 64-year-old woman with a simple ovarian cyst......Page 156
Case 49 - A 26-year-old woman with acute pelvic pain and free fluid in the pelvis......Page 159
Case 50 - A 36-year-old woman with fever and pelvic pain at 14 weeks’ gestation......Page 162
Case 51 - Acute fever and tachycardia in a 21-year-old woman during laparoscopy......Page 165
Case 52 - A 40-year-old woman with hypertension and first-trimester bleeding......Page 169
Case 53 - Nausea and vomiting at eight weeks’ gestation......Page 173
Case 54 - A 27-year-old woman with severe nausea and vomiting in pregnancy......Page 176
Case 55 - Early pregnancy with vaginal spotting......Page 180
Case 56 - Positive RPR on initial prenatal labs......Page 183
Case 57 - A high-speed motor vehicle accident during pregnancy......Page 186
Case 58 - A 32-year-old woman with fever and unilateral breast pain......Page 189
Case 59 - A 36-year-old woman with nipple pain postpartum......Page 192
Case 60 - A woman in first-trimester pregnancy with fever, malaise, nausea, and vomiting......Page 195
Case 61 - First-trimester flu-like symptoms in a 31-year-old woman......Page 198
Case 62 - Abdominal pain and distension seven days after egg retrieval for planned IVF......Page 201
Case 63 - Irregular bleeding in a 39-year-old nulliparous woman desiring fertility......Page 204
Case 64 - A 24-year-old woman with her third pregnancy loss......Page 207
Case 65 - A 38-year-old woman with worsening postpartum fatigue......Page 210
Case 66 - A 19-year-old woman with primary amenorrhea......Page 213
Case 67 - A 26-year-old woman with secondary amenorrhea......Page 217
Case 68 - Irregular bleeding in a 25-year-old woman......Page 221
Case 69 - A 28-year-old woman with irregular bleeding requiring transfusion......Page 225
Case 70 - A 29-year-old woman with secondary amenorrhea after a septic abortion......Page 228
Case 71 - Worsening dysmenorrhea in a 14-year-old girl......Page 231
Case 72 - A seven-year-old girl with vaginal bleeding......Page 234
Case 73 - A four-year-old girl falls while exiting the bathtub......Page 237
Case 74 - Worsening cyclic pain and amenorrhea in a 13-year-old girl......Page 240
Case 75 - Worsening cyclic pain and amenorrhea in a 13-year-old girl with a normal appearing but short vagina......Page 243
Case 76 - A 19-month-old girl with labial adhesions and acute urinary retention......Page 245
Case 77 - A 13-year-old girl with irregular menses and significant weight gain......Page 248
Case 78 - A 14-year-old girl with anemia......Page 251
Case 79 - A 13-year-old girl with vulvar irritation and new-onset behavioral problems......Page 255
Case 80 - A 10-year-old girl with lower abdominal pain......Page 258
Case 81 - Complete procidentia in a 70-year-old woman......Page 261
Case 82 - Incontinence in a 50-year-old woman after pessary placement......Page 263
Case 83 - A periurethral mass in a 25-year-old woman......Page 266
Case 84 - A periurethral mass in a 45-year-old woman......Page 269
Case 85 - New-onset incontinence in a 42-year-old woman......Page 272
Case 86 - Urinary leakage following hysterectomy......Page 275
Case 87 - Urinary retention following urethral sling surgery......Page 278
Case 88 - A urethral mass in a postmenopausal woman......Page 281
Case 89 - A 70-year-old woman with a new vulvar mass......Page 283
Case 90 - A 45-year-old woman with a fungating cervical mass......Page 285
Case 91 - A 48-year-old woman with a 4-month history of intermittent abdominal pain and urinary frequency......Page 288
Case 92 - A 65-year-old woman with profuse vaginal bleeding......Page 292
Case 93 - A 38-year-old woman with heavy vaginal bleeding 6 months after D&C for complete mole......Page 296
Case 94 - A 62-year-old woman with a vulvar lesion......Page 299
Case 95 - A 62-year-old woman with ovarian cancer and new-onset pelvic and right-leg pain......Page 301
Case 96 - A 64-year-old woman with ovarian cancer, emesis, and abdominal pain......Page 304
Case 97 - A 65-year-old woman with new-onset fatigue, parasthesias, and muscle cramps after chemotherapy for ovarian cancer......Page 308
Index......Page 311