Post Coital Bleeding | Cheat Sheet

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

283

Pages:

4
Author:

Mariam A. A.

Post Coital Bleeding History Can I confirm your name and date of birth? What is the colour of the bleeding? How much blood is there? Apart from the bleed does anything else come out. When did the bleeding begin? How long does the bleeding last for? Does the bleeding always happen on sexual intercourse? Have you had anything like this before? I know you said it happens after sex, but can you think of anything that may be the cause? How has this been affecting your life? Does anything make it better? Does anything make it worse? Associated features: Is there pain on intercourse Is there any pelvic or abdominal pain? Are there any changes to your weight or appetite? Is there any abnormal vaginal discharge? Do you have a fever? Can you feel any masses? Do you feel anything protruding? Are there any changes to urinary or bowel habits? Is there vaginal dryness Menstrual cycle Do you get it? When did you last have it? Regular vs irregular? Duration? Cycle length? Intermenstrual bleeding? Amount and flooding Investigations Vitals – features of fever -> for infections Bloods FBC (for infections and impact of extent of disease), LFTs + coagulation studies (for coagulopathies), EUC (for urinary tract diseases) STI screen -> for STIs CST -> already done TVUS and pelvic ultrasound Features of PID, polyps, cancers If suspicious for cancers -> may consider CTs or MRIs with or without contrast Colposcopy – cervix, vagina and vulva since there is post coital bleeding Hysterosalpingography -> visualisation of the uterus and the fallopian tubes Management Patient likely has an STI from chlamydia Offer antibiotics for chlamydia doxycycline at 100g twice daily as a 7-day course or a single dose of erythromycin as 1g Doxycycline is associated with gastrointestinal symptoms Doxycycline is best taken with food Advise on protected sex Advise patient that she may disclose information to her partner, and the anyoniums methods, and can also advise him to get tested. Partner should also be treated regardless of absence of symptoms to prevent re-infection. Give patients information on: on STIs protected sex benefits of quitting smoking to help reduce the risk of infection follow up: re screen in 3 to 4 months recommend serology for HIV, hepatitis B and syphilis -> both now in the 3 months’ time