1. Describe the principal causes of abnormal uterine bleeding.
2. Elicit a pertinent history in a patient with abnormal uterine bleeding.
3. Perform a focused physical examination to determine the etiology of abnormal uterine bleeding.
4. Interpret the results of other diagnostic tests, such as:
a. Serum human chorionic gonadotropin (hCG) titer and other endocrine assays
b. Microbiologic cultures
c. Complete blood count
d. Coagulation profile
e. Radiologic imaging studies
1. Describe the principal infections that affect the vulva and vagina.
2. Elicit a pertinent history in a patient with a possible infection of the vulva or vagina.
3. Perform a focused physical examination in a patient with a suspected infection of the vulva or vagina.
4. Perform selected tests to confirm the diagnosis of vulvar or vaginal infection:
a. Determination of vaginal pH
b. Saline microscopy
c. Potassium hydroxide microscopy
d. Bacterial and viral culture
e. Colposcopic examination
5. Interpret the results of diagnostic tests, such as:
a. Gram stain of suspicious lesion of the vulva or vagina
b. Bacterial and viral culture
c. Vulvar or vaginal biopsy
6. Describe the long-term follow-up that is necessary for a patient with a vulvar or vaginal infection, for example:
a. Assessing and treating sexual partner(s)
b. Assessing the patient for other possible genital tract infections
c. Counseling the patient with respect to measures that prevent reinfection with sexually transmitted diseases (STDs)
1. Describe the most common types of STDs, such as:
a. Chlamydia
b. Gonorrhea
c. Syphilis
d. Hepatitis B and hepatitis C
e. Human immunodeficiency virus (HIV)
f. Herpes simplex
g. Human papillomavirus
h. Chancroid
2. Elicit a pertinent history in a patient with a suspected STD.
3. Perform a focused physical examination to confirm the diagnosis and determine the specific cause of an STD.
4. Perform tests and/or interpret their results to confirm the diagnosis of an STD:
a. Aspiration of vesicle
b. Bacterial culture
c. Endocervical aspirate for Gram stain
d. Endocervical aspirate for nucleic acid probe
e. Endocervical culture
f. Endometrial biopsy
g. Pap test
h. Scraping of an ulcer or chancre
i. Serologic assays
j. Tzanck smear
k. Viral culture
5. Treat STDs with appropriate antimicrobial agents.
6. Describe the long-term follow-up for patients with an STD, including assessment of the patient’s sexual partner, discussion of preventive measures, and review of serious sequelae, such as:
a. Infertility
b. Ectopic pregnancy
c. Chronic pelvic pain
1. Describe the principal causes of, or predisposing factors for, spontaneous first-trimester abortion.
2. Describe the usual symptoms and findings experienced by a patient with an early pregnancy loss.
3. Perform a focused physical examination to confirm the diagnosis of early spontaneous abortion.
4. Describe the differential diagnosis of early spontaneous abortion.
5. Perform selected tests to confirm the diagnosis of early spontaneous abortion:
a. Endovaginal ultrasonography
b. Laparoscopy
6. Perform selected tests to confirm the diagnosis of early spontaneous abortion:
a. Quantitative hCG
7. Interpret other diagnostic tests, such as:
a. Qualitative and quantitative serum hCG
b. Serum progesterone
c. Complete blood count
8. Treat a patient with an early incomplete spontaneous abortion.
9. Describe and treat the complications that may develop as a result of treatment of an incomplete spontaneous abortion, for example:
a. Genital tract infection
b. Uterine perforation
c. Retained products of contraception
10. Describe the indications for anti-D immune globulin in patients experiencing an early spontaneous abortion.
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