A. Abnormal uterine bleeding

a. Endometrial biopsy
b. Endovaginal ultrasonography
c. Hysteroscopy
d. Laparoscopy

2. Treat abnormal uterine bleeding medically and surgically.
3. Describe the long-term follow-up that is necessary for a patient with abnormal uterine bleeding.

B. Vulvar dystrophies and dermatoses

a. Squamous cell hyperplasia
b. Lichen sclerosus
c. Lichen planus
d. Atrophic dermatitis

2. Elicit a pertinent history in a patient with a suspected vulvar dystrophy or dermatosis.
3. Perform a focused physical examination in a patient with a suspected vulvar dystrophy or dermatosis.
4. Perform selected diagnostic tests to confirm the diagnosis of a vulvar dystrophy or dermatosis, such as:

a. Colposcopy
b. Staining with dyes to localize the affected area
c. Vulvar biopsy

5. Treat the common vulvar dystrophies and dermatoses medically and surgically.
6. Describe the long-term follow-up that is essential for a patient with a vulvar dystrophy or dermatosis, including assessment of the risk for malignant change.

C. Pelvic masses

a. Weight loss or weight gain
b. Gastrointestinal symptoms
c. Menstrual abnormalities

3. Perform a focused physical examination to confirm the diagnosis of a pelvic mass.
4. Perform tests such as endovaginal or abdominal ultrasonography to confirm the diagnosis of a pelvic mass.
5. Interpret the results of other tests to confirm the diagnosis of a pelvic mass, for example:

a. MRI or CT scan
b. Serum markers, such as CA 125, alpha-fetoprotein, and human chorionic gonadotropin (hCG)

6. Treat benign pelvic masses medically and surgically, considering factors such as:

a. Patient age
b. General health
c. Patient preference
d. Desire for future childbearing
e. Symptom complex

7. Describe the appropriate follow-up for patients who have been treated for a benign pelvic mass.

D. Chronic pelvic pain

a. Microbiologic cultures of the genitourinary tract
b. Hysteroscopy
c. Laparoscopy
d. Injection of anesthetic agent at a specific trigger point
e. Mental status examination

5. Treat medically and surgically patients with chronic pelvic pain.
6. Describe the indications for referral of a patient to a subspecialist in a different field such as psychiatry or pain management.
7. Describe the appropriate long-term follow-up for a patient with chronic pelvic pain.

E. Endometriosis

a. Endovaginal ultrasonography
b. Laparoscopy and biopsy of a suspicious lesion

5. Perform selected tests to assess the fertility status of a patient with endometriosis (see Unit 5, Reproductive Endocrinology).
6. Describe the staging system for endometriosis according to the 1996 Revised American Society for Reproductive Medicine Classification of Endometriosis.
7. Treat endometriosis medically and surgically.
8. Describe the appropriate long-term follow-up in patients who have endometriosis.

F. Ectopic pregnancy

a. Endovaginal ultrasonography
b. Uterine curettage
c. Laparoscopy
6. Interpret the results of other diagnostic tests, such as:
a. Quantitative serum hCG titer
b. Serum progesterone
c. Complete blood count

6. Describe the indications and contraindications for, and complications of, medical management of an ectopic pregnancy.
7. Describe the indications for, and complications of, surgical management of an ectopic pregnancy.
8. Treat an affected patient medically and surgically.
9. Describe the indications for anti-D immune globulin in patients experiencing an ectopic pregnancy.
10. Describe the long-term follow-up that is indicated for a patient treated for an ectopic pregnancy.
11. Counsel patients regarding the recurrence risk for an ectopic pregnancy and prognosis for a normal intrauterine pregnancy.