Advanced Health Assessment of Women: Skills, Procedures, and Management

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Half Title: Advanced Health Assessment of Women
Author Bio
Book Title: Advanced Health Assessment of Women
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Contents
Contributors
Preface
Acknowledgments
Instructor Resources
Unit I: Female Reproduction
	Chapter 1: ANATOMY AND PHYSIOLOGY OF THE URINARY AND REPRODUCTIVE SYSTEMS
		GENERAL OVERVIEW
		OVARIES
		FALLOPIAN TUBES
		THE UTERUS
		VAGINA
		PELVIC SUPPORT
		UTERINE LIGAMENTS
		ASSOCIATED PELVIC ORGANS
		BIBLIOGRAPHY
Chapter 2: THE REPRODUCTIVE CYCLE
	REPRODUCTIVE CYCLE
	HORMONAL INFLUENCES EXPLAINED
	THE OVARIAN CYCLE
	THE ENDOMETRIAL CYCLE
	HORMONAL REGULATION AND FEEDBACK MECHANISMS (Figure 2.1)
	BIBLIOGRAPHY
Unit II: Health Assessment
	Chapter 3: THE HEALTH HISTORY
		DEFINITION OF SEXUAL HEALTH
		ELEMENTS OF A COMPREHENSIVE, DEVELOPMENTALLY RELEVANT SEXUAL HEALTH ASSESSMENT
		ADVANCED HEALTH HISTORY TECHNIQUES
		SPECIAL APPROACHES TO SEXUAL HEALTH HISTORY
		THE REPRODUCTIVE HEALTH HISTORY
		TECHNIQUES FOR SCREENING FOR SEXUAL ABUSE
		THE SEXUAL HISTORY OF THE LGBTQIA PATIENT
		HIV RISK ASSESSMENT
		SAMPLE QUESTIONS AND SCREENING TOOLS
		‌‌BIBLIOGRAPHY‌‌‌
		APPENDIX 3.1: Sample Prenatal Genetic Screen
		APPENDIX 3.2: Environmental Exposure History Form
		APPENDIX 3.3: Summary of Critical Issues in the HIV  Initial History
Chapter 4: TELEHEALTH IN WOMEN’S HEALTH SETTINGs‌‌‌
	TELEHEALTH
	DELIVERY OF TELEHEALTH
	ADVANTAGES AND DISADVANTAGES of TELEHEALTH
	EQUIPMENT INVOLVED WITH TELEHEALTH DELIVERY
	TIPS FOR FACILITATING TELEHEALTH VISITS
	TYPES OF TELEHEALTH SERVICES FOR WOMEN’S HEALTHcare SETTINGS
	BILLING AND CODING
	BIBLIOGRAPHY
Chapter 5: THE PHYSICAL EXAMINATION
	A COMPLETE PHYSICAL EXAMINATION IS AN INTEGRAL PART OF THE HEALTH ASSESSMENT OF WOMEN: COMPONENTS O
	EXAMINATION OF THE THYROID GLAND: THYROID DYSFUNCTION CAN CAUSE IRREGULAR MENSES, ANOVULATION, AND
	BREAST EXAMINATION (See Chapter 9, “Assessment of the  Female Breast”)
	PELVIC EXAMINATION EXPLAINED
	INSPECTION OF THE EXTERNAL GENITALIA
	PALPATION OF THE EXTERNAL GENITALIA
	THE BIMANUAL EXAMINATION
	PALPATION OF THE OVARIES AND FALLOPIAN TUBES
	RECTOVAGINAL EXAMINATION
	SPECULUM EXAMINATION
	UPON COMPLETION OF THE PELVIC EXAMINATION
	RESOURCE
	BIBLIOGRAPHY
Chapter 6: VAGINAL Microscopy AND VAGINAL Infections
	VAGINAL MICROSCOPY SUMMARY
	VAGINAL ECOLOGY
	HISTORY AND EXAMINATION
	pH ASSESSMENT
	SALINE WET MOUNT
	KOH PREP
	THE MICROSCOPE
	VAGINAL CANDIDIASIS
	BACTERIAL VAGINOSIS
	TRICHOMONIASIS
	DESQUAMATIVE INFLAMMATORY VAGINITIS
	GENITOURINARY SYNDROME OF MENOPAUSE FORMERLY VULVOVAGINAL ATROPHY (VVA) (See Chapter 24, “Genitouri
	CHEMICAL VAGINITIS
	VAGINAL GRAM STAIN
	BIBLIOGRAPHY
Chapter 7: SEXUALLY‌‌ TRANSMITTED INFECTIONS
	SEXUALLY TRANSMITTED INFECTIONS EXPLAINED
	CLINICAL EVALUATION OF PEOPLE WITH VAGINAS AND UTERUSES
	CASE STUDY
	ACKNOWLEDGMENT
	ADDITIONAL RESOURCE
	BIBLIOGRAPHY
Chapter 8: ASSESSMENT OF THE SKIN/AESTHETICS
	DERMATOLOGic ASSESSMENT: REVIEW OF BASIC CUTANEOUS  ANATOMY (FIGURE 8.1)
	CUTANEOUS ASSESSMENT
	DERMATOLOGIC ISSUES RELATED TO PREGNANCY
	DERMATOLOGIC ISSUES RELATED TO CONTRACEPTION
	GENERAL DERMATOLOGY
	COSMESIS AND PHOTOAGING
	BIBLIOGRAPHY
Chapter 9: ASSESSMENT OF THE FEMALE BREAST
	BASICS RELATED TO EXAMINATION OF THE FEMALE BREAST
	IMPORTANT STATISTICS
	ANATOMY AND PHYSIOLOGY OF THE BREAST
	BREAST SELF-AWARENESS
	INSPECTION OF THE BREASTS
	PALPATION OF THE BREAST
	PALPATE THE NIPPLE AND THE AREOLA
	PALPATION OF LYMPH NODES
	PHYSICAL EXAMINATION OF AN AUGMENTED BREAST
	CHARTING
	MAMMOGRAM
	CASE STUDY
	BIBLIOGRAPHY
Chapter 10: Breast Imaging
	BREAST IMAGING
	MAMMOGRAM
	BI-RADS: BREAST IMAGING REPORTING AND DATA SYSTEM
	WHAT DOES THE RADIOLOGIST ASSESS ON MAMMOGRAM?
	GUIDELINES FOR SCREENING MAMMOGRAM
	SCREENING MAMMOGRAM RECOMMENDATIONS FOR  AVERAGE-RISK WOMEN
	BREAST ULTRASOUND
	MAGNETIC RESONANCE IMAGING of the BREAST (Figure 10.8)
	MOLECULAR BREAST IMAGING
	THERMOGRAM BREAST IMAGING EXAMS‌‌
	PROS AND CONS OF BREAST IMAGING MODALITITES
	SCREENING IN SPECIAL CASES: PREGNANCY AND LACTATING
	BIBLIOGRAPHY
Chapter 11: MENTAL HEALTH SCREENING
	GENERAL MENTAL HEALTH
	ANXIETY
	DEPRESSION
	SUICIDE
	EATING DISORDERS
	POSTTRAUMATIC STRESS DISORDER
	SUBSTANCE ABUSE
	DEMENTIA
	CASE STUDY
	BIBLIOGRAPHY
Chapter 12: PRECONCEPTION CARE
	PRECONCEPTION CARE
	OVERALL GOALS FOR PRECONCEPTION CARE
	OVERALL RECOMMENDATIONS
	REPRODUCTIVE LIFE PLAN
	OPTIMAL WEIGHT MANAGEMENT
	CHRONIC DISEASE MANAGEMENT
	NUTRITION AND DIET
	IMMUNIZATIONS
	SEXUALLY TRANSMITTED INFECTIONS
	TERATOGEN EXPOSUREs/ENVIRONMENTAL EXPOSURES/OCCUPATIONAL EXPOSURES
	SUBSTANCE/OPIOID USE
	FAMILY AND GENETIC HISTORY
	PSYCHOSOCIAL RISKS
	SOCIAL DETERMINANTS OF HEALTH
	RESOURCES‌‌
	BIBLIOGRAPHY
Chapter 13: COMPLEMENTARY AND ALTERNATIVE MEDICAL THERAPIES
	INTRODUCTION
	OVERVIEW
	CATEGORIES OF COMPLEMENTARY ALTERNATIVE MEDICINE
	BRIEF OVERVIEW: COMPLEMENTARY ALTERNATIVE MEDICINE USE AND MENOPAUSAL OVERVIEW
	REASONS CITED FOR COMPLEMENTARY ALTERNATIVE MEDICINE USE
	MEDICAL CONCERNS REGARDING COMPLEMENTARY ALTERNATIVE MEDICINE USE
	ADDITIONAL RESOURCEs
Unit III: Evaluation of Special Populations
	Chapter 14: ASSESSMENT OF THE PREGNANT WOMAN
		INITIAL PRENATAL EVALUATION
		DOCUMENTATION OF PREGNANCY
		ESTIMATED DATE OF CONFINEMENT OR DELIVERY
		CURRENT IDENTIFYING DATA
		EVALUATE REACTIONS TO PREGNANCY
		CURRENT PHYSICAL SYMPTOMS
		HISTORY OF POSSIBLE EXPOSURES SINCE CONCEPTION
		MEDICAL HISTORY
		OBSTETRIC AND GYNECOLOGIC HISTORY
		SURGICAL HISTORY
		GENERAL HEALTH AND NUTRITION
		SOCIAL HISTORY
		FAMILY HISTORY
		PHYSICAL EXAMINATION
		LABORATORY TESTS
		PLANNING AN INITIAL VISIT
		CASE STUDY: Initial Prenatal Visit
		References
		BIBLIOGRAPHY
Chapter 15: ADOLESCENT HEALTH
	OVERVIEW
	CONFIDENTIALITY
	PREVENTIVE HEALTH AND EDUCATION
	IMMUNIZATIONS: RECOMMENDED IMMUNIZATIONS FOR ADOLESCENTS
	EDUCATION ON BODY DEVELOPMENT
	ATYPICAL MENSTRUAL BLEEDING IN ADOLESCENCE
	ABNORMAL UTERINE BLEEDING (AUB) IN ADOLESCENCE
	PREGNANCY IN ADOLESCENCE
	COUNSELING THE ADOLESCENT PATIENT REGARDING EMERGENCY CONTRACEPTIVES
	CARE FOR PREGNANT ADOLESCENT
	SEXUAL AND REPRODUCTIVE HEALTH
	MENTAL HEALTH
	EATING DISORDERS
	SUBSTANCE USE
	BULLYING
	SUICIDE PREVENTION
	SOCIAL MEDIA
	BIBLIOGRAPHY
Chapter 16: LACTATION ASSESSMENT AND MANAGEMENT
	ANATOMY AND PHYSIOLOGY
	NEWBORN
	DECIDING TO BREASTFEED
	OVER-THE-COUNTER AND ILLICIT DRUGS, PRESCRIPTION MEDICATIONS, AND HERBS
	SPECIAL POPULATIONS
	CULTURAL AND RELIGIOUS VIEWS AND PRACTICES
	RACIAL AND ETHNIC DISPARITIES IN BREASTFEEDING
	FIRST FEEDING
	MAINTAINING SUPPLY
	NUTRITION DURING LACTATION
	MILK EXPRESSION
	SPECIAL ISSUES
	FAMILY PLANNING AND LACTATION
	COMMUNITY SUPPORT AND RESOURCES
	BIBLIOGRAPHY
Chapter 17: Assessment and Clinical Evaluation of Obesity in Women
	OBESITY IN WOMEN
	MEASURES OF OBESITY
	PREVALENCE OF OBESITY
	GENDER DIFFERENCES IN OBESITY
	GENETIC CAUSES OF OBESITY
	MEDICAL CAUSES OF OBESITY
	EATING DISORDERS
	RISK FACTORS ASSOCIATED WITH EXOGENOUS OBESITY
	OBESITY-FOCUSED HEALTH HISTORY
	ADIPOSITY-FOCUSED PHYSICAL EXAMINATION
	PHYSICAL FINDINGS ASSOCIATED WITH CARDIOMETABOLIC RISK
	LABORATORY TESTING
	TREATMENT INTERVENTIONS
	DEVELOPMENT OF A WEIGHT MANAGEMENT PLAN
	CASE STUDY: Management of Obesity
	BIBLIOGRAPHY
Chapter 18: LESBIAN HEALTH (DON’T ASKWON’T TELL: LESBIAN WOMEN AND WOMEN WHO HAVE SEX WITH WOMEN)
	INTRODUCTION AND OVERVIEW
	SCREENING RECOMMENDATIONS FOR SEXUAL-MINORITY WOMEN (LESBIAN, BISEXUAL, AND WOMEN WHO HAVE SEX WITH
	USING INCLUSIVE LANGUAGE
	APPROACH TO PATIENT AND PROVIDER COMMUNICATION
	RISK ASSESSMENT AND REDUCTION
	APPROACH TO THE GYNECOLOGIC EXAM
	CASE STUDY: Identifying Risks and Opportunities
	BIBLIOGRAPHY
Chapter 19: TRANSGENDER HEALTHCARE
	INTRODUCTION AND OVERVIEW
	SCREENING RECOMMENDATIONS FOR TRANSGENDER INDIVIDUALS
	PATIENT AND PROVIDER COMMUNICATION
	TAKING A MEDICAL AND SEXUAL HISTORY
	APPROACH TO A PHYSICAL AND OR GENITAL EXAM
	RISK REDUCTION AND MONITORING (Table 19.5)
	CASE STUDY
	BIBLIOGRAPHY
Chapter 20: WOMEN VETERANS: When the Woman Was a Warrior
	INTRODUCTION
	SPECIFIC AREAS OF CONCERN
	CONCLUSION
	Acknowledgment
	BIBLIOGRAPHY
Chapter 21: MALE SEXUAL AND REPRODUCTIVE HEALTH
	INTRODUCTION
	ANATOMY AND PHYSIOLOGY (Figure 21.1)
	ASSESSMENT
	PATHOPHYSIOLOGY
	SEXUAL HEALTH SCREENING AND IMMUNIZATION
	FAMILY PLANNING
	SEXUALLY TRANSMITTED (AND OTHER) INFECTIONS
	INFERTILITY
	SEXUAL DYSFUNCTION
	PATIENT EDUCATION AND RESOURCES
	CASE STUDY
	BIBLIOGRAPHY
Unit IV: Evaluation of Special Gynecologic Problems
	Chapter 22: ASSESSMENT OF MENOPAUSAL STATUS
		MENOPAUSE EXPLAINED
		PHYSIOLOGY OF MENOPAUSE
		MENOPAUSE INTRODUCTION AND CLINICAL ISSUES
		HEALTH EVALUATION
		INTERVENTIONS
		PHARMACOLOGIC OPTIONS
		NON-HORMONAL PHARMACOLOGIC OPTIONS
		CASE STUDY
		BIBLIOGRAPHY
Chapter 23: OSTEOPOROSIS AND EVALUATION OF FRACTURE RISK
	SCOPE OF THE PROBLEM
	OSTEOPOROSIS EXPLAINED
	MEASUREMENT OF BONE DENSITY
	THE PROCEDURE
	DIAGNOSTIC ASSESSMENT
	LIFETIME MONITORING RECOMMENDATIONS
	TREATMENT CHOICES
	BIBLIOGRAPHY
Chapter 24: GENITOURINARY SYNDROME OF MENOPAUSE AND VULVOVAGINAL ATROPH‌‌Y
	GENITOURINARY SYNDROME OF MENOPAUSE EXPLAINED
	PATHOPHYSIOLOGY
	INDICATIONS FOR EVALUATION
	ASSESSMENT
	DIAGNOSTIC TESTING AND DIFFERENTIAL DIAGNOSIS
	TREATMENT CONSIDERATIONS
	FOLLOW-UP
	RESOURCES
	BIBLIOGRAPHY
Chapter 25: ASSESSMENT OF PELVIC PAIN
	PELVIC PAIN
	PELVIC PAIN ASSESSMENT
	ACUTE PELVIC PAIN
	CHRONIC PELVIC PAIN
	BIBLIOGRAPHY
Chapter 26: ASSESSMENT OF VULVAR PAIN AND VULVODYNIA
	VULVAR PAIN
	ASSESSMENT OF A WOMAN WITH VULVAR PAIN
	DIFFERENTIAL DIAGNOSES
	MANAGEMENT
	PATIENT EDUCATION AND CLINICIAN RESOURCES
	BIBLIOGRAPHY
Chapter 27: POLYCYSTIC OVARIAN SYNDROME
	OVERVIEW AND DEFINITION OF POLYCYSTIC OVARIAN  SYNDROME
	CRITERIA FOR DIAGNOSIS OF PCOS
	CLINICAL SCREENING
	CLINICAL INTERVENTION
	CASE STUDY: Polycystic Ovarian Syndrome and Fertility Preservation
	BIBLIOGRAPHY
Chapter 28: ABNORMAL UTERINE BLEEDING
	ABNORMAL UTERINE BLEEDING
	CLINICAL EVALUATION OF THE WOMAN WHO PRESENTS WITH abnormal uterine bleeding
	PATHOPHYSIOLOGY AND DIFFERENTIAL DIAGNOSES
	DIAGNOSTIC TESTING
	CLINICAL MANAGEMENT OF Abnornmal uterine bleeding
	CASE STUDY
	BIBLIOGRAPHY
Chapter 29: AMENORRHEA
	AMENORRHEA
	BIBLIOGRAPHY
Chapter 30: PREMENSTRUAL SYNDROME AND PREMENSTRUAL DYSPHORIC DISORDER
	DEFINITIONS
	ETIOLOGY
	SYMPTOMS
	PHARMACOLOGIC MANAGEMENT (Table 30.2)
	CASE STUDY
	BIBLIOGRAPHY
Unit V: Evaluation of the Pelvic Floor
	Chapter 31: PELVIC ORGAN PROLAPSE
		PELVIC ORGAN PROLAPSE EXPLAINED
		ASSESSMENT
		STEP-BY-STEP ASSESSMENT OF PELVIC ORGAN PROLAPSE
		MANAGEMENT OF PELVIC ORGAN PROLAPSE
		BIBLIOGRAPHY‌‌‌
Chapter 32: URINARY INCONTINENCE
	BLADDER DYSFUNCTION EXPLAINED
	PATHOPHYSIOLOGY OF THE LOWER URINARY TRACT SYSTEM
	Urinary incontinence EXPLAINED
	TYPES OF Urinary incontinence
	DIAGNOSTIC TESTING AND DIFFERENTIAL DIAGNOSIS
	FOLLOW-UP
	NATIONAL ORGANIZATIONS THAT PROVIDE VALUABLE Urinary incontinence RESOURCES
	BIBLIOGRAPHY
Chapter 33: SEXUAL HEALTH AND RELATED PROBLEMS
	DEFINITION of SEXUAL HEALTH AND RELATED PROBLEMS
	SEXUAL HISTORY
	SEXUAL DYSFUNCTION
	HORMONES AND SEXUALITY
	MEDICATIONS THAT IMPACT SEXUALITY (Table 33.2)
	TREATMENT (Table 33.3)
	BIBLIOGRAPHY
Unit VI: Assessment of Women at Risk
	Chapter 34: THE SEXUAL ASSAULT VICTIM
		INTRODUCTION
		SEXUAL ASSAULT EXPLAINED
		SOME REASONS WHY WOMEN MAY NOT REPORT SEXUAL ASSAULT
		THE FORENSIC EXAMINATION
		GUIDELINES FOR THE PRIMARY CARE PROVIDER FOLLOWING SEXUAL ASSAULT
		MANAGEMENT
		BIBLIOGRAPHY
Chapter 35: INTIMATE PARTNER VIOLENCE
	INTRODUCTION
	VIOLENCE AND ABUSE EXPLAINED
	ASSESSMENT OF Intimate partner violence
	HEALTH CONSEQUENCES OF intimate partner violence
	CONCLUSION
	BIBLIOGRAPHY
Chapter 36: ASSESSMENT AND RESPONSE TO HUMAN TRAFFICKING
	TRAFFICKING DEFINED
	ETIOLOGY AND INCIDENCE
	RISK FACTORS (Box 36.1)
	GUIDELINES FOR PRIMARY CARE PROVIDERS RESPONDING TO SUSPICION OR DISCLOSURES OF HUMAN TRAFFICKING
	TRAUMA-INFORMED CARE
	TREATMENT AND MANAGEMENT
	OTHER CONSIDERATIONS FOR RESPONSE
	DEFINITION AND TYPES OF FEMALE GENITAL MUTILATION
	BIBLIOGRAPHY
Unit VII: Infertility and Subfertility Assessment
	Chapter 37: Initial Evaluation of Infertility
		Infertility explained
		Health assessment of the infertile woman/couple
		Physical examination of the infertile woman
		THE INITIAL WORKUP
		MALE ASSESSMENT
		Bibliography
		APPENDIX 37.1 Assessment Forms
Chapter 38: Methods to Detect Ovulation
	Methods to detect ovulation
	Hormonal evaluation of ovulation
	The endometrial biopsy
	Uterine cavity and fallopian tube assessment
	Ovarian reserve testing
	Baseline hormone testing
	Postcoital test: no longer part of the current day  infertile evaluation
	Ovulation induction
	Bibliography
Chapter 39: INTRAUTERINE INSEMINATION
	INTRAUTERINE INSEMINATION
	BIBLIOGRAPHY
Unit VIII: Contraception
	Chapter 40: THE CONTRACEPTIVE CONSULT
		REPRODUCTIVE JUSTICE
		CONTRACEPTION
		KEY CONSIDERATIONS TO CONTRACEPTION
		KEY centers for disease control and prevention RECOMMENDATIONS TO LIMIT BARRIERS FOR ACCESS TO CONT
		CONTRACEPTIVE METHODS
		SELECTING A CONTRACEPTIVE METHOD
		BIBLIOGRAPHY
Chapter 41: MEDICAL ELIGIBILITY CRITERIA FOR CONTRACEPTIVE USE
	THE CENTERS FOR DISEASE CONTROL AND PREVENTION MEDICAL ELIGIBILITY CRITERIA EXPLAINED
	BIBLIOGRAPHY
Chapter 42: Cervical Cap and the One-Size Diaphragm
	The cervical cap and one-size diaphragm explained
	Description of the cervical cap and one-size diaphragm
	Size selection
	Protection against STIs and HIV/ AIDS
	FemCap Protocol
	CAYA Protocol
	Directions for use
	Bibliography
Chapter 43: INTRAUTERINE CONTRACEPTION
	THE INTRAUTERINE CONTRACEPTIVE EXPLAINED
	THE INSERTION
	MANAGEMENT OF SIDE EFFECTS
	FOLLOW-UP VISIT AS NEEDED
	REMOVAL
	MANAGEMENT OF SIDE EFFECTS AND COMPLICATIONS
	EXPULSION
	BIBLIOGRAPHY
Chapter 44: CONTRACEPTIVE IMPLANTS
	ETONOGESTREL IMPLANT (NEXPLANON) EXPLAINED
	NEXPLANON INSERTION
	IMPLANT REMOVAL PROCEDURE
	PATIENT AND PROVIDER RESOURCES
	BIBLIOGRAPHY
Unit IX: Investigative Procedures
	Chapter 45: Cervical Cancer Screening and Colposcopy
		Screening for cervical cancer
		Bibliography
Chapter 46: GENETIC TESTING FOR HEREDITARY BREAST AND OVARIAN CANCER
	INTRODUCTION AND OVERVIEW: CANCERS OF THE BREAST AND OVARY IMPOSE A SIGNIFICANT BURDEN ON WOMEN’S H
	FACTS ABOUT BREAST AND OVARIAN CANCER
	FACTS ABOUT BRCA1 AND BRCA2
	IDENTIFICATION OF WOMEN WHO MAY BE CANDIDATES FOR TESTING
	PRETEST EDUCATION AND COUNSELING
	INTERPRETATION OF BRCA TEST RESULTS
	MANAGEMENT OPTIONS FOR THE UNAFFECTED WOMAN WHO TESTS BRCA POSITIVE
	MANAGEMENT OPTIONS FOR THE WOMAN WITH BREAST OR OVARIAN CANCER WHO TESTS BRCA POSITIVE
	IMPLICATIONS OF A NEGATIVE TEST OR Variants of uncertain significance
	CONSIDER SYNDROMES OTHER THAN BRCA, HEREDITARY BREAST AND OVARIAN CANCER
	EXPANDED TESTING OPTIONS WITH NEXT-GENERATION  GENE SEQUENCING
	ACKNOWLEDGMENT
	BIBLIOGRAPHY
Chapter 47: Urinalysis and Urinary tract infections‌‌
	Urinary Tract Infection
	Urinary evaluation
	Principles related to the procurement of urine
	The clean catch
	Physical examination of the urine
	The Chemical Analysis
	Microscopic examination
	Management of Urinary tract infection
	Bibliography
Unit X: Advanced Skills
	Chapter 48: VULVAR BIOPSY
		VULVAR CANCER EXPLAINED
		NONNEOPLASTIC EPITHELIAL DISORDERS OF THE VULVAR SKIN  AND MUCOSA
		DIFFERENTIAL DIAGNOSIS OF OTHER VULVAR DERMATOSES
		VULVAR BIOPSY
		ASSESSMENT
		INDICATIONS
		PATIENT PREPARATION
		THE PROCEDURE
		FOLLOW-UP
		TEACH VULVAR SELF-EXAMINATION
		BIBLIOGRAPHY
Chapter 49: ENDOMETRIAL BIOPSY
	ENDOMETRIAL BIOPSY EXPLAINED
	SOME COMMENTS CONCERNING ENDOMETRIAL CANCER
	SOME COMMENTS CONCERNING Luteal-phase defect
	ENDOMETRIAL BIOPSY EXAMINATION EXPLAINED
	INDICATIONS FOR BIOPSY STUDY
	CONTRAINDICATIONS TO BIOPSY STUDY
	Examination of the Woman
	SUPPLIES
	PREPARATION
	INFORMED CONSENT AND EDUCATION
	THE PROCEDURE
	TECHNIQUE
	COMMON PROBLEMS
	AFTER THE BIOPSY PROCEDURE
	COMPLICATIONS (Table 49.1)
	FOLLOW-UP
	DIAGNOSIS
	BIBLIOGRAPHY
Chapter 50: ACROCHORDONECTOMY (SKIN TAG REMOVAL)
	ACROCHORDONECTOMY (REMOVAL OF SKIN TAGS) EXPLAINED
	ACROCHORDON EXPLAINED
	REMOVAL
	FOLLOW-UP
	BIBLIOGRAPHY
Chapter 51: CERVICAL POLYPECTOMY
	POLYPS EXPLAINED
	POLYPS ARE EASY TO REMOVE IN THE OFFICE AT THE TIME OF THE VISIT
	BIBLIOGRAPHY
Chapter 52: DRAINAGE OF BARTHOLIN’S ABSCESS
	BARTHOLIN’S GLANDS EXPLAINED
	TREATMENT OF BARTHOLIN’S GLAND ABSCESS INVOLVES INCISION AND DRAINAGE OF CYST AND INSERTION OF WORD
	PREPARATION
	THE PROCEDURE
	FOLLOW-UP
	BIBLIOGRAPHY
Chapter 53: Pessary Insertion
	Pessary
	General principles for fitting a pessary
	General Pessary Insertion Technique
	Recommendations for Post-Fitting Follow- up
	Description of the various types of pessaries
	Nontraditional Inserts
	Bibliography
Unit 11: Pharmacologic Management
	Chapter 54: PHARMACOLOGIC MANAGEMENT SUMMARIES IN WOMEN’S HEALTH
Unit 12: Supplemental Chapters
	Chapter 55: In-Office Sonohysterography
		Sonohysterography explained
		The Hysteroscopy
		Bibliography
Chapter 56: Donor Insemination
	Donor insemination explained
	Indications
	Success rates
	Source of donor
	Shipping of frozen specimens
	Preparation of the donor
	Specimen quality
	Home insemination using frozen sperm
	Bibliography
Chapter 58: PELVIC FLOOR ELECTRICAL STIMULATION
	URINARY INCONTINENCE IS A COMMON CONDITION DEFINED AS AN INVOLUNTARY LEAKAGE OF URINE
	PELVIC FLOOR ELECTRICAL STIMULATION
	BIBLIOGRAPHY
Chapter 59: PERCUTANEOUS TIBIAL NERVE STIMULATION
	PERCUTANEOUS TIBIAL NERVE STIMULATION DEFINITION
	Overactive bladder STATISTICS
	INDICATIONS
	CONTRAINDICATIONS
	TREATMENT EFFICACY
	TREATMENT FREQUENCY
	RESPONSE TO TREATMENT
	AVOID USE OF percutaneous tibial nerve stimulation NEEDLE IN THE FOLLOWING:
	RISKS OF TREATMENT: LOW
	THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD-10) CODES THAT SUPPORT MEDICAL NECESSITY (www.wps
	Percutaneous tibial nerve stimulation PROCEDURE
	IMPORTANT ISSUES TO KEEP IN MIND
	FUTURE CONSIDERATIONS UNDER CURRENT RESEARCH
	ADDITIONAL RESOURCE
	BIBLIOGRAPHY
	APPENDIX 59.1 Percutaneous Tibial Nerve Stimulation (PTNS) Worksheet
Index