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DIAGNOSTIC METHODS IN GYNECOLOGY
General overview
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METHODS - gynecology History Clinical examination Microbiology
Serology Oncology- prebiopsy Morphology Endoscopy
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History Family / genetic factors Personal - blood pressure, BMI, etc…
gynecological - obstetric Menstrual cycle Delivery – spontaneus / S.C. Gynecologicla disease Contraception / hormonal therapy Status present Sexual life
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Gynecological examination
palpation cervix, uterus, adnexis, cavum Douglasi, abdominal wall, small pelvis, urinary bladder - pain, resistence, peritoneal irritation In speculis Pathology of : introitus, vulva, cervix (speculae: Simpsons, Scherbacks, Cuzks) Examination per rectum- palpation pediatric gynecology cervix, uterus, adnexis, cavum Douglasi Examination in anestesia / analgesia
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Pre-bioptic examination methods
Kolposcopy Screening examination 6 - 40x (magnification) native kolposcopy Cervical and vulvar patholgy Change of the epithelium, Inflammation angiogenesis Pre-cancerosis, tumor process
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Colposcopy
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Pre-bioptic examination methods
Expanded colposcopy Acetic acid – diferentiation of squamous and cylindric epithelium – change of the colour and transparence Schiller´s examination – Lugol´s dilution – squamous epithelium is brown, cylindric epithelium or erosion are non-colured
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Pre-bioptic examination methods
Functional cytology changes of the epithelium during the menstruation cycle diagnotic of the mestrual cycle disorders Oncological cytology The most important screening methods for ca cervicis Cytological crieiria of the smear from the cervix – exocervix / endocervix
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Pre-bioptic examination methods
Classification of the oncological cytology – Bethesda system SIL – squamous intraepithelial leasion LSIL HSIL ASCUS HPV infection
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Breast examination shape, density, skin and nipple of the breast palpation: 4 quadrants, nipple discharge recommendation: self examination once a months Mamograph screening programme: from 45 years – every 24 months – event. ultrasound
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Ultrasound The most important diagnostic method Abdominal ultrasound
Pediatric gynecology Abdominal tumors, ascites Vaginal ultrasound Small pelvis pathology Ectopic pregnancy Tumors ot the ovaries and uterus Doppler
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Endoscopic methods Vaginoscopy Hysteroscopy Laparoscopy Cystoscopy
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Hysteroscopy
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laparoscopy
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ENDOSKOPIE a KALIBRACE
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METHODS III.- urogynecology
History Clinics Laboratory testing Morphology Endoscopy Urodynamics
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Vyznačen inklinační úhel uretry – tzv. úhel
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UPP - equipment
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Invasive diagnostic and treatment methods
Dilatation of the cervix curretage Punction of the Douglas space Biopsy of the cervix Biopsy of the vulva
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We want something better !
More interesting! Videos,please!!
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OK:After the short break you are invited for:
Some clips from laparoscopies
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