Obs and Gynae pocket doctor template

this is the gynae history from the POCKET DOCTOR booklet:

INTRO

CHECK
Patient name and age

PRESENTING COMPLAINT

HISTORY OF PRESENTING COMPLAINT

1. BLEEDING
menarche
period regularity
heavy? if yes: pad changing per day/flooding/clots/tiredness
LMP
IMB/PCB/PMB
Discharge: if yes: colour, smell

2. FERTILITY
Sexual contacts
STI's
contraception: barrier and birth control
HRT if post-menopause
Pregnancy attempts
Smears: last date and result
Breast screening

3. PAIN
Painful periods? at what part of cycle
Painful sex? On penetration/during

4. UROGYNAE
Prolapse: dragging sensation/something 'coming down'. Back pain.
Urinary: incontinence? relation to coughing/sneezing/straining
Urinary symptoms: freq, noct, dysuria, strangury, hameaturia, unable to interrupt stream.
Bowel habits: esp change in habits.

OBSTETRIC HISTORY
Pregnancies: date delivered, mode, weight, problems.
Miscarriages: gestation?
Termination: gestation, reason?
ectopics

PAST MEDICAL HISTORY
esp gynae operations

DRUG HISTORY

FAMILY HISTORY

SOCIAL HISTORY

summary
address pesky concerns

[Kindly written up by a friend]