By Paul D Blumenthal MD MPH, Jonathan S. Berek MD MMS
Office established systems in surgical fields are swiftly starting to be bearing in mind faster analysis and remedy. This new book, A functional advisor to place of work Gynecologic Procedures provides the step by step consultant to office-based approaches physicians have to deal with ladies within the ambulatory setting.
Covering the main common place of work gynecologic techniques, this new e-book covers symptoms, right positioning, anesthesia and gear wanted for over 35 office-based approaches. Chapters additionally current cautious advice on powerful sufferer management.
Perform gynecologic systems in a cheap ambulatory surroundings, whereas enhancing the end result to your sufferers with this easy-to-use medical reference.
• Written by means of the school, fellows, and citizens of the Stanford division of Obstetrics and Gynecology
• comprises foreword via prestigious Editor, Dr. Jonathan Berek
• functional, illustrated consultant offers the “need-to-know” details on acting universal workplace procedures
• CPT codes are indexed to save lots of you time
• Over 250 complete color-figures (illustrations, photographs) aid determine and exhibit how one can practice techniques
• handy significant other site comprises totally searchable textual content and pictures offering you entry to the content material anytime
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Additional resources for A practical guide to office gynecologic procedures
Evaluate for patterns such as punctation, mosaicism, or abnormal appearing vessels that suggest moderate or severe dysplasia. b. Draw a map of any lesions noted and their location, using the face of the cervix as a clock, with the cervical os at the center, and the squamocolumnar junction drawn as it appears on the ectocervix for reference. c. Consider digital photography and save for medical records (if available). 7. Use the green filte examination to accentuate any abnormal vasculature. 8. Dilute Lugol’s iodine solution may be used to aid in detection (Schiller’s test).
III. Colposcopy in pregnant patients 1. Avoid ECC. 2. Limit biopsies to lesions suggesting severe dysplasia or invasive cancer. 3. Anticipate heavier bleeding if biopsies are obtained. 4. Schedule postpartum follow-up for repeat colposcopy. Aftercare • Bleeding from biopsy sites • Apply direct pressure. • Silver nitrite—Dry area with cotton swab and then immediately apply silver nitrate stick. • Monsel’s solution—Apply liberally to bleeding area and observe for styptic effect.
The wet prep is typically performed in conjunction with a potassium hydroxide (KOH) prep to look for vaginal candidiasis. KOH selectively lyses epithelial cells, as well as red and white blood cells, making it easier to identify unaffected fungal elements if present. Relevant Anatomy The various organisms causing vulvovaginitis infect different areas of the female anatomy. Trichomonas is a vaginal pathogen, while Candida infects both the vagina and vulva. Patient Position • Dorsal lithotomy Landmarks • Wet prep specimen is optimally taken from the anterior vaginal fornix, as the posterior fornix is more likely to be contaminated by semen or vaginally applied medications.