1. Step 8
1.1. Diagnostic decision
1.1.1. endocervicle chlamydia (STD)
1.2. Mechanism
1.2.1. unprotected sex
1.2.2. infected multipartner
1.3. Presentation
1.3.1. vaginal discharge
1.3.2. anxious
1.3.3. lower abdominal discomfort
1.3.4. contact bleeding
1.3.5. cervical tenderness
1.4. supporting date
1.4.1. microbiology
1.4.1.1. PCR positive chlamydia
1.4.2. physical examination
1.5. 10 minutes
2. Step 6
2.1. Review session 1
2.1.1. anatomy of external genitalia, vagina and glands
2.1.2. vaginal discharge
2.1.2.1. types
2.1.2.2. causes
2.1.2.2.1. physiological
2.1.2.2.2. STD
2.1.2.2.3. pregnancy, UTI or cyst??
2.1.2.2.4. others
2.1.2.3. history, examination and investigation
2.1.3. medicolegal consideration for a 16 y o female undergoing a pelvic examination
2.2. 30 minutes
3. Step 7
3.1. Inquiry plan and info gathering
3.1.1. History of presenting complaint
3.1.1.1. vagina discharge
3.1.1.1.1. three w ago
3.1.1.1.2. no odor no itching
3.1.1.1.3. no color
3.1.1.1.4. increasing
3.1.1.2. abdominal discomfort with sex over the last w
3.1.1.3. unusual heavy period
3.1.1.3.1. lasting for 7 days
3.1.1.3.2. usually regular 28 and last for 3 days
3.1.1.4. menrche 13
3.1.1.5. no fever
3.1.2. sexual health history
3.1.2.1. uses condom
3.1.2.2. tooked OC for three m
3.1.2.3. stopped OC three m ago
3.1.2.4. two partners in the last year
3.1.2.5. paul 17 y for one m
3.1.2.5.1. vaginal
3.1.2.5.2. receptive oral
3.1.2.6. 1 m ago with jason 18
3.1.2.6.1. sometimes with condoms
3.1.2.6.2. vaginal
3.1.2.7. thinks her partners have other partners
3.1.2.8. last time three days ago with paul
3.1.2.9. first intercourse 14 y
3.1.2.10. no pregnancy
3.1.3. Previous medical / surgical history
3.1.3.1. tonsilectomy
3.1.4. Drug history / allergy
3.1.4.1. marijuana
3.1.4.1.1. 2-3- a year
3.1.5. Family history
3.1.6. Social / occupational history
3.1.6.1. smoking
3.1.6.1.1. 5 cigriatte per day
3.1.6.1.2. alcohol
3.1.6.2. with her mother , two siblings
3.1.6.3. plans to leave school
3.1.6.4. want a hourse trainer jib
3.1.6.5. father sepreated , regular contact
3.1.6.6. popular in school since 10
3.1.7. Systemic review
3.1.8. physical examination
3.1.8.1. vital
3.1.8.2. inspection
3.1.8.2.1. nervious
3.1.8.3. bilteral tenderness
3.1.8.4. no rebound tenderness
3.1.8.4.1. for appendicitis
3.1.8.5. gentile
3.1.8.5.1. explained process
3.1.8.5.2. perineium and vulva are normal in inspection
3.1.8.5.3. moderate purulent discharge
3.1.8.5.4. contact bleeding
3.1.8.5.5. by manula exam
3.1.8.5.6. pap smear
3.1.8.5.7. serology
3.1.8.5.8. microbiology