Investigation in Gynaecology

BLOOD ROUTINE Hemoglobin estimation-Excessive bleeding Total and differential count PID ESR Platelet count,BT,CT-Pubertal menorhagia Serology-VDRL,australia antigen,HIV

URINALYSIS. Urine routine and microscopy, Physical examination, Chemical estimation of protein and sugar, Pus cells,casts. Culture and drug sensitivity, Indications-Pus cells, UTI Cystocele Urinary complaints Fistula, Urine pregnancy test– for diagnosis of pregnancy

URETHRAL DISCHARGE Method of collection Urethra squeesed against symphysis pubis from behind forwards using sterile gloved fingers, Discharge through external urethral meatus collected with sterile swabs, Swabs-microscopy and culture

Methods of urine collection Midstream collection, Catheter collection, Suprapubic bladder puncture.

Vaginal discharge Method of collection Patient not to have vaginal douche for 24hrs, Cusco's bivalve speculum introduced, Discharge from posterior fornix on the blade of speculum or cervical canal taken with a swab, microscopic examination-Discharge mixed with normal saline culture

Identification of organisms in the slide.Normal discharge-normal vaginal cellswith doderle in bacilli, Trichomonal vaginalis-hanging droppreparation shows motile flagellatedorganisms of varying shape, Gardnerella vaginosis(bacterial/nonspecific vaginitis)-clue cells,fewinflammatory cells,free floating clumps ofgardnerella,scanty lactobacilli

Vaginal candidasis Vaginal discharge + equal amount of 10% KOH, Caustic potash dissolves all cellular debris,leaving behind more resistant yeast like organisms, Typical hyphae,budding spores or mycelia detected

EXFOLIATIVE CYTOLOGY- PAPANICOLAOU TEST Pap test-Screening test for cancer, First described by Papanicolaou and Traut in 1943, Routine gynaecological examination in females,esp above 35 years, Yearly screening for 3 years followed by 5 yearly test, Uses-1.screening for cancer 2.identification of local viral infections like herpes andcondyloma accuminata3.Cytohormonal study.