Amennorrhea

HISTORY_LIST
age of menarche
date of last menstrual period (LMP)
never had a period
regular cycle length between periods
metorrhagia
normal cycle length =
length of bleeding time regular
length of bleeding time irregular
bleeding time =
scant flow
moderate flow
severe flow (menorrhagia)
number of pads per day
no pain during periods
scant pain during periods
moderate pain during periods
severe pain during periods
galactorrhea
sexually active
birth control method
birth control pills
rhythm method
condoms
diaphragm (IUD)
Depo-Provera
Norplant
symptoms of pregnancy
obesity
recent head injury
menopause
symptoms of menopause
INFECTIOUS DISEASES
STD's
post partum infections
CHRONIC DISEASES OR DISORDERS
thyroid dz.
SURGERY/PREVIOUS HOSPITALIZATIONS
D & C
post partum hemorrhage 
PREVIOUS TESTS
pregnancy
TRAUMA OR INJURIES
head injury
SOCIAL HISTORY
smoking
alcohol
caffeine
illicit drugs - cocaine
ALLERGY
medications
foods
seasonal
FAMILY HISTORY
genetic abnormalities

MEDS_LAB_TESTS
**** MEDS
phenothiazines
alpha-methyldopa
estrogen
progesterone
tricyclic antidepressants
opiates
**** LAB
urine or serum pregnancy test
Electrolytes
prolactin
FSH
LH
estadiol
LFT's
TSH
T3
T3RU
T4
**** TESTS
MRI of head

REVIEW_OF_SYSTEMS_1
GENERAL
weight changes
appetite changes
anorexia
difficulty sleeping
fever
chills
polyphagia
hypophagia
changes in thirst
sleeping habit change
bowel habit change
fatigue
hypertension
previous physical exams
SKIN
pigmentation changes
texture changes
lesions
eruptions
pruritis
easy bruising
easy bleeding
unusual hair loss
changes in hair distribution
skin masses
finger/toe nail change
rashes
hives
striae
skin atrophy
uremic frost
hirsutism
plethora
neurofibromatosis lesion
HEENT
head trauma
skull fractures
head masses
hearing loss
vertigo
chronic ear infection
ear discharge
ear pain
hearing aid use
loss of vision
recent change in vision
photophobia
diplopia (double vision)
glaucoma
exudates
dry eyes
eye pain
cataracts
eye surgery
itchy eyes
excessive tearing
corrective lenses
nose bleeds
chronic sinusitis
nasal fractures
nasal drainage
polyps
changes in sense of smell
edentulous (without teeth)
partial plate
full plate
recent dental work
oral lesions
tonsillitis
strep throat
tongue problems
voice changes
chronic hoarseness
chronic halitosis
NECK
neck masses
enlarged thyroid gland
brachial cleft cysts
neck injury

REVIEW_OF_SYSTEMS_2
CHEST
chronic coughing
sputum production
hemoptysis
wheezing
pneumonia
bronchitis
TB
TB exposure
SOB (altered by position?)
edema
chest pains
pacemaker
HEART
MI
coronary artery disease
heart murmur
heart valve disease
left ventricular hypertrophy
mistral valve stenosis
pericarditis
palpitations
DOE
paroxysmal nocturnal dyspnea
orthopnea
edema
hypertension
rheumatic fever
cardiomyopathy
ectopic heart beats
arrhythmia
exercise intolerance
claudication
heart medications
ABDOMEN
abdominal pain
nausea
vomiting
diarrhea
constipation
hematochezia
hematemesis
hemorrhoids
GI x-rays
GI scopings
rectal bleeding
ulcers
bowel polyps
bowel incontinence
gall bladder disease
gall stones
hepatitis
cirrhosis
hepatomegaly
splenomegaly
GU
renal insufficiency
renal failure
dialysis
kidney stones
kidney disease
kidney cyst
flank pain
hematuria
pyuria
dysuria
chronic cystitis
nocturia
anuria
hesitancy
enuresis
change in urine color
prostatitis
epididymitis
scrotal problems
TURP
pain on intercourse
genital lesions
genital discharge

REVIEW_OF_SYSTEMS_3
OB/GYN
Gravida
Para
miscarriages
abortions
living children
metorrhagia
menorrhagia
irregular menses
problems in pregnancy
use of contraception
breast masses
nipple discharge
breast skin changes
changes in axillary nodes
monthly breast exam
breast feeding children
EXTREMITIES
difficulty with gait
weakness
joint swelling
joint stiffness
muscle pain
muscle swelling
muscle injuries
sagittal plan scoliosis
coronal plane scoliosis
fractured bones
SLE
osteoarthritis
rheumatoid arthritis
fibromyalgia
NEURO
seizures
head injury
LOC
loss of coordination
difficulty in balance
sciatica
difficulty in fine motor skills
difficulty speaking
CVA (stroke)
weakness in arms
weakness in legs
tingling in legs and feet
tingling in arms
PSYCHIATRIC
depression
bipolar disorder
suicide attempts
psychiatric hospitalizations 
personality disorders
ENDOCRINE
goiter
exophthalmos
dry skin
dry hair
intolerance to heat
intolerance to cold
changes in growth
sterility
impotence
decreased libido
LYMPHATIC AND HEMATOLOGICAL
lymphadenopathy
transfusion
anemia


PHYSICAL_EVAL_1
VITALS
BP
Pulse
Temp
GENERAL
rate of bleeding
obesity
SKIN
acne
hirsutism
alopecia
HEENT
papilledema
optic atrophy
NECK
thyroid palpable
thyroid nodules
trachea midline
trachea shifted
CHEST
breast development by Tanner staging
Tanner Stage I (Preadolescent
   - no breast buds)
Tanner Stage II (Breast & papilla
   - small mounds)
Tanner Stage III (Breast & aerola
  enlarged; - no contour separation
Tanner Stage IV (Areola & papilla 
   form secondary mound)
Tanner Stage V (Mature breast)
normal symmetry and 
   contour of breast
asymmetry and contour of breast
discharge form nipple
breast mass
breast tenderness
HEART
Rate and rhythm are regular
GU
Pubic hair by Tanner staging
Tanner Stage I 
	(Preadolescent - no hair)
Tanner Stage II (Sparse &
   - lightly pigmented hair)
Tanner Stage III (Darker, beginning 
  to curl, increased amount of hair
Tanner Stage IV 
	(Coarse, curly, abundant
   	hair but less than adult)
Tanner Stage V 
 Full adult hair triangle,
 spread to medial surface of thighs
RECTAL
guaiac (occult blood)

PHYSICAL_EVAL_2
OB/GYN
vaginal dryness
vulvar nodules
vaginal obstruction
uterine enlargement
uterine tenderness
uterine myomas
cervical tenderness on movement
adnexal masses
adnexal tenderness
ovarian cysts
ovarian tumors



DIFF_DIAGNOSIS
PRIMARY OVARIAN FAILURE
Gonadal dysgenesis
SECONDARY OVARIAN FAILURE
Pituitary prolactinoma
ENDOCRINE DZ.
estrogen secreting tumor
androgen secreting tumor
polycystic ovarian syndrome
OTHERS
Hypogonadotropic dysfunction
Hypothalamic dysfunction
Anorexia nervosa
Psychogenic
Outflow tract abnormalities
Intrauterine synechiae 
  (Asherman's syndrome)


