Diagnosing and managing gynecologic conditions


Diagnosingand managing gynecologic conditions

Author’s name

Diagnosingand managing gynecologic conditions

Case 2

Differential diagnoses

The following are the possible differential diagnoses for the clientin case 2 and their explanation.

  1. Adenomyosis – It is a condition whereby glandular tissue that is ectopic is found in the myometrium. It is characterized by abnormal vaginal bleeding and on palpation, there is an abdominal mass that may be firm and large in size.

  2. Endometrial carcinoma-It is the uncontrolled proliferation of endometrial cells, which when unnoticed can be metastatic. Most common signs and symptoms include vaginal bleeding that is not associated with menstrual periods. On palpation, the mass may be non-tender and irregular in shape.

  3. Endometrial hyperplasia-It refers to the massive proliferation of the endometrial cells. It is characterized by enlargement of endometrial tissue.

Possible Diagnoses

  1. Leiomyoma

  2. Endometriosis

  3. Dysfunctional Uterine Bleeding


Leiomyoma- It is a benign neoplasm of the muscular wall of theuterus composed primarily of smooth muscle. It can be multiple andfirm. It can reach 15cm and above in size.

This is the most likely diagnosis forthis lady because of the abnormal vaginal bleeding that isnot associated with menstrual periods. On palpation, it wasfirm and had a 4cm diameter. Leiomyomas are common in sexually activeand reproductive women like this 42-year old lady. More than 50% ofthe cases involve African- Americans.

Treatment and management

The treatment plan will begin with preoperational patient teaching,medication and then surgical management.

Preoperational teaching. I will explain to the client thediagnosis and the purpose of surgery to alleviate anxiety. Prepartionof theatre requirements also ensure successful intraoperationalperiod.

Medical management- Since they are tumors, medical managementhas a little role to play. Phenoxybenzamine, 10mg P.O qD is indicatedfor pain. Gabapentin 300mg P.O qD isalso indicated for pain management. They are also administeredas needed.

Surgical management- Ablation or surgical excision is the mosteffective managementform. It will be done with proper nursing care in the preoperational,intraoperational and postoperational stages.

Education strategies

Advice the patient to undertake frequent check-ups. Thishelps in early diagnosis and management.

Adherence to Regimen- This maximizes theeffectiveness of therapy.

Nutritional adjustments. Nutrition ensures optimal body immunityagainst cancerous cells.

Community diagnosis has to be implemented because other women couldbe suffering in silence.

Media coverage of similar signs and symptoms to ensure that womencome for early diagnosis and treatment.

Avoidance of carcinogenic environments like polluted places.


Office of Research onWomen’s Health (ORWH).(2016).&nbspOrwh.od.nih.gov.Retrieved 26 June 2016, from http://orwh.od.nih.gov/

Office on Women`s Health.(2016).&nbspWomenshealth.gov.Retrieved 26 June 2016, from http://www.womenshealth.gov/index.php

Women`s Health – CDC.(2016).&nbspCdc.gov.Retrieved 26 June 2016, from http://www.cdc.gov/women/