Vaginal Discharge

Differential Diagnosis :  Normal : Lactobacillus 70 % and non-Lactobacillus 30 %

• Bacterial Vaginosis  ----- 50 %
• Candida                    ----- 30 %
• Trich                         ----- 15 % 

Visual inspection : Inflammatory response Vaginal discharge e.g thin-thick gray-white-green,frothy

Vaginal pH : Normal: < 4.5 Use Nitrazine paper

Micro-exam : Wet Prep Saline and KOH

Urinary incontinence types and its treatment

Ask your patient about the symptoms ? 

Bladder diary: Name / Date

Fluids

• type and amount of fluids

Urination 

• Strong urge to urinate (Y,N)
• Amount urinated in toilet (S,M,L)

Accidents

• Amount of leakage (S,M,L)
• Activity preceding leakage

Here are the examples of Urinary incontinence

Submaximal Exercise Testing

Cardiovascular Angiography

Safe Motherhood initiative (ACOG)

These images are provided by ACOG (American Congress of Obstetricians and Gynecologists)

First Line Management with Hydralazine

 First Line Management with Labetalol