April 1, 2009

Per vaginal bleeding in 40 years old female

A 40 years old female presented to your clinic with the history of per vaginal bleeding associated with dysparaeunia, suprapubic pain, loss of appetite and loss of weight. A cervical examination is performed and the picture shows comparison between normal appearance of cervix and patient’s cervix.

1) What other history you would like to ask

2) Describe the picture B

3) What are the investigation that you would like to perform

4) What is the common causative agent for above condition

5) Outline the Pathophysiology of the disease.



- Earlier age sexual activity

-Multiple sexual partner

-Any history of infection with human papilloma virus?

-Family history of cervical cancer

-Did spouse have multiple sexual partner?

- Any history of sexual transmitted disease?

-Did spouse have sexual transmitted disease?

-Smoking, alcohol consumption


- Abnormal shape of cervix

-Irregular vagina mucosa

- Cervical bleeding


-PAP Smear test

-Antibody detection for HPV

4) Human papilloma virus


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