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Bloomberg School BIO 624 - GENERAL INFORMATION

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WOMEN'S INTERAGENCY HIV STUDYQUESTION BY QUESTION SPECIFICATIONSGYNECOLOGICAL EXAMFORM 8GENERAL INFORMATIONAffix participant's ID label to form, or, if ID label is not available, record the ID number in the space provided.Record the WIHS Study Visit number. The form version is pre-printed. Use the form version dated 04/01/99.Record initials of the examiner.Record the date the gynecological exam is performed – including the month, day and year. Example: 06/06/95.Verify with participant her date of birth and record the month, day and year in the space provided.Record the actual time you began to perform the gynecological exam. Remember to use leading zeros, e.g., 08:00. Circle the code indicating AM (1) or PM (2). Record the actual time you ended the gynecological exam. Remember to use leading zeros, e.g., 08:00. Circle the code indicating AM (1) or PM (2). Please Note: This information is to be entered upon completion of the gynecological exam.SECTION A: GYNECOLOGICAL EXAMA number of vaginal and cervical specimens are collected during the GYN exam. Refer to the Gynecological Exam section of the WIHS Manual of Operations for the order and method of collection and tests to be performed.A1. EXTERNAL GENITALIAA1a–e:Prior to inserting a clean vaginal speculum, examine the thighs, pubis, vulva, perineum, and perianal region and record your findings in each location. Circle "1" if "NORMAL," "2" if "ABNORMAL" and "3" if "NOT DONE." If any item "a–e" is abnormal, go to PROMPT.PROMPT: COMPLETE LESION CHART (LOCATED AT A19, PAGE 3) AFTER COMPLETING THE EXAM.A2. VAGINAWIHS QxQ Form 8: Gynecological Exam – 04/01/99aPage 1 of 7A2a–b:Assess the vaginal mucosa for erythema and atrophy. Circle "1" if "PRESENT," "2" if "ABSENT."A3. Record vaginal pH. Use a leading zero if necessary.A4. Assess vaginal discharge volume and circle appropriate response code. Circle "1" if "NORMAL," "2" if "INCREASED."A5. Assess vaginal discharge color and circle appropriate response code.A6. Assess vaginal discharge character and circle all appropriate response codes. More than one code may be circled.CERVICAL EXAMINATIONA7. We are interested in knowing whether the cervix is present or absent. Circle the appropriate response code. If cervix is absent, skip to A14.A8. We would like to know if the cervical exam was done. If "DONE," circle "1" and proceed to A9. If "NOT DONE," circle "2," specify the reason why in 25 characters or less and skip to A12.A9a. Assess the presence and severity of any cervical lesions. If "ABSENT," circle "2" and proceed to A9b. If "PRESENT," circle "1." COMPLETE LESION CHART (LOCATED AT A19, PAGE 3) FOR ANY LESIONS PRESENT AFTER COMPLETING THE EXAM.A9b. Assess the presence of any visible ectopy. If "ABSENT," circle "2" and proceed to A9c. If "PRESENT," circle "1."A9c. Assess the presence of any friability. If "ABSENT," circle "2" and proceed to A10. If "PRESENT," circle "1."A10. Assess the presence of cervical exudate and circle appropriate response code. If there is nocervical exudate, circle "2" and skip to A12.A11. Assess cervical discharge color and circle appropriate response code.A12. Assess the presence or absence of cervical motion tenderness and circle the appropriate response code. UTERINE EXAMINATIONA13. We are interested in knowing whether the uterus is present or absent. Circle the appropriate response code. If uterus is absent, skip to A14.A13a. Assess the presence or absence of uterine tenderness and circle the appropriate response code.A13b. Assess the presence or absence of uterine enlargement and circle the appropriate response code.WIHS QxQ Form 8: Gynecological Exam – 04/01/99aPage 2 of 7ADNEXAL EXAMINATIONA14. We are interested in knowing whether the adnexae are present or absent. Circle the appropriate response code. If adnexae are absent, skip to A15.A14a. Assess the presence or absence of right adnexal tenderness and circle the appropriate response code. A14b. Assess the presence or absence of left adnexal tenderness and circle the appropriate response code. A14c. Assess the presence or absence of a right adnexal mass and circle the appropriate responsecode.A14d. Assess the presence of absence of a left adnexal mass and circle the appropriate response code.A15. Assess the presence or absence of any cul-de-sac mass and circle the appropriate reponse code.A16. ANUSA16a. Assess the presence or absence of any external hemorrhoids. Circle appropriate response code and proceed to A16b.A16b. Assess presence or absence of rectal discharge. Circle appropriate response code and proceed to A16c.A16c. Assess the presence or absence of anal tenderness. Circle the appropriate response code and proceed to A17.A17. We would like to know if the rectal exam was done. Circle the appropriate response code.A18. Assess the presence or absence of an anal fissure. Circle the appropriate response code.GYNECOLOGICAL EXAM & ABNORMALITY/LESION CHARTThe following are definitions of the numbered regions on the abnormal lesion chart at A19 on page 3:The labia majora (locations 1 and 2) extend from the area of the clitoris (13) posteriorly to the perineum (7 and 8). The lateral aspects are covered with pubic hair. The inner aspects of the labia majora are not hair-bearing, but may have prominent sebaceous glands. The labia majora are separated from the labia minora (3 and 4) by the interlabialsulcus. The labia minora are covered by keritonized squamous mucosa and extend from the region of the clitoris to the introitus (5 and 6).Anteriorly, covering the pubic synthesis, is the mons pubis (15). Lateral to the pubis are the inguinal regions (9 and 10). The inner thighs (11 and 12) are lateral to the hair-bearing regions of the labia majora.WIHS QxQ Form 8: Gynecological Exam – 04/01/99aPage 3 of 7The urethra (14) and periurethral region is located between the clitoris and vagina introitus and is demarcated laterally by the inner aspects of the labia minora.The perineum (7 and 8) is the region located between the vaginal introitus and anus.The perianal region is the area immediately surrounding the external anal sphincter and is arbitrarily divided into four quadrants: upper left, lower left, lower right and upper right (27, 28, 29 and 30). The internal anal canal (31) is examined via anoscopy (anal colposcopy). The region beyond the perianus blends with the inner thighs (11 and 12).A19. We would like to know if any abnormalities or lesions were found


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