👩‍⚕️ Chapter 585 · Gynecologic History & Physical Examination

Nelson Textbook of Pediatrics 22nd Edition — Comprehensive guidance for age-appropriate gynecologic assessment from neonate to adolescent. Includes exam techniques, positioning, normal variants, and common findings. Key focus: neonatal estrogen effects, prepubertal hypoestrogenism, labial traction, vaginoscopy, and adolescent confidentiality.

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📋 30 Clinical Scenarios — Gynecologic History & Exam

📇 High‑Yield Review Cards

🩺 Clinical Presentations: Pediatric & Adolescent Gynecology

Select a presentation for diagnostic clues and approach.

📋 Stepwise Approach: Gynecologic Examination by Age

🔑 Key Principles (Nelson Ch.585)
• Neonatal: Supine frog-leg position, assess hymenal patency, clitoral size (width >6mm or length >6.5mm → further eval).
• Prepubertal: Labial traction, knee-chest position for lower vagina, avoid forcible restraint.
• Adolescent: Confidentiality, chaperone, speculum exam only if indicated (Pap deferred until 21).
• Vaginoscopy: Indicated for foreign body, lesions, or trauma; can use 2% lidocaine gel.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Chapter Summary: Gynecologic History & Physical Examination