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Old 09-22-2011
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Steps History: 1+CK+CS
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Default CCS: atrophic vaginitis



62 yo
vaginal itching
clear discharge
painful intercourse

vulvar erythema
mucus bleed during exam

dd

atrophic vag
bacterial vagi
candidial vagi
vulvar ca
cervicitis
tricho

office work up

cbc cmp lipid profile as a health maintainance exam-safer to do bu no credit

wet prep
trich
gono
chly
pap
may need emb colpo etc if finding in cervix or pap

if pap positive story goes further
otherwise
cou

vaginal gelly for lubrication
local hrt
estrogen cream

follow up as needed

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