Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Rachel is a 15-year-old grade 9 student who has come to the walk-in clinic requesting ‘the pill’. She has been dating John, who has not accompanied her, for 6 months and she feels that it is time for them to have sex. She has never had intercourse. John is 18 and will finish grade 12 this year. Rachel lives with her mother and two younger brothers. She has always been healthy and is on no medications. She states that she smokes occasionally and sometimes drinks. After a discussion regarding the implications of her decision and the issues of the options available, Rachel is given three months of oral contraceptives (OCP) and instructions. There is a plan to follow-up with her family doctor for a refill and a pap smear. Three months later, Rachel experiences heavy vaginal bleeding accompanied by suprapubic pain. She is very frightened and comes to the ER with her mother. She states that she thinks her last period was a month ago but it was not really normal and she has had spotting intermittently since starting the pill. She says that she is not on any other medications but two months ago she was on an antibiotic for 5 days for a bad cough. The antibiotic made her very nauseated.

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Susan Weiss is a 53 year old woman (G3P3) who presents to her family doctor stating she is having difficulty sleeping. She is waking up drenched through the night. She complains of having sweating episodes throughout the day that are debilitating and embarrassing. She is irritable with her family and states they do not understand "the change". It has been 18 months since her last period. She has no libido and when she tries to be intimate with her partner, she is extremely dry.

Rachel is a 15-year-old grade 9 student who has come to the walk-in clinic requesting ‘the pill’. She has been dating John, who has not accompanied her, for 6 months and she feels that it is time for them to have sex. She has never had intercourse. John is 18 and will finish grade 12 this year. Rachel lives with her mother and two younger brothers. She has always been healthy and is on no medications. She states that she smokes occasionally and sometimes drinks. After a discussion regarding the implications of her decision and the issues of the options available, Rachel is given three months of oral contraceptives (OCP) and instructions. There is a plan to follow-up with her family doctor for a refill and a pap smear. Three months later, Rachel experiences heavy vaginal bleeding accompanied by suprapubic pain. She is very frightened and comes to the ER with her mother. She states that she thinks her last period was a month ago but it was not really normal and she has had spotting intermittently since starting the pill. She says that she is not on any other medications but two months ago she was on an antibiotic for 5 days for a bad cough. The antibiotic made her very nauseated.

Intrapartum management of spontaneous labour. Fetal health surveillance in labour. Operative vaginal birth. Indications for caesarean sections. Management of pregnancy at 41+0 to 42+0 weeks

Samira Shah is a 27 year old woman who works as a waitress in a local restaurant and is in her first pregnancy. She is slightly overweight (pre-pregnancy BMI 28.5). Her prenatal care has been unremarkable although she was found to be rubella non-immune and had a positive glucose challenge test (GCT) followed by a negative glucose tolerance test (GTT). Now at 38 weeks, she has abdominal cramping and slight bright red vaginal bleeding. Her husband, Sunny, informs Hanna’s midwife of this. Her midwife comes to their apartment to assess Samira.

Prevalence of Abnormal Uterine Bleeding. Impact of Abnormal Uterine Bleeding (AUB) on Women. Clinical, Economic, and Lifestyle. Pathogenesis of AUB. A brief look at causality. Investigation and treatment of women with AUB. What to do, when to do it.

Mei Wang, a 24-year-old fitness instructor, stopped taking the oral contraceptive pill (OCP) 12 months ago, in order to conceive. She has remained amenorrheic since then. Mei's puberty was appropriate in terms of timing and secondary sexual development. However, she has always had infrequent and at times extremely heavy menstrual bleeding. As a teenager, she was prescribed the OCP to regulate her periods. She has been on the OCP ever since.

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Shalini Mehta is a successful 35-year-old lawyer who married five years ago. Her partner Varun is a 56-year-old judge who left his former wife to be with Shalini. He has three grown children and one grandchild. Varun was never as keen on starting a new family as Shalini, but he loves her and "wants what she wants". For the first three years of their marriage, Shalini continued on the birth control pill, as she wanted to focus on establishing her career further. She states that she had been on the pill since she was 18. Two years ago she stopped the pill and had hopes that she would be trying for her second baby by now.

Rosemary, a 38-year-old G2A1, is seen with her 42-year-old husband for their first antenatal visit. She is 10 weeks 1 day pregnant by an LMP of January 18th. She is sure of the date and her periods were 4 days every 28-30 days. She states that she is trying to eat quite well because she does not believe in taking vitamins. She says that she tries to have a gluten-free diet. Rosemary had a therapeutic abortion when she was 27. She and her husband are both healthy. She is on no medications. Both of their families are from Ireland and they do not know of any family health problems. Their GP discusses issues regarding the pregnancy with them, including dietary issues and the potential benefits of a prenatal vitamin and an iron supplement. Rosemary’s prenatal bloodwork is normal. She is booked for an ultrasound, which is done at 12 weeks. The ultrasound is normal and shows a single embryo with measurements consistent with her LMP. At 17 weeks, her GP calls to tell her that her IPS test is positive for Down syndrome and she would like the couple to go to the University hospital to discuss their options. They are devastated with the news and do not know what to do as they are both Roman Catholic.

Prevalence of Abnormal Uterine Bleeding. Impact of Abnormal Uterine Bleeding (AUB) on Women. Clinical, Economic, and Lifestyle. Pathogenesis of AUB. A brief look at causality. Investigation and treatment of women with AUB. What to do, when to do it.

Discuss and practice the components of the Gynecological and Sexual histories. Pro-Comp Connection – LGBT2SQ+ Patients. LGBTQ2S+ patients in Canada experience worse health outcomes than their heterosexual, cisgender peers.

Shalini Mehta is a successful 35-year-old lawyer who married five years ago. Her partner Varun is a 56-year-old judge who left his former wife to be with Shalini. He has three grown children and one grandchild. Varun was never as keen on starting a new family as Shalini, but he loves her and "wants what she wants". For the first three years of their marriage, Shalini continued on the birth control pill, as she wanted to focus on establishing her career further. She states that she had been on the pill since she was 18. Two years ago she stopped the pill and had hopes that she would be trying for her second baby by now.

Shalini Mehta is a successful 35-year-old lawyer who married five years ago. Her partner Varun is a 56-year-old judge who left his former wife to be with Shalini. He has three grown children and one grandchild. Varun was never as keen on starting a new family as Shalini, but he loves her and "wants what she wants". For the first three years of their marriage, Shalini continued on the birth control pill, as she wanted to focus on establishing her career further. She states that she had been on the pill since she was 18. Two years ago she stopped the pill and had hopes that she would be trying for her second baby by now.

Rachel is a 15-year-old grade 9 student who has come to the walk-in clinic requesting ‘the pill’. She has been dating John, who has not accompanied her, for 6 months and she feels that it is time for them to have sex. She has never had intercourse. John is 18 and will finish grade 12 this year. Rachel lives with her mother and two younger brothers. She has always been healthy and is on no medications. She states that she smokes occasionally and sometimes drinks. After a discussion regarding the implications of her decision and the issues of the options available, Rachel is given three months of oral contraceptives (OCP) and instructions. There is a plan to follow-up with her family doctor for a refill and a pap smear. Three months later, Rachel experiences heavy vaginal bleeding accompanied by suprapubic pain. She is very frightened and comes to the ER with her mother. She states that she thinks her last period was a month ago but it was not really normal and she has had spotting intermittently since starting the pill. She says that she is not on any other medications but two months ago she was on an antibiotic for 5 days for a bad cough. The antibiotic made her very nauseated.

Savita Singh, a 33-year-old married woman, is seeing her physician for amenorrhea. She was suspected of having diabetes mellitus 6 months ago after a round of routine blood tests. The diagnosis of diabetes mellitus was confirmed with repeat testing soon thereafter. Savita was immediately counselled on the importance of lifestyle modification, with special attention to weight loss and exercise at least 3 times per week. Since then, Savita has found it very challenging to integrate these recommendations into her busy lifestyle and says she has “only lost 3 pounds.” Savita has always had irregular menstrual cycles since menarche at age 11, generally having periods once every 1-3 months on average. She could not reliably predict when a period would start or end. Her menses were sometimes very light and sometimes extremely heavy. For the past 6 months, however, she has had no period whatsoever. Savita has never been on any medications. Her family history is significant for type 2 diabetes and premature coronary artery disease, with her father having had a myocardial infarction at the age of 45. On physical examination, Savita has a weight of 77 kg and height of 153 cm. Her abdominal circumference is measured at 93 cm at the umbilicus. There are small skin tags and hyperpigmentation noted at the back of her neck and in both axillae. Her abdomen has some striae but they are pale, thin and not depressed. She has excessive hair growth on the upper arms, upper chest, abdomen, lower back and face with a Ferriman-Gallwey score of 16/36. There is mild acne and her hairline appears to be receding. There are no virilizing signs on exam. Fundoscopic examination reveals changes consistent with early non-proliferative diabetic retinopathy. Examination of the feet does not show any signs of neuropathy.

Mei Wang, a 24-year-old fitness instructor, stopped taking the oral contraceptive pill (OCP) 12 months ago, in order to conceive. She has remained amenorrheic since then. Mei's puberty was appropriate in terms of timing and secondary sexual development. However, she has always had infrequent and at times extremely heavy menstrual bleeding. As a teenager, she was prescribed the OCP to regulate her periods. She has been on the OCP ever since.

Shalini Mehta is a successful 35-year-old lawyer who married five years ago. Her partner Varun is a 56-year-old judge who left his former wife to be with Shalini. He has three grown children and one grandchild. Varun was never as keen on starting a new family as Shalini, but he loves her and "wants what she wants". For the first three years of their marriage, Shalini continued on the birth control pill, as she wanted to focus on establishing her career further. She states that she had been on the pill since she was 18. Two years ago she stopped the pill and had hopes that she would be trying for her second baby by now.

Mei Wang, a 24-year-old fitness instructor, stopped taking the oral contraceptive pill (OCP) 12 months ago, in order to conceive. She has remained amenorrheic since then. Mei's puberty was appropriate in terms of timing and secondary sexual development. However, she has always had infrequent and at times extremely heavy menstrual bleeding. As a teenager, she was prescribed the OCP to regulate her periods. She has been on the OCP ever since.

Susan Weiss is a 53 year old woman (G3P3) who presents to her family doctor stating she is having difficulty sleeping. She is waking up drenched through the night. She complains of having sweating episodes throughout the day that are debilitating and embarrassing. She is irritable with her family and states they do not understand "the change". It has been 18 months since her last period. She has no libido and when she tries to be intimate with her partner, she is extremely dry.

Susan Weiss is a 53 year old woman (G3P3) who presents to her family doctor stating she is having difficulty sleeping. She is waking up drenched through the night. She complains of having sweating episodes throughout the day that are debilitating and embarrassing. She is irritable with her family and states they do not understand "the change". It has been 18 months since her last period. She has no libido and when she tries to be intimate with her partner, she is extremely dry.

Susan Weiss is a 53 year old woman (G3P3) who presents to her family doctor stating she is having difficulty sleeping. She is waking up drenched through the night. She complains of having sweating episodes throughout the day that are debilitating and embarrassing. She is irritable with her family and states they do not understand "the change". It has been 18 months since her last period. She has no libido and when she tries to be intimate with her partner, she is extremely dry.

JoAnne is a 28-year-old G4T1A2L1 Inuk from Baker Lake, Nunavut. Her last menstrual period was February 11. She has a regular, 28-day cycle and had a positive home urine test on March 14. She tells you that she is concerned because she had a DVT in her last pregnancy and was told that she has antiphospholipid antibody syndrome. She has been on warfarin since her son was born 2 years ago. She had 2 miscarriages at 8 and 10 weeks prior to her son being born. She is concerned about the effect of the medicine on her baby and also her risk of developing another clot.

JoAnne is a 28-year-old G4T1A2L1 Inuk from Baker Lake, Nunavut. Her last menstrual period was February 11. She has a regular, 28-day cycle and had a positive home urine test on March 14. She tells you that she is concerned because she had a DVT in her last pregnancy and was told that she has antiphospholipid antibody syndrome. She has been on warfarin since her son was born 2 years ago. She had 2 miscarriages at 8 and 10 weeks prior to her son being born. She is concerned about the effect of the medicine on her baby and also her risk of developing another clot.

JoAnne is a 28-year-old G4T1A2L1 Inuk from Baker Lake, Nunavut. Her last menstrual period was February 11. She has a regular, 28-day cycle and had a positive home urine test on March 14. She tells you that she is concerned because she had a DVT in her last pregnancy and was told that she has antiphospholipid antibody syndrome. She has been on warfarin since her son was born 2 years ago. She had 2 miscarriages at 8 and 10 weeks prior to her son being born. She is concerned about the effect of the medicine on her baby and also her risk of developing another clot.

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

JoAnne is a 28-year-old G4T1A2L1 Inuk from Baker Lake, Nunavut. Her last menstrual period was February 11. She has a regular, 28-day cycle and had a positive home urine test on March 14. She tells you that she is concerned because she had a DVT in her last pregnancy and was told that she has antiphospholipid antibody syndrome. She has been on warfarin since her son was born 2 years ago. She had 2 miscarriages at 8 and 10 weeks prior to her son being born. She is concerned about the effect of the medicine on her baby and also her risk of developing another clot.

Rosemary, a 38-year-old G2A1, is seen with her 42-year-old husband for their first antenatal visit. She is 10 weeks 1 day pregnant by an LMP of January 18th. She is sure of the date and her periods were 4 days every 28-30 days. She states that she is trying to eat quite well because she does not believe in taking vitamins. She says that she tries to have a gluten-free diet. Rosemary had a therapeutic abortion when she was 27. She and her husband are both healthy. She is on no medications. Both of their families are from Ireland and they do not know of any family health problems. Their GP discusses issues regarding the pregnancy with them, including dietary issues and the potential benefits of a prenatal vitamin and an iron supplement. Rosemary’s prenatal bloodwork is normal. She is booked for an ultrasound, which is done at 12 weeks. The ultrasound is normal and shows a single embryo with measurements consistent with her LMP. At 17 weeks, her GP calls to tell her that her IPS test is positive for Down syndrome and she would like the couple to go to the University hospital to discuss their options. They are devastated with the news and do not know what to do as they are both Roman Catholic.

Rosemary, a 38-year-old G2A1, is seen with her 42-year-old husband for their first antenatal visit. She is 10 weeks 1 day pregnant by an LMP of January 18th. She is sure of the date and her periods were 4 days every 28-30 days. She states that she is trying to eat quite well because she does not believe in taking vitamins. She says that she tries to have a gluten-free diet. Rosemary had a therapeutic abortion when she was 27. She and her husband are both healthy. She is on no medications. Both of their families are from Ireland and they do not know of any family health problems. Their GP discusses issues regarding the pregnancy with them, including dietary issues and the potential benefits of a prenatal vitamin and an iron supplement. Rosemary’s prenatal bloodwork is normal. She is booked for an ultrasound, which is done at 12 weeks. The ultrasound is normal and shows a single embryo with measurements consistent with her LMP. At 17 weeks, her GP calls to tell her that her IPS test is positive for Down syndrome and she would like the couple to go to the University hospital to discuss their options. They are devastated with the news and do not know what to do as they are both Roman Catholic.

Intrapartum management of spontaneous labour. Fetal health surveillance in labour. Operative vaginal birth. Indications for caesarean sections. Management of pregnancy at 41+0 to 42+0 weeks

Samira Shah is a 27 year old woman who works as a waitress in a local restaurant and is in her first pregnancy. She is slightly overweight (pre-pregnancy BMI 28.5). Her prenatal care has been unremarkable although she was found to be rubella non-immune and had a positive glucose challenge test (GCT) followed by a negative glucose tolerance test (GTT). Now at 38 weeks, she has abdominal cramping and slight bright red vaginal bleeding. Her husband, Sunny, informs Hanna’s midwife of this. Her midwife comes to their apartment to assess Samira.

One hour after giving birth to baby Varkey, Mrs. Shah states that she feels lightheaded as she sits upright for the first time. Her midwife who has been monitoring her closely following the delivery helps her to lay back down. She notes that Samira is somewhat pale and that her pulse is rapid and thready. She palpates the uterus and finds the fundus is above the umbilicus. As the midwife massages the fundus, a large grapefruit size blood clot is expressed followed by blood that soaks the bed sheets. As summoned help arrives, Samira’s BP is found to be 85/50 and her heart rate 120.

One hour after giving birth to baby Varkey, Mrs. Shah states that she feels lightheaded as she sits upright for the first time. Her midwife who has been monitoring her closely following the delivery helps her to lay back down. She notes that Samira is somewhat pale and that her pulse is rapid and thready. She palpates the uterus and finds the fundus is above the umbilicus. As the midwife massages the fundus, a large grapefruit size blood clot is expressed followed by blood that soaks the bed sheets. As summoned help arrives, Samira’s BP is found to be 85/50 and her heart rate 120.

Li Chin is a 19-year-old woman from Hong Kong who has been in Canada for one year studying Computer Science at McMaster University. She is a known carrier of Hepatitis B, but is otherwise healthy and on no medication. You are a family physician working at Student Health Services at the university. Li came to see you today for a routine prenatal appointment at 28 weeks gestational age. You inquire as to Li's plans for feeding her baby after birth. She is uncertain and has not yet considered this. When you recommend that she breastfeed her baby, she asks why. She doesn’t know anyone who has breastfed. She is uncertain as to whether or not she would be able to do it.

Li Chin is a 19-year-old woman from Hong Kong who has been in Canada for one year studying Computer Science at McMaster University. She is a known carrier of Hepatitis B, but is otherwise healthy and on no medication. You are a family physician working at Student Health Services at the university. Li came to see you today for a routine prenatal appointment at 28 weeks gestational age. You inquire as to Li's plans for feeding her baby after birth. She is uncertain and has not yet considered this. When you recommend that she breastfeed her baby, she asks why. She doesn’t know anyone who has breastfed. She is uncertain as to whether or not she would be able to do it.

Perineum and Pelvis, Male and Female genital organs and breast

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Perineum and Pelvis, Male and Female genital organs and breast

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Perineum and Pelvis, Male and Female genital organs and breast

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Perineum and Pelvis, Male and Female genital organs and breast

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Perineum and Pelvis, Male and Female genital organs and breast

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Perineum and Pelvis, Male and Female genital organs and breast

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Perineum and Pelvis, Male and Female genital organs and breast

Manuel Pereira and his wife have been trying to conceive a child for 16 months. After 12 months of trying, Michelle sought medical advice and so far, her investigations have been negative. You have suggested that since it takes two to make a baby, Manuel should undergo evaluation. Manuel reluctantly attends your clinic. He is quite certain that their inability to conceive can not be "his fault" because he fathered a child, by mistake, when he was 18

Perineum and Pelvis, Male and Female genital organs and breast

Perineum and Pelvis, Male and Female genital organs and breast

Perineum and Pelvis, Male and Female genital organs and breast

Perineum and Pelvis, Male and Female genital organs and breast

Perineum and Pelvis, Male and Female genital organs and breast

Perineum and Pelvis, Male and Female genital organs and breast

Perineum and Pelvis, Male and Female genital organs and breast