Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Regular menstrual periods and absence of other symptoms would seem to rule out a problem related to pregnancy.
• Absence of bowel and urinary symptoms would seem to rule out these as sources of perineal blood.
• Absence of symptoms related to the perineum would seem to rule out dermatitis and other cutaneous causes. This can be confirmed by physical exam.

• Most likely source for the blood would be cervix or vagina.
• History of post-coital bleeding suggests some degree of trauma is involved.