Abnormal Uterine Bleeding: Test your skills with these 5 questions
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Herbert L. Muncie Jr., MD, is a Professor of Family Medicine in the Department of Family Medicine, LSU Health, New Orleans, Louisiana. Dr. Muncie is also a faculty member of the National Family Medicine Board Review course.

Question 1 of 5

A 48-year-old G2P2 woman presents to your clinic after having 4 months of irregular heavy menses. She says her last menstrual period (LMP) was 10 days ago and lasted 8 days. Two months before that, she had a period that lasted 3 days.

She reports no previous history of abnormal bleeding. She doesn’t take any medication and her physical exam, including a pelvic examination, is normal. A recent complete blood count (CBC) was normal. Her only sexual partner, her husband, had a vasectomy 10 years ago, and she is not pregnant. Her last Pap smear, 2 years earlier, was normal.

Which therapy or evaluation would be the next most appropriate step for this patient?

Endometrial biopsy to rule out cancer.

Two months’ use of a combination oral hormonal contraceptive.

Low-dose estrogen hormone therapy for 1 month.

Vaginal hysterectomy (including cervix but not the ovaries).

This quiz is not accredited for CME.

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