VAGINAL BLEEDING

Question 1

Dysfunctional uterine bleeding DDx:

5

Answer 1

1. Coagulation disorder (vWD, hemophilia).
2. Cervical cancer.
3. Moral pregnancy.
4. Hypothyroidism.
5. DM.

Question 2

Dysfunctional uterine bleeding workup:

10

Answer 2

1. Urine hCG.
2. Pelvic exam.
3. Cervical culture.
4. Pap smear.
5. CBC.
6. ESR.
7. Glucose.
8. PT/PTT.
9. LH/FSH, TSH, prolactin.
10. US pelvis.

Question 3

Endometrial cancer DDx:

5

Answer 3

1. Cervical cancer.
2. Atrophic endometrium.
3. Endometrial hyperplasia.
4. Endometrial polyps.
5. Atrophic vaginitis.

Question 4

Endometrial cancer workup:

7

Answer 4

1. Pelvic exam.
2. Pap smear.
3. Endometrial biopsy.
4. Endometrial curettage.
5. US pelvis.
6. Colposcopy.
7. Hysteroscopy.

Question 5

Cervical cancer DDx:

4

Answer 5

1. Endometrial cancer.
2. Cervical polyp.
3. Cervicitis.
4. Trauma (eg cervical laceration).

Question 6

Cervical cancer workup:

5

Answer 6

1. Pelvic exam.
2. Pap smear.
3. Colposcopy and biopsy.
4. HPV testing.
5. Endometrial biopsy.

Question 7

Spontaneous abortion DDx:

2

Answer 7

1. Ectopic pregnancy.

2. Molar pregnancy.

Question 8

Spontaneous abortion workup:

6

Answer 8

1. Urine hCG.
2. Quantitative serum hCG.
3. US abdo/pelvis.
4. Pelvic exam.
5. CBC.
6. PT/PTT.

Question 9

Ectopic pregnancy DDx:

3

Answer 9

1. Ruptured ovarian cyst.
2. Ovarian torsion.
3. Pelvic inflammatory disease.

Question 10

Ectopic pregnancy workup:

5

Answer 10

1. Urine hCG.
2. Quantitative serum hCG.
3. US abdo/pelvis.
4. Pelvic exam.
5. Cervical cultures.