A 47-year-old woman has heavy irregular bleeding for 6 months. BMI is 38 kg/m2. Pregnancy test is negative and hemoglobin is 10.2 g/dL. Pelvic exam

Question

A 47-year-old woman has heavy irregular bleeding for 6 months. BMI is 38 kg/m2. Pregnancy test is negative and hemoglobin is 10.2 g/dL. Pelvic exam shows no cervical lesion. Which of the following is the most appropriate next step in management?

Accepted Answer

Perform endometrial sampling

Answer

Treat with antibiotics for 6 months

Answer

Order CA-125 as the first test

Answer

Start estrogen monotherapy without evaluation

Answer

Reassure and repeat evaluation after menopause

Abnormal uterine bleeding — USMLE Step 3 MCQ

A 47-year-old woman has heavy irregular bleeding for 6 months. BMI is 38 kg/m2. Pregnancy test is negative and hemoglobin is 10.2 g/dL. Pelvic exam shows no cervical lesion. Which of the following is the most appropriate next step in management?