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Endometrial cancer evaluation — USMLE Step 3 MCQ

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ModerateOB/GYN (prenatal care, contraception, screening)Endometrial cancer evaluationUSMLE Step 3

A 56-year-old woman who completed menopause 5 years ago reports 2 episodes of painless vaginal bleeding. She has obesity and hypertension. Pelvic examination shows no cervical lesion. Transvaginal ultrasound shows endometrial thickness of 8 mm. Which of the following is the most appropriate next step in management?

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Correct answer: C — Perform endometrial biopsy

Postmenopausal bleeding with thickened endometrium requires endometrial sampling to evaluate for hyperplasia or cancer.

Reference: ACOG Evaluation of Postmenopausal Bleeding