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Postmenopausal bleeding — ABIM Board MCQ

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HardWomen's Health/Men's HealthPostmenopausal bleedingABIM Board

A 61-year-old woman has postmenopausal bleeding for 2 weeks. She has obesity and hypertension and has not used hormone therapy. Pelvic examination shows blood from the cervical os without visible cervical lesion. Hemoglobin is 12.4 g/dL. Which of the following is the most appropriate diagnostic study?

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Correct answer: B — Endometrial evaluation with transvaginal ultrasonography or biopsy

Postmenopausal bleeding requires evaluation for endometrial cancer or hyperplasia. Transvaginal ultrasonography to assess endometrial thickness or endometrial biopsy are appropriate initial approaches depending on context and availability.

Reference: ACOG Postmenopausal Bleeding Guidance