Health, 29.11.2020 14:40 miyah916

A 50-year-old G3P3 comes to the office due to heavy periods, spotting between menses, fatigue and weakness. Over the past six to eight months, she has noticed a significant increase in the amount of her menstrual bleeding, currently requiring a box of 30 pads for each month. She has noticed an increase in the amount of blood clots and cramping pain during menses. Her previous history is significant for hypertension for 10 years, controlled with hydrochlorothiazide and a postpartum bilateral tubal ligation 20 years ago. She has no history of abnormal Pap smears and no sexually transmitted infections. Blood pressure is 138/84; pulse 82; respirations 20; weight 220 pounds; height 68 inches. On pelvic exam, uterus is approximately 10-week size. She is nontender on bimanual exam and no adnexal masses are appreciated. A Pap smear one month ago was normal, and her hematocrit is 29 and she is asymptomatic. What is the next best step in the management of this patient?A. HysterectomyB. Endometrial biopsyC. ErythropoietinD. Blood transfusionE. Endometrial ablation

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A 50-year-old G3P3 comes to the office due to heavy periods, spotting between menses, fatigue and we...

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