12-07-2008, 12:39 AM
A 48-year-old woman with a history of migraine headache is evaluated during a routine visit. Her headaches have been less of a problem since she quit taking birth control pills 2 years ago; however, she has had menstrual irregularity for the past 6 months. She noted mid-cycle spotting the first 2 months and about 5 days of mid-cycle heavy bleeding during the third month and again this past month. She wonders whether she should try a different birth control pill to regulate her period.
The patient has no signs or symptoms of illness, and her examination is normal. A pregnancy test is negative.
Which of the following should be done at this time?
( A ) Measure serum thyroid-stimulating hormone.
( B ) Prescribe a low-dose oral contraceptive.
( C ) Perform an endometrial biopsy.
( D ) Prescribe conjugated equine estrogens, 2.5 mg daily for 10 to 21 days.
( E ) Check the INR and platelet count
The patient has no signs or symptoms of illness, and her examination is normal. A pregnancy test is negative.
Which of the following should be done at this time?
( A ) Measure serum thyroid-stimulating hormone.
( B ) Prescribe a low-dose oral contraceptive.
( C ) Perform an endometrial biopsy.
( D ) Prescribe conjugated equine estrogens, 2.5 mg daily for 10 to 21 days.
( E ) Check the INR and platelet count
