06-17-2010, 11:41 AM
For each patient with vaginal bleeding, select the most likely diagnosis.
A) Bacterial vaginosis
B) Precocious puberty
C) Urinary tract infection
D) Vaginal foreign body
E) Vaginal laceration
F) von Willebrand's disease
21. A 12-year-old girl is brought to the physician by her mother because of heavy vaginal bleeding since her first menstrual period began 1 week ago. She has to change sanitary pads every 2 hours, and her mother is concerned that this is not normal. Her blood pressure is 80/60 mm Hg, and pulse is 110/min. Breast and axillary and pubic hair
development are Tanner stage 4. Pelvic examination shows normal external genitalia, a small normal-appearing cervix, and a small uterus. Her hemoglobin level is 7 g/dL.
22. A 7-year-old girl is brought to the physician by her mother 4 hours after she noticed that her daughter had blood on her underwear. She has no signs of sexual development. Examination shows normal external genitalia. There is a foul-smelling discharge.
A) Bacterial vaginosis
B) Precocious puberty
C) Urinary tract infection
D) Vaginal foreign body
E) Vaginal laceration
F) von Willebrand's disease
21. A 12-year-old girl is brought to the physician by her mother because of heavy vaginal bleeding since her first menstrual period began 1 week ago. She has to change sanitary pads every 2 hours, and her mother is concerned that this is not normal. Her blood pressure is 80/60 mm Hg, and pulse is 110/min. Breast and axillary and pubic hair
development are Tanner stage 4. Pelvic examination shows normal external genitalia, a small normal-appearing cervix, and a small uterus. Her hemoglobin level is 7 g/dL.
22. A 7-year-old girl is brought to the physician by her mother 4 hours after she noticed that her daughter had blood on her underwear. She has no signs of sexual development. Examination shows normal external genitalia. There is a foul-smelling discharge.