53-year-old woman comes to the emergency department due to heavy vaginal bleeding The bleeding started yesterday as dark
brown vaginal spotting and has increased to now soaking a thick menstrual pad every 2 hours. Menarche was at age 14. Menopause
was at age 45 and the patient has had no prior episodes of vaginal bleeding since then. She smoked half a pack of cigarettes daily for
20 years; she does not use alcohol or illicit drugs The patient’s mother died of breast cancer at age 77. Blood pressure is 110/70 mm
Hg and pulse is 94/min. BMI is 37 kg/m2 The abdomen is obese, soft, and nontender, with no rebound or guarding Pelvic
examination shows dark red blood in the posterior vaginal vault and a 3-cm friable mass on the ectocervix and extending laterally
The lesion is actively bleeding Hemoglobin is 10.2 g/dl Pelvic ultrasonography reveals a thin endometrial stripe and no adnexal
masses. Which of the following is a risk factor for this patient’s condition?
- QA Chronic anovulation
- 0 B. Delayed menarche
- 0 C. Early menopause
- 0 D. Endometriosis
- 0 E. Family history
- 0 F. Obesity
- 0 G. Tobacco use
- 0 H. Use of progestin intrauterine device
0 voters