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Old 11-04-2012
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Arrow Gyrus Daily Questions; Obstetrics & Gynecology #3

A 16-year-old girl had had irregular vaginal bleeding every 1 to 4 weeks since she first started menstruating approximately 10 months ago. The bleeding is usually light but sometimes is heavy. Her last episode of bleeding (moderate in quantity) lasted for about 2 weeks. The next best step is to:

A Perform an endometrial biopsy
B Start oral contraceptives
C Placement of an intrauterine device
D Obtain a pregnancy test
E Obtain a pelvic ultrasound
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Old 11-04-2012
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to check for pregnancy before giving OCPs or not, that is the question



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D Obtain a pregnancy test
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The answer is D
Abnormal uterine bleeding is due to either a structural lesion or a hormonal imbalance. In adolescents, the most common cause for abnormal uterine bleeding is anovulation and pregnancy. Obtaining a pregnancy test is always the first step in the evaluation and management of abnormal bleeding for reproductive age women. Although it is likely that this patient has anovulatory or oligovulatory bleeding and using oral contraceptives may be important for treatment, it is most important to first rule out pregnancy.
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