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Old 08-09-2013
XpaezX's Avatar
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Smile OB/GYN question #6

A 16 y/o girl comes to the office because of irregular vaginal spotting. Her menstrual periods have always been normal and she has never had bleeding between periods in the past. She has no other medical complains and takes no medications besides a daily oral OCP you prescribed 2 months ago. She has no known drug allergies. PE including pelvic examination is within normal limits. A urinary pregnancy test is negative. At this time you should.
A. Perform endometrial biopsy.
B. Discontinue OCP;s
C. Perform a Pelvic USG.
D. Perform a Vaginal USG.
E. Determine FSH/LH levels.
F. Perform free androgen levels.
G. Reassure and observe.
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Old 08-09-2013
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Quote:
Originally Posted by XpaezX View Post
A 16 y/o girl comes to the office because of irregular vaginal spotting. Her menstrual periods have always been normal and she has never had bleeding between periods in the past. She has no other medical complains and takes no medications besides a daily oral OCP you prescribed 2 months ago. She has no known drug allergies. PE including pelvic examination is within normal limits. A urinary pregnancy test is negative. At this time you should.
A. Perform endometrial biopsy.
B. Discontinue OCP;s
C. Perform a Pelvic USG.
D. Perform a Vaginal USG.
E. Determine FSH/LH levels.
F. Perform free androgen levels.
G. Reassure and observe.
G..>Reassure and observe
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Old 08-09-2013
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Reassure and observe....looks like breakthrough bleeding due to OCP's
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Old 08-10-2013
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The correct answer is G. Reassure and observe.

As anomali and Kais perfectly described.. This patient is experiencing the most common adverse effect of OCP's, which is vaginal spotting. Which can be present in up to 70% of women who begin taking OCP's. This patient previously had regular normal periods, however since she started taking the OCP's the vaginal spotting happened, which can be linked in time with the beginning of OCP's. Reassurance and observation is all that is needed.
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