Pretest

Please select the appropriate answer for each option and click the "submit" button.


An 18-year-old woman is in your office complaining of heavy menstrual bleeding (HMB) associated with cramping. She states that her periods occur at regular intervals but last 10 days each month. She averages 18 pads per day, which interferes with her playing college field hockey. She has no other history of bleeding disorders and her physical exam is unremarkable. Which of the following tests would you order to further evaluate this patient's HMB?

βhCG
CBC
Coagulation panel
Transvaginal ultrasound
Hysteroscopy

The patient's physical exam is unremarkable; she has a normal size uterus. Blood work shows a negative βhCG, Hgb=10.2. Transvaginal ultrasound demonstrates no evidence of organic pathology. In addition to iron supplementation, which of the following therapeutic options should be considered as initial therapy for this patient?

Nonsteroidal anti-inflammatories (NSAIDs)
Oral tranexamic acid
Combined oral contraceptives (COCs)
Myomectomy
Uterine fibroid embolization