phuluong2k
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A 75-year-old woman comes to the physician because of irregular vaginal bleeding. She has been menopausal for the past 25 years, but has noted on-and-off spotting for the past 2 years, which she finds intolerable. She has a complicated past medical history including hypertension, diabetes, and severe chronic obstructive pulmonary disease. Examination is unremarkable. An endometrial biopsy is performed that demonstrates an endometrial polyp with atypical cells that are difficult to grade. Which of the following is the most appropriate next step in management?
A. Hormone replacement therapy
B. Oral contraceptive pill
C. Hysteroscopy
D. Laparoscopy
E. Hysterectomy
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| mani
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E. Hysterectomy
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| phuluong2k
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No one else ?
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| ARJ
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Dear Phuluong I am very much busy nowadays....Plz wait for couple of days before mentioning the answer..............Thank you
seems E. Hysterectomy
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| phuluong2k
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I stick on E too
But answer is C, hysteroscopy to cut the polyps
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| achilles
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i wud have gone for hysterectomy too...whats the explanation phuluong
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| stepkiller
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hmmm. endometrail polps demand hysteroscopy may be
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| DrS
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And in addition this lady has a complicated past medical history which is going to make surgery very risky.
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| achilles
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yes that is another good point that must be considered (which i missed too), the complicated past medical history which was in the question so that we must not pick hysterectomy ...and there are two types of hysteroscopy...a smaller one which can be used inside the office to diagnose and a larger one used to remove the polyp and is done under anaesthesia in the hospital.
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" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
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