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A 16-year-old female comes to the emergency department because of heavy vaginal bleeding. She has no pain. Since menarche, mense have usually been irregular. she has as steady boyfriend and uses condoms for contraception. She has no other medical problems. She does not use alcohol, tobacco, or drugs. Her temperature is 37C (99F), blood pressure is 110/60 mm Hg, pulse is 90/mm, and respirations are 16/min. Physical examination shows continuous vaginal bleeding. Pregnancy test is negative. coagulation studies are within normal limits. Ultrasound shows no abnormalities. Which of the following is the most appropriate next step in management?

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emergency dilatation and curettage High dose medroxyprogesterone Intravenous conjugated estrogens Hysteroscopy Start high dose GnRH agonists.
I choose B. But the correct answer is C. Can anyone tell me why?








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