A 15 year old girl is brought to the Emergency Department by her mother on day 2 of her period because of heavy vaginal bleeding. She had her first period at 14 but that her periods have remained very irregular and heavy and it is nearly 8 weeks since the last one. She has no medical problems, has no personal or family history of bleeding dyscrasia, and takes no medications. Though she has a regular boyfriend she denies any sexually activity. On examination, T 37°C, PR 96/min, BP 110/70 mm Hg, and RR 12/minute. She has a BMI of 22 and some mild facial acne. Gynaecological examination reveals an intact hymen. Urine β-hCG is negative. Haemoglobin is 108 g/L (115-165). Which of the following options would be the most appropriate management?

Question

A 15 year old girl is brought to the Emergency Department by her mother on day 2 of her period because of heavy vaginal bleeding. She had her first period at 14 but that her periods have remained very irregular and heavy and it is nearly 8 weeks since the last one. She has no medical problems, has no personal or family history of bleeding dyscrasia, and takes no medications.  Though she has a regular boyfriend she denies any sexually activity. On examination, T 37°C, PR 96/min, BP 110/70 mm Hg, and RR 12/minute.  She has a BMI of 22 and some mild facial acne. Gynaecological examination reveals an intact hymen. Urine β-hCG is negative.  Haemoglobin is 108 g/L (115-165). Which of the following options would be the most appropriate management?

Accepted Answer

Commence a low dose combined oral contraceptive pill.

Answer

Admit for diagnostic laparoscopy.

Answer

Admit for laparotomy.

Answer

Outpatient hysteroscopy.

Answer

Repeat haemoglobin in 3 months.

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A 15 year old girl is brought to the Emergency Department by her mother on day 2...

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