QuestionSBA
QuestionChoice
Postmenopausal bleeding is a red flag for gynaecological malignancy, as well as the fact this patient is losing weight. The fact she is nulliparous is a risk factor for endometrial cancer.
10027791
a
Endometrial cancer
QuestionChoice
Postmenopausal bleeding is a red flag for gynaecological malignancy, as well as the fact this patient is losing weight. The fact she is nulliparous is a risk factor for endometrial cancer. There is no mention of risk factors for cervical cancer such as smoking or multiple sexual partners. Additionally, post-menopausal bleeding should always be considered endometrial cancer until proven otherwise.
10027794
d
Cervical cancer
QuestionChoice
This is the most common cause of postmenopausal bleeding, however, malignancy should be considered and ruled out first. There are also some red flag symptoms in this patient's history such as weight loss.
10027795
e
Vaginal atrophy
QuestionChoice
Cyclical combined HRT can cause vaginal bleeding- it is quite common in the first six months of use. However, this woman has been taking HRT for three years so any side effects are unlikely to start now.
10027792
b
Side effect of HRT
QuestionChoice
There is no mention of bleeding anywhere else in the body, such as recurrent epistaxis, that would suggest a systemic bleeding disorder.
10027793
c
Bleeding disorder
Concept
Chapter
2693
6002
Endometrial cancer
Topic
176
Gynaecology
17956
A 68-year-old woman comes to you complaining of vaginal bleeding. She states she went through menopause over 10 years ago so she is not sure why her periods have suddenly come back. Upon further questioning, she tells you that she has not had a period for 5 years, but before that there was some spotting and irregular bleeding. She thinks she may have lost some weight recently as her clothes feel a bit baggier. She does not have any children and has never been pregnant. She also has been taking hormone replacement therapy (HRT) to help manage her menopausal symptoms for 3 years.

In terms of her current symptoms, what is the most important diagnosis to consider?
a