A 44yo woman complains of heavy bleeding per vagina. Transvaginal US was done and normal.
Which of the following would be the most appropriate inv for her?
a. Hysterectomy
b. Endometrial biopsy
c. CBC
d. High vaginal swab
e. Coagulation profile
answer: E
Bleeding in a woman of this age should lead us to exclude endometrial cancer, this was done as the TVS was normal, if it showed endometrial thickness >4mm we would do a biopsy
High swab would be good if we suspected PID but no discharge, pelvic pain, older age, normal TVS makes it unlikely
Coagulation profile should be checked
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