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A 23-year-old G0P0 woman presents to the office with complaints that she has not had a menstrual cycle in 7 months. Upon further questioning, she states that she has had irregular menses since menarche. She has also noticed an increase in facial hair and acne for many years. She denies any history of medical problems and has a strong family medical history of diabetes. On examination, she is noted to have a normal blood pressure (BP), pulse, respiratory rate, and temperature. She is obese with a body mass index (BMI) of 34 kg/m2. She is noted to have some hirsutism and acanthosis nigricans (of neck and inner thighs). Her pelvic examination is limited by her obesity but normal.
Discuss the major hormones that affect menstrual cycles.
Discuss the healthcare provider’s role in collecting a thorough menstrual history.
Discuss at least 3 differential diagnoses for abnormal uterine bleeding. Provide rationales for why the diagnosis is included and the best way to rule out the differential diagnosis.
Discuss the presumptive (most likely) diagnosis for the patient’s presentation. What is the treatment plan based on this diagnosis? Make sure to support with evidence.
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SCIENCE
HEALTH SCIENCE
NURSING
NURSE N523
