STUDENT PROBLEM-BASED LEARNING SESSION
A 56 year-old G0 presents to the clinic with complaints of intermittent vaginal bleeding. She went through the menopause 2 years ago and had no vaginal bleeding until 6 months ago when she had a three day episode of light bleeding. Since that time, she has had another 3 such episodes. Past medical history is remarkable for well-controlled hypertension, depression and “borderline” diabetes for which the patient is on a diet to which she is minimally adherent. She never used contraceptives but was unable to become pregnant. She has had a laparoscopic cholecystectomy. She takes Lisinopril and Zoloft. Her family history is non-contributory. On examination, she has normal vital signs, she weighs 247 pounds. Her heart, lungs and abdominal exams are normal. On pelvic examination, she has normal external genitalia, normal vagina and cervix. The bimanual exam is difficult secondary to the patient's habitus, but the uterus feels slightly enlarged and no adnexal masses are palpable.
Endometrial cancer is the most common malignancy.
The APGO Educational Objectives related to this topic are the following:
*Designated as Priority One in the APGO Medical Student Educational Objectives, 8 th Edition