Question

A 27 year old G0 presents with heavy menstrual periods and pain during menses. Her symptoms began two and a half years ago when she discontinued her oral contraceptive medication so that she could attempt to become pregnant. Her symptoms seem to be getting worse, and her pain is now only minimally controlled with over-the-counter medications. Current medications include escitalopram and as-needed ibuprofen and naproxen. Pelvic examination reveals a nontender, fixed, retroverted uterus. Speculum examination shows small bluish spots in the posterior fornix, but no cervical drainage or discharge. There is moderate uterosacral nodularity on rectovaginal examination. The patient's hematocrit is 30%, and her urine beta-hCG is negative. Which of the following is the most likely diagnosis in this patient?

A. Endometrial carcinoma
B. PID
C. Endometritis
D. Premenstrual dysphoric disorder
E. Endometriosis

Answer 1

The most likely diagnosis in this patient is Endometriosis. It is a condition where the endometrial tissue grows outside the uterus, causing pelvic pain and other symptoms. Treatment options include medication and surgery.

Step-by-step explanation:

The most likely diagnosis in this patient is Endometriosis. Endometriosis is a condition in which endometrial tissue grows outside the uterus. The main symptom is pelvic pain, which can range from mild to severe. Other symptoms may include heavy menstrual bleeding, painful periods, and infertility. Diagnosis is typically made through a combination of medical history, physical examination, and imaging tests. Treatment options include medication for pain management and surgery to remove the abnormal tissue.