Post-course Quiz-Abnormal Uterine Bleeding

You are seeing a 15 year old girl in your clinic. Her mother reports that she is concerned that her daughter’s periods are irregular. Her daughter had her menarche at 13 years old. She has her menses every four to six weeks. Her menses last for 5-7 days. The patient reports that she changes her menstrual pads every 3-4 hours and sometimes passes small blood clots.

A 17 year old female is scheduled to see you. She reports that her menses have been heavier than usual. Her menarche started at 13 years of age. For 2 years after menarche, her menses occurred once a month and lasted for 5 days. Over the past 2 years, her menses became irregular and now occur every 30-60 days and last for 7-14 days. Today, she reports that she is currently on her menses and that she has been bleeding for the past 3 weeks. She reports passing large blood clots. The patient states that she needs to change her pads every 1-2 hours and they are soaked, when she changes them.

A 13 year old female reports heavy menses. Her menarche occurred at age 12 years. She and her mother report that her menses occur every 30-60 days and last for 7-14 days. She passes small and large blood clots. She denies episodes of presyncope or syncope. She states that she is not bleeding currently. Vital signs are normal and there are no orthostatic blood pressure changes. You obtain a complete blood count and her hemoglobin is 10g/dl and her platelet count is 280,000.

A 14-year-old girl is sent to your medical institution because she is having prolonged heavy menses. The patient is pale, out of breath, and gets tired very quickly after walking. When you see your patient, it has been 30 days of heavy menstrual bleeding. Her mother says that she occasionally observed varying degrees of blood loss during the 30 days, while that morning the mother found her daughter’s mattress was soaked in blood. Which of the following would you prioritize to complete? Choose all that apply.

What are the criteria for dysfunctional bleeding?

By the Armenian protocols and clinical guidelines which of the following conditions is considered a menstrual disorder and requires medical intervention? Choose all that apply.