An 18-Year-Old Woman Comes to the Office Due to Lower

question 369

Multiple Choice

An 18-year-old woman comes to the office due to lower abdominal pain that radiates to her lower back and thighs during menses.  The patient had no pain while on oral contraceptives but stopped taking them 5 months ago due to unscheduled breakthrough bleeding.  Menstrual periods now occur every 30 days with 5 days of bleeding.  The pain and bleeding are worse on the second day, requiring the patient to change her pad every 4 hours.  She also has nausea and fatigue during the first 2 days of menses.  The patient is sexually active with a male partner and uses condoms inconsistently.  She has no intermenstrual bleeding or pain with intercourse.  Vital signs are normal.  BMI is 19.5 kg/m².  Pelvic examination reveals a small, mobile uterus and no palpable adnexal masses.  Which of the following is the most likely diagnosis in this patient?

• A)Adenomyosis
• B)Endometriosis
• C)Intermittent ovarian torsion
• D)Pelvic congestion syndrome
• E)Primary dysmenorrhea
• F)Uterine leiomyoma

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Definitions:

Environmental Factors

Aspects of the surroundings that can affect processes, behaviors, and development, encompassing both natural and human-made influences.

Human Development

The multidisciplinary study of how people change and how they remain the same over time, considering physical, cognitive, social, and emotional aspects.

Gerontology

The study of aging and the problems that elderly individuals encounter.

Maturational Studies

Research studies that focus on how an individual's behavior changes as they age, emphasizing the role of genetic factors and biological processes.