06-11-2007, 10:53 AM
For each patient with vaginal bleeding, select the
most likely
diagnosis.
A
) Bacterial vaginosis
B
) Precocious puberty
C
) Urinary tract infection
D
) Vaginal foreign body
E
) Vaginal laceration
F
) von Willebrand's disease
21. A 12-year-old girl is brought to the physicianby her mother
because of heavy vaginal bleeding since her first
menstrual period began 1
week ago. She has to change sanitary pads every 2
hours, and her
mother is concerned that this is not normal. Her
blood pressure is 80/60 mm
Hg, and pulse is 110/min. Breast and axillary and
pubic hair
development are Tanner stage 4. Pelvic examination
shows normal external
genitalia, a small normal-appearing cervix, and a
small uterus. Her
hemoglobin level is 7 g/dL.
22. A 7-year-old girl is brought to the physician
by her mother 4
hours after she noticed that her daughter had blood on
her underwear.
She has no signs of sexual development. Examination
shows normal
external genitalia. There is a foul-smelling
discharge.
most likely
diagnosis.
A
) Bacterial vaginosis
B
) Precocious puberty
C
) Urinary tract infection
D
) Vaginal foreign body
E
) Vaginal laceration
F
) von Willebrand's disease
21. A 12-year-old girl is brought to the physicianby her mother
because of heavy vaginal bleeding since her first
menstrual period began 1
week ago. She has to change sanitary pads every 2
hours, and her
mother is concerned that this is not normal. Her
blood pressure is 80/60 mm
Hg, and pulse is 110/min. Breast and axillary and
pubic hair
development are Tanner stage 4. Pelvic examination
shows normal external
genitalia, a small normal-appearing cervix, and a
small uterus. Her
hemoglobin level is 7 g/dL.
22. A 7-year-old girl is brought to the physician
by her mother 4
hours after she noticed that her daughter had blood on
her underwear.
She has no signs of sexual development. Examination
shows normal
external genitalia. There is a foul-smelling
discharge.