12-28-2008, 11:01 AM
cbc/ cmp/ pt-ptt/ U/A/ stool guaiac test / Blood group and cross match / Serum ESTROGEN, LH, FSH, TSH, Abdominal USG, Cervical culture, gonorrhea and chlamydia / pap/ biopsy [ if Visible lesions of the vulva, vagina, or cervix} --> if needed -- Transfusion of PRBC
endometrial biopsy--office setting --> if -ve D&C, saline infused TVUS, Flexible hysteroscopy directed biopsy and removal of small polyp / [HRT also take progesterone with the estrogen and may have monthly withdrawal bleeding. Again, this is a normal side effect that usually does not require treatment.]
{vagina or vulva pro-- local application of estrogen or HRT.} --> Endometrial hyperplasia---cyclic progesterone / Iron sulfate --> the lining of the uterus may be tested again f/up by endometrial biopsy -->Then do D&C if still abnormal ------
OR If family completed OR If biopsy shows atypia:-----Consult obg----Hyterectomy
endometrial biopsy--office setting --> if -ve D&C, saline infused TVUS, Flexible hysteroscopy directed biopsy and removal of small polyp / [HRT also take progesterone with the estrogen and may have monthly withdrawal bleeding. Again, this is a normal side effect that usually does not require treatment.]
{vagina or vulva pro-- local application of estrogen or HRT.} --> Endometrial hyperplasia---cyclic progesterone / Iron sulfate --> the lining of the uterus may be tested again f/up by endometrial biopsy -->Then do D&C if still abnormal ------
OR If family completed OR If biopsy shows atypia:-----Consult obg----Hyterectomy