A 50-year-old G3P3 comes to the office due to heavy periods, spotting between menses, fatigue and weakness. Over the past six to
eight months, she has noticed a significant increase in the amount of her menstrual bleeding, currently requiring a box of 30 pads for each month. She has noticed an increase in the amount of blood clots and cramping pain during menses. Her previous history is significant for hypertension for 10 years, controlled with hydrochlorothiazide and a postpartum bilateral tubal ligation 20 years ago. She has no history of abnormal Pap smears and no sexually transmitted infections. Blood pressure is 138/84; pulse 82; respirations 20; weight 220 pounds; height 68 inches. On pelvic exam, uterus is approximately 10-week size. She is nontender on bimanual exam and no adnexal masses are appreciated. A Pap smear one month ago was normal, and her hematocrit is 29 and she is asymptomatic. What is the next best step in the management of this patient?A. HysterectomyB. Endometrial biopsyC. ErythropoietinD. Blood transfusionE. Endometrial ablation
The next best step in the management of this patient is endometrial biopsy. Endometrial biopsy is when a small piece of tissue is removed from the endometrium of the patient.
The removed tissue is then examined by the medical practitioner in order to determine any abnormalities in the cell and thereby form a diagnosis. This will be vital to get the necessary information that'll be used in taking care of the patient.
The environment that the bacterial cell is in can affect plasma membrane stability. The cell must constantly adjust the chemistry of its plasma membrane in order to maintain homeostasis.
