Question:
A postmenopausal woman presents with blood-stained discharge. Her BP is 170/100 mm Hg. What is the next best step?
A postmenopausal woman presents with blood-stained discharge. Her BP is 170/100 mm Hg. What is the next best step?
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Postmenopausal bleeding always needs evaluation. Never simply reassure without ruling out malignancy.
Updated On: May 14, 2026
- Reassure
- PV exam, Pap smear, TVUSG
- Refer to cardiologist
- Wait and watch
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The Correct Option is B
Solution and Explanation
Concept:
Postmenopausal bleeding or blood-stained discharge is abnormal and must be evaluated for malignancy, especially endometrial and cervical cancer.
Step 1: Identify the red flag symptom.
Any bleeding after menopause is considered abnormal until proven otherwise.
Step 2: Plan the evaluation.
Initial evaluation includes: \[ \text{Pelvic examination + Pap smear + Transvaginal ultrasonography} \] TVUSG helps assess endometrial thickness.
Step 3: Avoid reassurance or waiting.
Reassurance and wait-and-watch are wrong because malignancy must be ruled out. Therefore, the correct answer is PV exam, Pap smear, TVUSG.
Step 1: Identify the red flag symptom.
Any bleeding after menopause is considered abnormal until proven otherwise.
Step 2: Plan the evaluation.
Initial evaluation includes: \[ \text{Pelvic examination + Pap smear + Transvaginal ultrasonography} \] TVUSG helps assess endometrial thickness.
Step 3: Avoid reassurance or waiting.
Reassurance and wait-and-watch are wrong because malignancy must be ruled out. Therefore, the correct answer is PV exam, Pap smear, TVUSG.
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