Given these changes from the original case, what is your diagnosis?
What is your diagnostic explanation?
As compared to the long case, this patient is a 57 year old female presenting with the chief complaint of abnormal vaginal bleeding. She states that she has had intermittent vaginal bleeding for the past couple of days. She has only needed a light pad throughout these days. She is concerned because her last menstrual period was at the age of 53. She is sexually active with her husband, and they do not use contraception. She is nulliparous. Her last pap smear was 1 year ago, and she has never had an abnormal pap smear or any STIs. She denies any dyspareunia, dysuria, hot flashes, fever/chills, abdominal pain, weight loss/gain, constipation, diarrhea, and nausea/vomiting. She has never experienced similar symptoms before.
VS: Temp 98.6, HR 80, BP 136/78, RR 14, Height 5’5”, Weight 185, BMI 30.8
General: Alert and oriented. No acute distress.
Abdomen: Soft, non-distended. Bowel sounds present. No tenderness to light/deep palpation.
Genital: Normal appearing external genitalia. Cervix appears smooth without any lesions or masses.
Vaginal vault is pink without lesions or masses. Bimanual exam unremarkable.
Labs: Endometrial biopsy-endometrioid adenocarcinoma