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pt. is a 35 year old female. presents to clinic with c/o heavy, irregular menses. She reports she has been having difficult menstrual periods for 3 or 4 years. Pt. states she has been wanting to have a baby. She has not used any contraception for 5 months. Since her menses is irregular, she sometimes does not get a menstrual cycle for 8 weeks, but then when she buys the kit to check for pregnancy, it is negative; then she gets a heavy cycle sometimes with small clots. She has never had a pelvic exam and knows very little about her family history, except that she herself was a large baby weighing over 9 pounds. pt. is a cashier and spends a lot of time on her feet. She feels tired and frustrated. PT. reports acne and chin hair.
Vital Signs: 141/88, 82, 16, 98.2 weight 240 height 64in General: Obese, good hygiene Head/Neck: Thyroid
What are some of your differential diagnoses in this case?
What other information would you seek from this patient?
What tests or diagnostic tools would you consider in this case, if any?
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