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: ThyroidWhat 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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