Short case study

Present History:
Sama mohamed, a 21 year old single patient who lives in Nefisha. She works in a

s
clothes shop and have no special habits of medical importance. She is not married.
Complaint:
She presented to the outpatient clinic complaining of irregular menses of 3 months
Subjective duration.
Present History:
The patient was normal when she noticed change of her menstrual pattern 3 months
ago. She suffers from metrorrhagia as her last menstrual period was on 31/12 and then
she came to the outpatient clinic on 24/3 stating that she has her menses. It developed
with acute onset and intermittent course with no aggravating or relieving factors. It’s
fresh blood with clots but not associated with pain. The amount is the same as her
normal menses (2soaked pads/day).
The condition is associated with discharge of small amount which is odorless, white in
color and thin in consistency. There is no itching.
Review of other systems was irrelevant.

Examination:
-General:
No pallor or signs of anemia

o
objective
Pulse rate: 85 beats\min
RR: 16 beats/min
Temperature: 36.8ºC
Blood pressure: 125\85
*Abdominal:
No masses are detected

metrorrhagia

A
assesment
 :Management
:during attack*
antifibrinolytics: tranexamic acid 500mg orally-

P
plan
NSAIDS:mefanimic acid 500mg orally three times daily-
:hormonal therapy*
OCPS: for 21days/month-
gestagens: 10mg orally daily-
:surgical treatment*
D&C