Problem:
A 47-year-old woman presents to the clinic with complaints of vaginal bleeding, vague abdominal pain, and nausea. She says she has not been feeling well for the past few months. She has class 2 obesity and denies any weight loss. She reports her periods have been irregular for the past year. Her last menstrual period, before she began having this current vaginal bleeding, was 4 months ago. She has a 30-pack-year history of smoking and drinks 3 to 4 alcoholic beverages daily. She is on no medications other than the estrogen pellets she receives from a hormone clinic for vasomotor symptoms. A physical exam is unremarkable except for blood clots at the cervical os. What is the most important diagnostic study to appropriately evaluate this patient? Need Assignment Help? A. Transvaginal ultrasound B. Endometrial sampling C. MRI of the pelvis D. Serum tumor markers