C. Irregular bleeding D. Increased blood pressure 28. A 31-year-old woman came to gynecologic unit with complaints of lower abdominal pain, pain during coitus, abnormal vaginal discharge . and fever. On physical examination, the nurse found uterine and adnexa tenderness. What is the most likely confirmatory manifestation for this patient?(Tikimt 2013/Octobe 2020) A. Pain during coitus B. Lower abdominal pain C Abnormal vagina l discharge D. Uterine and adnexal tenderness 29.A woman came to a gynecologic OPD with complaints of excessive and irregular uterine bleeding . The woman cannot remember when her menstrual period started. The amount and duration of bleeding also vary during each cycle. What is the most likely explanation of this finding?(Tikimt 2013/Octobe r 2020) A. Menorrhagia B. Metrorrhaqia C. Polymenorrhea D . Menometrorrhagia 30.An adolescent girl came with complaints of difficulty and pain during sexual intercourse. She has regular menstrual period with abdomina I cramps. On pelvic examination: a nurse identified I loses of hymen membrane and a membrane like structure with small perforation on middle third of vagina. The nurse suspected that her problem is vaginal congenital anomalies. What is the most likely manifestation for diagnosis of this condition? (Tikimt

28. The most likely confirmatory manifestation for this patient is D. Uterine and adnexal tenderness. This is because the presence of uterine and adnexal tenderness, along with the other symptoms mentioned, suggests a possible infection or inflammation in the pelvic region, such as pelvic inflammatory disease (PID). PID is a common cause of lower abdominal pain, pain during coitus, abnormal vaginal discharge, and fever in women of reproductive age.<br /><br />29. The most likely explanation for this finding is B. Metrorrhagia. Metrorrhagia refers to irregular bleeding between menstrual periods. The excessive and irregular uterine bleeding described in the question, with varying amounts and durations of bleeding during each cycle, is characteristic of metrorrhagia. Menorrhagia refers to heavy menstrual bleeding, polymenorrhea refers to frequent menstrual periods, and menometrorrhagia refers to heavy menstrual bleeding with irregular timing.<br /><br />30. The most likely manifestation for diagnosis of this condition is the loss of hymen membrane and the presence of a membrane-like structure with small perforations on the middle third of the vagina. These findings suggest a congenital anomaly of the vagina, such as a vaginal septum or imperforate hymen. These conditions can cause difficulty and pain during sexual intercourse due to the abnormal structure of the vaginal opening. Regular menstrual periods with abdominal cramps are also common in individuals with vaginal congenital anomalies.