D. increased blood pressure 28. A 31-year-old woman came to gynecologic unit with complaints of lower abdominal pain, pain during coitus, abnorma l 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/October 2020) A. Pain during coitus B. Lower abdominal pain C Abnormal vaginal discharge D. Uterine and adnexal tenderness 29. A woman came to a gynecologic : OPD with complaints of excessive and irregular uterine bleeding 1. 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/October 2020) A. Menorrhagia B. Metrorrhagia C. Polymenorrhea D Menometrorrhagia

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. The tenderness in the uterus and adnexa (ovaries and fallopian tubes) is a key physical examination finding that helps confirm the diagnosis of PID.<br /><br />29. The most likely explanation for the excessive and irregular uterine bleeding in this woman is D. Menometrorrhagia. Menometrorrhagia refers to heavy and irregular menstrual bleeding that occurs at irregular intervals. This condition is characterized by excessive menstrual bleeding that varies in duration and amount from cycle to cycle. The woman's inability to remember when her menstrual period started and the variability in the amount and duration of bleeding are consistent with menometrorrhagia.