Rosh Emergency Medicine Practice Test 2025 – The Complete All-in-One Guide to Exam Success!

In cases of heavy vaginal bleeding combined with a tender uterus, uterine fibroids emerge as a likely underlying condition. Uterine fibroids, or leiomyomas, are benign smooth muscle tumors of the uterus that can cause significant menstrual irregularities, including heavy menstrual bleeding (menorrhagia). The presence of a tender uterus often indicates that the fibroids may be undergoing degeneration or that there is an associated inflammatory process.

Heavy bleeding typically occurs when fibroids distort the uterine lining, leading to an increased surface area that can contribute to prolonged and excessive menstrual flow. The tenderness may result from the increased size of the fibroids infiltrating surrounding tissues or from changes associated with their growth.

While other conditions like endometriosis, adenomyosis, and ovarian cyst ruptures can also present with pelvic pain or bleeding, they typically manifest differently in terms of menstrual symptoms or tender uterine findings. Endometriosis is more commonly associated with pelvic pain and less likely to present solely as heavy bleeding without other characteristic symptoms. Adenomyosis may cause heavy bleeding and a tender uterus but is often linked to a specific history of childbirth and other symptoms. Ovarian cyst rupture primarily presents with acute abdominal pain rather than heavy menstrual bleeding.

Therefore, considering the specific