A 57 year old postmenopausal patient presents for her annual…

A 57 year old postmenopausal patient presents for her annual examination.  Since you last saw her, she stopped hormone replacement because of vaginal spotting.  She is now experiencing hot flashes and night sweats as well as continued vaginal bleeding.  Her medical history is otherwise unremarkable.  She wants your opinion about resuming hormone replacement. Which diagnosis is least likely?

An 80-year-old woman presents for evaluation of a “bulge on…

An 80-year-old woman presents for evaluation of a “bulge on her bottom” she noted after gardening over the weekend.  She has no discomfort and no difficulty with bowel or bladder elimination.  On examination, you note her cervix extends 1 cm beyond the vestibule (vaginal opening) with straining.   There are no lesions or excoriations noted.  Of the following, what is the best INITIAL treatment option for this patient?