This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
A 19 year old female develops bleeding from the nose during menstruation. What is she most likely suffering from? 
Select and explain. 
A. Vicarious menstruation, B. Henosch Schonlein Purpura, C. Persistant urachus, D. Bleeding diathesis
A: Vicarious menstruation
Answer: A: Vicarious menstruation 
Explanation: Patient in the question is most likely suffering from vicarious menstruation. It is a condition which is occasionally found in adolescent girls in which they develop monthly epistaxis due to the vascular congestion of nasal mucosa, in concordance with menses. Ref: Textbook of Pediatric Emergency Medicine edited by Gary R. Fleisher page 975.