Soru

A 66-year-old woman is evaluated at an ambulatory clinic as a new patient. She recently lost her health insurance and has not received comprehensive medical care for the past two years. She has a history of essential hypertension, for which she takes amlodipine. She underwent natural menopause at age 52. During the review of systems, the patient mentions that two months ago she experienced three days of light vaginal bleeding, which she attributed to "normal changes of aging." The bleeding has not recurred. She has a 45 pack-year smoking history and currently smokes one pack of cigarettes daily. Her father died of a ruptured abdominal aortic aneurysm at age 75. A review of her records shows a normal screening colonoscopy and negative cervical human papillomavirus (HPV) testing performed at age 64. She recently received a normal screening mammography and an updated influenza vaccine at a local health fair. Vital signs show a blood pressure of 136/84 mm Hg, heart rate of 76/min, and body mass index (BMI) of 29 kg/m $^2$. Physical examination, including a pelvic examination, is unremarkable with no active bleeding. Which of the following sets of diagnostic and screening tests is the most appropriate next step in the management of this patient?