Benign gynaecology: haematometra: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Benign gynaecology: haematometra

Sample item

A 55-year-old postmenopausal woman who received pelvic radiotherapy years ago has lower abdominal pain, and examination shows a firm, tender, enlarged uterus. Ultrasound shows a fluid-filled endometrial cavity. What is the likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cervical stenosis causing haematometra or pyometra

Cervical stenosis after radiotherapy, surgery or atrophy can block drainage of the endometrial cavity, producing a fluid-distended uterus (haematometra or pyometra). Dilatation of the cervix drains the collection, and a sample should be taken to exclude carcinoma, which can itself cause stenosis. Antibiotics are needed for pyometra.

Option by option

  • A. Normal postmenopausal changes

    A fluid-filled enlarged tender uterus is not a normal postmenopausal finding.

  • B. Adenomyosis

    Adenomyosis causes a diffusely enlarged uterus with myometrial changes, not a fluid-filled cavity.

  • C. Endometrial polyp only

    A polyp does not usually distend the cavity with fluid.

  • D. Cervical stenosis causing haematometra or pyometra (correct)

    Correct. Obstruction of the cervical canal causes fluid retention in the uterus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Cervical stenosis causing haematometra or pyometra. Cervical stenosis after radiotherapy, surgery or atrophy can block drainage of the endometrial cavity, producing a fluid-distended uterus (haematometra or pyometra).

Why is "Normal postmenopausal changes" not the answer?

A fluid-filled enlarged tender uterus is not a normal postmenopausal finding.

Why is "Adenomyosis" not the answer?

Adenomyosis causes a diffusely enlarged uterus with myometrial changes, not a fluid-filled cavity.

Why is "Endometrial polyp only" not the answer?

A polyp does not usually distend the cavity with fluid.

What concept does this question test?

It tests Benign gynaecology: haematometra in OBG. Dilatation of the cervix drains the collection, and a sample should be taken to exclude carcinoma, which can itself cause stenosis. Antibiotics are needed for pyometra.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Benign gynaecology: haematometra?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.