Benign gynaecology: pelvic congestion syndrome: 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: pelvic congestion syndrome

Sample item

A parous woman aged 35 has a chronic dull pelvic ache that worsens by evening, after standing and at the end of menstruation, with dyspareunia. Imaging shows dilated tortuous pelvic and ovarian veins. What is the diagnosis?

AEndometriosisBChronic PIDCAdenomyosisDPelvic congestion syndrome

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

The answer and the reasoning

D. Pelvic congestion syndrome

Pelvic congestion syndrome is chronic pelvic pain from venous incompetence and dilated ovarian and pelvic veins, typically in parous women, worsened by standing and relieved by lying. Doppler, CT or venography shows the dilated veins, and treatment includes ovarian vein embolisation, hormonal suppression and sometimes surgery. Laparoscopy may show no other pathology.

Option by option

A. Endometriosis
Endometriosis shows cyclical pain and lesions rather than dilated veins.
B. Chronic PID
Chronic PID gives pain with adnexal tenderness, fever or adhesions.
C. Adenomyosis
Adenomyosis gives heavy periods and a bulky tender uterus.
D. Pelvic congestion syndrome (correct)
Correct. Dilated pelvic veins with positional pain is pelvic congestion syndrome.

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.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Pelvic congestion syndrome. Pelvic congestion syndrome is chronic pelvic pain from venous incompetence and dilated ovarian and pelvic veins, typically in parous women, worsened by standing and relieved by lying.

Why is "Endometriosis" not the answer?

Endometriosis shows cyclical pain and lesions rather than dilated veins.

Why is "Chronic PID" not the answer?

Chronic PID gives pain with adnexal tenderness, fever or adhesions.

Why is "Adenomyosis" not the answer?

Adenomyosis gives heavy periods and a bulky tender uterus.

What concept does this question test?

It tests Benign gynaecology: pelvic congestion syndrome in OBG. Doppler, CT or venography shows the dilated veins, and treatment includes ovarian vein embolisation, hormonal suppression and sometimes surgery. Laparoscopy may show no other pathology.

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: pelvic congestion syndrome?

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.