Benign gynaecology: transverse vaginal septum: 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: transverse vaginal septum

Sample item

A 15-year-old with primary amenorrhoea has cyclical lower abdominal pain. Examination shows normal vulva and hymen with no bulge on straining and the vagina ends blindly at a short distance. Ultrasound shows haematocolpos. What is the diagnosis?

AImperforate hymenBTransverse vaginal septumCMRKH syndromeDComplete androgen insensitivity

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

The answer and the reasoning

B. Transverse vaginal septum

In an imperforate hymen, a bluish bulging membrane is visible at the introitus, whereas a transverse vaginal septum lies higher in the vagina, and the vulva and hymen appear normal with a shortened vagina. Cyclical pain and haematocolpos distinguish it from agenesis syndromes in which there is no functioning endometrium. Surgical excision of the septum is the treatment.

Option by option

A. Imperforate hymen
An imperforate hymen would bulge at the introitus.
B. Transverse vaginal septum (correct)
Correct. A normal-looking hymen and a short blind vagina with haematocolpos points to a transverse septum.
C. MRKH syndrome
MRKH has no uterus and no cyclical pain with haematocolpos.
D. Complete androgen insensitivity
Androgen insensitivity has no uterus and no haematocolpos.

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 B, Transverse vaginal septum. In an imperforate hymen, a bluish bulging membrane is visible at the introitus, whereas a transverse vaginal septum lies higher in the vagina, and the vulva and hymen appear normal with a shortened vagina.

Why is "Imperforate hymen" not the answer?

An imperforate hymen would bulge at the introitus.

Why is "MRKH syndrome" not the answer?

MRKH has no uterus and no cyclical pain with haematocolpos.

Why is "Complete androgen insensitivity" not the answer?

Androgen insensitivity has no uterus and no haematocolpos.

What concept does this question test?

It tests Benign gynaecology: transverse vaginal septum in OBG. Cyclical pain and haematocolpos distinguish it from agenesis syndromes in which there is no functioning endometrium. Surgical excision of the septum is the treatment.

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: transverse vaginal septum?

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.