Gynaecological endocrinology: acute heavy bleeding: 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 · Gynaecological endocrinology: acute heavy bleeding

Sample item

A haemodynamically stable 38-year-old with heavy menstrual bleeding for 10 days and normal pelvic ultrasound needs medical control of bleeding. Which oral regimen is commonly used?

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

The answer and the reasoning

A. Norethisterone 5 mg three times daily

High-dose oral progestins such as norethisterone 5 mg three times daily rapidly stabilise the endometrium and control anovulatory bleeding, and tranexamic acid can be used alongside. The dose is tapered over weeks, and withdrawal bleeding follows stopping. NSAIDs and antifibrinolytics reduce blood loss, but aspirin and anticoagulants worsen it.

Option by option

  • A. Norethisterone 5 mg three times daily (correct)

    Correct. Oral norethisterone is a standard way to arrest acute abnormal uterine bleeding.

  • B. Aspirin 600 mg four times daily

    Aspirin impairs platelet function and increases bleeding.

  • C. Warfarin

    Warfarin would worsen bleeding.

  • D. Clomiphene 100 mg daily

    Clomiphene induces ovulation and is not used to stop bleeding.

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 A, Norethisterone 5 mg three times daily. High-dose oral progestins such as norethisterone 5 mg three times daily rapidly stabilise the endometrium and control anovulatory bleeding, and tranexamic acid can be used alongside.

Why is "Aspirin 600 mg four times daily" not the answer?

Aspirin impairs platelet function and increases bleeding.

Why is "Warfarin" not the answer?

Warfarin would worsen bleeding.

Why is "Clomiphene 100 mg daily" not the answer?

Clomiphene induces ovulation and is not used to stop bleeding.

What concept does this question test?

It tests Gynaecological endocrinology: acute heavy bleeding in OBG. The dose is tapered over weeks, and withdrawal bleeding follows stopping. NSAIDs and antifibrinolytics reduce blood loss, but aspirin and anticoagulants worsen it.

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 Gynaecological endocrinology: acute heavy bleeding?

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.