Benign gynaecology: vulvodynia: 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: vulvodynia

Sample item

A 28-year-old has burning pain at the vaginal entrance on intercourse and tampon insertion. Touching the vestibule with a cotton swab reproduces the pain, and the vulva looks normal with no infection. What is the diagnosis?

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

The answer and the reasoning

B. Provoked vestibulodynia (vulvodynia)

Vulvodynia is chronic vulval pain without an identifiable cause, and provoked vestibulodynia is localised to the vestibule and reproduced by the cotton swab test. Treatment includes avoidance of irritants, topical lidocaine, pelvic floor physiotherapy, low-dose tricyclics and psychosexual support. Infection, dermatoses and neoplasia must be excluded first.

Option by option

  • A. Lichen sclerosus

    Lichen sclerosus shows white atrophic skin changes.

  • B. Provoked vestibulodynia (vulvodynia) (correct)

    Correct. Provoked vestibular pain reproduced by the swab test is vestibulodynia.

  • C. Herpes simplex infection

    Herpes shows vesicles or ulcers.

  • D. Vulval carcinoma

    Carcinoma would show a visible lesion.

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 B, Provoked vestibulodynia (vulvodynia). Vulvodynia is chronic vulval pain without an identifiable cause, and provoked vestibulodynia is localised to the vestibule and reproduced by the cotton swab test.

Why is "Lichen sclerosus" not the answer?

Lichen sclerosus shows white atrophic skin changes.

Why is "Herpes simplex infection" not the answer?

Herpes shows vesicles or ulcers.

Why is "Vulval carcinoma" not the answer?

Carcinoma would show a visible lesion.

What concept does this question test?

It tests Benign gynaecology: vulvodynia in OBG. Treatment includes avoidance of irritants, topical lidocaine, pelvic floor physiotherapy, low-dose tricyclics and psychosexual support. Infection, dermatoses and neoplasia must be excluded first.

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: vulvodynia?

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.