Gynaecological endocrinology: endometrial sampling: 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: endometrial sampling

Sample item

A 48-year-old obese woman with type 2 diabetes has had irregular heavy periods for 8 months. Transvaginal ultrasound shows a thickened endometrium without a focal lesion. Which is the most appropriate next investigation?

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

The answer and the reasoning

A. Outpatient endometrial sampling with a Pipelle

Abnormal uterine bleeding after 45 years, or at any age with risk factors such as obesity and diabetes from unopposed oestrogen, calls for endometrial histology to exclude hyperplasia and carcinoma. A Pipelle gives a quick outpatient sample. Hysteroscopy with biopsy follows if sampling is inadequate or a focal lesion is suspected.

Option by option

  • A. Outpatient endometrial sampling with a Pipelle (correct)

    Correct. Tissue diagnosis is needed in this age group with risk factors.

  • B. Repeat ultrasound after the next menstrual period

    Waiting and repeating the scan delays a diagnosis that carries malignant potential.

  • C. Cervical cytology alone

    Cytology screens the cervix and does not sample the endometrium.

  • D. Serum CA-125

    CA-125 is neither sensitive nor specific for endometrial pathology.

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, Outpatient endometrial sampling with a Pipelle. Abnormal uterine bleeding after 45 years, or at any age with risk factors such as obesity and diabetes from unopposed oestrogen, calls for endometrial histology to exclude hyperplasia and carcinoma.

Why is "Repeat ultrasound after the next menstrual period" not the answer?

Waiting and repeating the scan delays a diagnosis that carries malignant potential.

Why is "Cervical cytology alone" not the answer?

Cytology screens the cervix and does not sample the endometrium.

Why is "Serum CA-125" not the answer?

CA-125 is neither sensitive nor specific for endometrial pathology.

What concept does this question test?

It tests Gynaecological endocrinology: endometrial sampling in OBG. A Pipelle gives a quick outpatient sample. Hysteroscopy with biopsy follows if sampling is inadequate or a focal lesion is suspected.

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: endometrial sampling?

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.