Benign gynaecology: hysteroscopy distension medium: 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: hysteroscopy distension medium

Sample item

During hysteroscopic resection of a submucous fibroid using 1.5 percent glycine as the distension medium, the patient develops confusion, nausea and seizure. Serum sodium is 118 mmol/L. What is the most likely diagnosis?

AHypoglycaemiaBAnaphylaxis to the mediumCAir embolismDDilutional hyponatraemia from excessive fluid absorption (TURP-like syndrome)

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

The answer and the reasoning

D. Dilutional hyponatraemia from excessive fluid absorption (TURP-like syndrome)

Non-electrolyte media such as glycine or sorbitol are absorbed through opened venous sinuses and cause dilutional hyponatraemia and cerebral oedema. Strict fluid deficit monitoring prevents it, and the procedure is stopped if the deficit exceeds the set limit. Management includes stopping the procedure, diuretics and cautious sodium correction.

Option by option

A. Hypoglycaemia
Glycine does not cause hypoglycaemia, and the measured sodium points elsewhere.
B. Anaphylaxis to the medium
Anaphylaxis would cause bronchospasm and hypotension without hyponatraemia.
C. Air embolism
Air embolism presents with sudden cardiovascular collapse, not a low sodium.
D. Dilutional hyponatraemia from excessive fluid absorption (TURP-like syndrome) (correct)
Correct. Absorption of hypotonic glycine causes hyponatraemia with neurological symptoms.

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, Dilutional hyponatraemia from excessive fluid absorption (TURP-like syndrome). Non-electrolyte media such as glycine or sorbitol are absorbed through opened venous sinuses and cause dilutional hyponatraemia and cerebral oedema.

Why is "Hypoglycaemia" not the answer?

Glycine does not cause hypoglycaemia, and the measured sodium points elsewhere.

Why is "Anaphylaxis to the medium" not the answer?

Anaphylaxis would cause bronchospasm and hypotension without hyponatraemia.

Why is "Air embolism" not the answer?

Air embolism presents with sudden cardiovascular collapse, not a low sodium.

What concept does this question test?

It tests Benign gynaecology: hysteroscopy distension medium in OBG. Strict fluid deficit monitoring prevents it, and the procedure is stopped if the deficit exceeds the set limit. Management includes stopping the procedure, diuretics and cautious sodium correction.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: hysteroscopy distension medium?

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.