Gynaecological endocrinology: coelomic metaplasia: 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: coelomic metaplasia

Sample item

A 14-year-old premenarchal girl is found to have an ovarian endometrioma. Which theory best explains endometriosis in a girl who has never menstruated?

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

The answer and the reasoning

A. Coelomic metaplasia

Coelomic metaplasia proposes that peritoneal mesothelium, derived from coelomic epithelium, transforms into endometrial-type tissue. It can explain disease before menarche and rare disease in men. Retrograde menstruation is the best explanation for most pelvic disease, and vascular spread explains distant sites.

Option by option

  • A. Coelomic metaplasia (correct)

    Correct. It does not require menstruation to have occurred.

  • B. Haematogenous spread

    Haematogenous or lymphatic spread explains deposits in the lung or distant nodes, not this ovarian disease.

  • C. Retrograde menstruation

    Retrograde menstruation requires menstruation, which has not yet occurred.

  • D. Iatrogenic implantation

    Iatrogenic implantation follows surgery such as caesarean scars, and she has had no operation.

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, Coelomic metaplasia. Coelomic metaplasia proposes that peritoneal mesothelium, derived from coelomic epithelium, transforms into endometrial-type tissue.

Why is "Haematogenous spread" not the answer?

Haematogenous or lymphatic spread explains deposits in the lung or distant nodes, not this ovarian disease.

Why is "Retrograde menstruation" not the answer?

Retrograde menstruation requires menstruation, which has not yet occurred.

Why is "Iatrogenic implantation" not the answer?

Iatrogenic implantation follows surgery such as caesarean scars, and she has had no operation.

What concept does this question test?

It tests Gynaecological endocrinology: coelomic metaplasia in OBG. It can explain disease before menarche and rare disease in men. Retrograde menstruation is the best explanation for most pelvic disease, and vascular spread explains distant sites.

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 Gynaecological endocrinology: coelomic metaplasia?

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.