Complications of pregnancy: theca lutein cysts in mole: 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 · Complications of pregnancy: theca lutein cysts in mole

Sample item

After suction evacuation of a complete hydatidiform mole, a 24-year-old woman is found to have bilateral enlarged multilocular ovarian cysts of about 8 cm. She is haemodynamically stable and has no pain. What is the best management?

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

The answer and the reasoning

C. Observation with serial hCG

Theca lutein cysts result from ovarian overstimulation by very high hCG. They regress spontaneously over weeks to months as hCG falls, so they are observed unless complicated by torsion or rupture. Serial hCG monitoring continues to detect gestational trophoblastic neoplasia.

Option by option

  • A. Laparoscopic cystectomy now

    Cystectomy exposes her to surgical risk for cysts that resolve spontaneously.

  • B. Bilateral oophorectomy now

    Oophorectomy is unnecessary because the cysts regress and the woman is young.

  • C. Observation with serial hCG (correct)

    Correct. These are hCG-driven, self-limiting cysts and need only observation.

  • D. Methotrexate for the cysts

    Methotrexate is for gestational trophoblastic neoplasia, not for hCG-driven cysts.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Observation with serial hCG. Theca lutein cysts result from ovarian overstimulation by very high hCG.

Why is "Laparoscopic cystectomy now" not the answer?

Cystectomy exposes her to surgical risk for cysts that resolve spontaneously.

Why is "Bilateral oophorectomy now" not the answer?

Oophorectomy is unnecessary because the cysts regress and the woman is young.

Why is "Methotrexate for the cysts" not the answer?

Methotrexate is for gestational trophoblastic neoplasia, not for hCG-driven cysts.

What concept does this question test?

It tests Complications of pregnancy: theca lutein cysts in mole in OBG. They regress spontaneously over weeks to months as hCG falls, so they are observed unless complicated by torsion or rupture. Serial hCG monitoring continues to detect gestational trophoblastic neoplasia.

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 Complications of pregnancy: theca lutein cysts in mole?

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.