Postpartum haemorrhage and emergencies: choriocarcinoma after term delivery: 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 · Postpartum haemorrhage and emergencies: choriocarcinoma after term delivery

Sample item

Six weeks after a normal term delivery, a woman has irregular heavy bleeding. The uterus is bulky and soft, and chest X-ray shows multiple round opacities. Curettage tissue is non-diagnostic. Which investigation should be sent next?

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

The answer and the reasoning

B. Serum beta-hCG

Persistent or recurrent bleeding after any pregnancy, including a normal term birth, with lung metastases should prompt a beta-hCG measurement. A very high level confirms gestational choriocarcinoma, which is treated with chemotherapy. Histology can be unhelpful because of necrosis.

Option by option

  • A. MRI pelvis for adenomyosis

    Adenomyosis would not cause multiple round lung opacities.

  • B. Serum beta-hCG (correct)

    Correct. Beta-hCG is the marker that identifies gestational trophoblastic neoplasia, including after term delivery.

  • C. Coagulation profile

    A coagulation profile is relevant to bleeding disorders but does not explain lung nodules and a bulky uterus.

  • D. Serum progesterone

    Progesterone does not identify trophoblastic disease.

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, Serum beta-hCG. Persistent or recurrent bleeding after any pregnancy, including a normal term birth, with lung metastases should prompt a beta-hCG measurement.

Why is "MRI pelvis for adenomyosis" not the answer?

Adenomyosis would not cause multiple round lung opacities.

Why is "Coagulation profile" not the answer?

A coagulation profile is relevant to bleeding disorders but does not explain lung nodules and a bulky uterus.

Why is "Serum progesterone" not the answer?

Progesterone does not identify trophoblastic disease.

What concept does this question test?

It tests Postpartum haemorrhage and emergencies: choriocarcinoma after term delivery in OBG. A very high level confirms gestational choriocarcinoma, which is treated with chemotherapy. Histology can be unhelpful because of necrosis.

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 Postpartum haemorrhage and emergencies: choriocarcinoma after term delivery?

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.