Gynaecological endocrinology: preoperative fibroid shrinkage: 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: preoperative fibroid shrinkage

Sample item

A woman with a 10 cm fibroid and haemoglobin of 8 g/dL is planned for myomectomy in 3 months. Which pre-treatment shrinks the fibroid and allows haemoglobin to recover?

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

The answer and the reasoning

A. GnRH agonist

A GnRH agonist induces amenorrhoea, lets haemoglobin recover and shrinks the fibroid substantially. It is used for a limited period before surgery because of hypo-oestrogenic effects and rapid regrowth after stopping.

Option by option

  • A. GnRH agonist (correct)

    Correct. A GnRH agonist shrinks the fibroid and produces amenorrhoea before surgery.

  • B. Tranexamic acid

    Tranexamic acid reduces bleeding but does not shrink the fibroid.

  • C. Combined oral contraceptive

    A contraceptive pill reduces bleeding and has no consistent effect on fibroid size.

  • D. Mefenamic acid

    Mefenamic acid modestly reduces bleeding and does not shrink the fibroid.

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 A, GnRH agonist. A GnRH agonist induces amenorrhoea, lets haemoglobin recover and shrinks the fibroid substantially.

Why is "Tranexamic acid" not the answer?

Tranexamic acid reduces bleeding but does not shrink the fibroid.

Why is "Combined oral contraceptive" not the answer?

A contraceptive pill reduces bleeding and has no consistent effect on fibroid size.

Why is "Mefenamic acid" not the answer?

Mefenamic acid modestly reduces bleeding and does not shrink the fibroid.

What concept does this question test?

It tests Gynaecological endocrinology: preoperative fibroid shrinkage in OBG. It is used for a limited period before surgery because of hypo-oestrogenic effects and rapid regrowth after stopping.

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: preoperative fibroid shrinkage?

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.