Gynaecological endocrinology: adolescent bleeding: 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: adolescent bleeding

Sample item

A 14-year-old with acute heavy bleeding, Hb 6 g/dL and unstable vital signs needs urgent treatment. After resuscitation, which treatment is appropriate to arrest the bleeding?

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

The answer and the reasoning

C. IV conjugated oestrogen, followed by oral progestin or COC taper

Anovulatory bleeding in adolescents causes prolonged endometrial shedding. High-dose IV conjugated oestrogens (25 mg every 4 to 6 hours) rapidly stabilise the endometrium, followed by progestin or COC. Tranexamic acid and transfusion are used. A bleeding disorder such as von Willebrand disease should be excluded.

Option by option

  • A. Oral iron only

    Oral iron treats anaemia only.

  • B. Immediate hysterectomy

    Hysterectomy is inappropriate.

  • C. IV conjugated oestrogen, followed by oral progestin or COC taper (correct)

    Correct. Oestrogen promotes rapid endometrial healing.

  • D. Tamoxifen

    Tamoxifen does not stop bleeding.

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, IV conjugated oestrogen, followed by oral progestin or COC taper. Anovulatory bleeding in adolescents causes prolonged endometrial shedding.

Why is "Oral iron only" not the answer?

Oral iron treats anaemia only.

Why is "Immediate hysterectomy" not the answer?

Hysterectomy is inappropriate.

Why is "Tamoxifen" not the answer?

Tamoxifen does not stop bleeding.

What concept does this question test?

It tests Gynaecological endocrinology: adolescent bleeding in OBG. High-dose IV conjugated oestrogens (25 mg every 4 to 6 hours) rapidly stabilise the endometrium, followed by progestin or COC. Tranexamic acid and transfusion are used. A bleeding disorder such as von Willebrand disease should be excluded.

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: adolescent bleeding?

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.