Gynaecological endocrinology: adenomyosis: 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: adenomyosis

Sample item

A 42-year-old multiparous woman has progressive dysmenorrhoea, heavy menses and a uniformly enlarged, globular tender uterus. What is the most likely diagnosis and best imaging modality?

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

The answer and the reasoning

D. Adenomyosis; MRI or transvaginal ultrasound

Adenomyosis is the presence of endometrial glands within the myometrium, producing a symmetrically enlarged boggy uterus. MRI shows a thickened junctional zone (above 12 mm). Definitive treatment is hysterectomy, with LNG-IUS or GnRH analogues as medical options.

Option by option

  • A. Endometrial carcinoma; X-ray

    Endometrial carcinoma is diagnosed by biopsy.

  • B. Ovarian cyst; HSG

    HSG does not diagnose ovarian cysts.

  • C. Fibroid uterus; CT scan

    Fibroids give an irregular, nodular enlargement.

  • D. Adenomyosis; MRI or transvaginal ultrasound (correct)

    Correct. A globular uterus with dysmenorrhoea is characteristic.

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 D, Adenomyosis; MRI or transvaginal ultrasound. Adenomyosis is the presence of endometrial glands within the myometrium, producing a symmetrically enlarged boggy uterus.

Why is "Endometrial carcinoma; X-ray" not the answer?

Endometrial carcinoma is diagnosed by biopsy.

Why is "Ovarian cyst; HSG" not the answer?

HSG does not diagnose ovarian cysts.

Why is "Fibroid uterus; CT scan" not the answer?

Fibroids give an irregular, nodular enlargement.

What concept does this question test?

It tests Gynaecological endocrinology: adenomyosis in OBG. MRI shows a thickened junctional zone (above 12 mm). Definitive treatment is hysterectomy, with LNG-IUS or GnRH analogues as medical options.

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: adenomyosis?

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.