Menopause: postmenopausal 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 · Menopause: postmenopausal bleeding

Sample item

In a woman with postmenopausal bleeding, what is the first-line investigation?

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

The answer and the reasoning

D. Transvaginal ultrasound for endometrial thickness, followed by endometrial sampling

Postmenopausal bleeding needs exclusion of endometrial cancer, which occurs in about 10 per cent. An endometrial thickness of 4 mm or less has a very low risk. If it is thicker or bleeding recurs, endometrial biopsy or hysteroscopy is done.

Option by option

  • A. Pap smear alone

    A Pap smear screens the cervix and does not assess the endometrium.

  • B. Hormone assay

    Hormone assays do not diagnose cancer.

  • C. Observation for 6 months

    Waiting delays diagnosis.

  • D. Transvaginal ultrasound for endometrial thickness, followed by endometrial sampling (correct)

    Correct. TVS followed by biopsy is the standard pathway.

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 D, Transvaginal ultrasound for endometrial thickness, followed by endometrial sampling. Postmenopausal bleeding needs exclusion of endometrial cancer, which occurs in about 10 per cent.

Why is "Pap smear alone" not the answer?

A Pap smear screens the cervix and does not assess the endometrium.

Why is "Hormone assay" not the answer?

Hormone assays do not diagnose cancer.

Why is "Observation for 6 months" not the answer?

Waiting delays diagnosis.

What concept does this question test?

It tests Menopause: postmenopausal bleeding in OBG. An endometrial thickness of 4 mm or less has a very low risk. If it is thicker or bleeding recurs, endometrial biopsy or hysteroscopy is done.

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 Menopause: postmenopausal 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.