Gynaecological oncology: vulval disease: 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 oncology: vulval disease

Sample item

A postmenopausal woman has intensely itchy, white atrophic, parchment-like vulval skin with loss of labia minora. What is the first-line treatment?

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

The answer and the reasoning

B. Topical ultrapotent corticosteroid (clobetasol propionate)

Lichen sclerosus is a chronic inflammatory condition with a 3 to 5 per cent lifetime risk of vulval squamous carcinoma. It is treated with clobetasol 0.05 per cent ointment and long-term follow-up. Biopsy any non-healing or hyperkeratotic area.

Option by option

  • A. Topical oestrogen alone

    Oestrogen alone is ineffective.

  • B. Topical ultrapotent corticosteroid (clobetasol propionate) (correct)

    Correct. Potent topical steroids are first-line.

  • C. Vulvectomy

    Vulvectomy is not indicated for benign disease.

  • D. Topical antifungal

    Antifungals do not treat lichen sclerosus.

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, Topical ultrapotent corticosteroid (clobetasol propionate). Lichen sclerosus is a chronic inflammatory condition with a 3 to 5 per cent lifetime risk of vulval squamous carcinoma.

Why is "Topical oestrogen alone" not the answer?

Oestrogen alone is ineffective.

Why is "Vulvectomy" not the answer?

Vulvectomy is not indicated for benign disease.

Why is "Topical antifungal" not the answer?

Antifungals do not treat lichen sclerosus.

What concept does this question test?

It tests Gynaecological oncology: vulval disease in OBG. It is treated with clobetasol 0.05 per cent ointment and long-term follow-up. Biopsy any non-healing or hyperkeratotic area.

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 oncology: vulval disease?

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.