Gynaecological endocrinology: endometrial hyperplasia: 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: endometrial hyperplasia

Sample item

A 42-year-old obese woman with heavy irregular bleeding has endometrial biopsy showing hyperplasia without atypia. What is the preferred treatment?

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

The answer and the reasoning

D. Levonorgestrel-releasing intrauterine system

Hyperplasia without atypia has a low risk of progression and is treated with progestogens, with the intrauterine system being most effective, followed by repeat biopsy. Hysterectomy is reserved for atypical hyperplasia or failed treatment. Weight loss is encouraged.

Option by option

  • A. Pelvic radiotherapy

    Radiotherapy has no role in benign hyperplasia.

  • B. Observation with no follow-up

    Without treatment or follow-up, bleeding and progression risk remain.

  • C. Immediate hysterectomy

    Hysterectomy is for atypical hyperplasia in women who have completed childbearing.

  • D. Levonorgestrel-releasing intrauterine system (correct)

    Correct. Progestogen therapy reverses hyperplasia without atypia.

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, Levonorgestrel-releasing intrauterine system. Hyperplasia without atypia has a low risk of progression and is treated with progestogens, with the intrauterine system being most effective, followed by repeat biopsy.

Why is "Pelvic radiotherapy" not the answer?

Radiotherapy has no role in benign hyperplasia.

Why is "Observation with no follow-up" not the answer?

Without treatment or follow-up, bleeding and progression risk remain.

Why is "Immediate hysterectomy" not the answer?

Hysterectomy is for atypical hyperplasia in women who have completed childbearing.

What concept does this question test?

It tests Gynaecological endocrinology: endometrial hyperplasia in OBG. Hysterectomy is reserved for atypical hyperplasia or failed treatment. Weight loss is encouraged.

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: endometrial hyperplasia?

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.