Endometriosis: 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 · Endometriosis

Sample item

A 30-year-old nulliparous woman has primary infertility, progressive severe dysmenorrhoea and deep dyspareunia. Examination shows a fixed retroverted uterus and tender nodules in the uterosacral ligaments. Which test provides the definitive diagnosis?

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

The answer and the reasoning

B. Laparoscopy with histology of the lesions

The history suggests endometriosis. Direct visualisation at laparoscopy with biopsy is the reference standard for diagnosis and also allows treatment. Imaging may show an endometrioma but cannot exclude peritoneal disease.

Option by option

  • A. Pelvic ultrasound

    Ultrasound may show endometriomas but does not confirm peritoneal or deep disease.

  • B. Laparoscopy with histology of the lesions (correct)

    Correct. Seeing and biopsying the lesions confirms the diagnosis.

  • C. Hysterosalpingography

    Hysterosalpingography checks tubal patency but does not diagnose endometriosis.

  • D. Serum CA-125

    CA-125 can be raised in many conditions and is neither sensitive nor specific.

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, Laparoscopy with histology of the lesions. The history suggests endometriosis.

Why is "Pelvic ultrasound" not the answer?

Ultrasound may show endometriomas but does not confirm peritoneal or deep disease.

Why is "Hysterosalpingography" not the answer?

Hysterosalpingography checks tubal patency but does not diagnose endometriosis.

Why is "Serum CA-125" not the answer?

CA-125 can be raised in many conditions and is neither sensitive nor specific.

What concept does this question test?

It tests Endometriosis in OBG. Direct visualisation at laparoscopy with biopsy is the reference standard for diagnosis and also allows treatment. Imaging may show an endometrioma but cannot exclude peritoneal disease.

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 Endometriosis?

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.