MCQs on Other Gynaecology Disorders

MCQ Bank Gynaecology Module

Written by Dr. Priya Menon (MBBS, FRANZCOG) – Obstetrician and Gynaecologist

Question 1

A 26-year-old woman presents to your clinic on the 6th day of her menstrual cycle with mild lower abdominal pain. She lives with her male partner and has no children. On examination, she has a blood pressure of 110/70 mmHg, pulse rate of 90 bpm, and temperature of 37.5°C. No adnexal mass is palpated; however, on vaginal exam cervical motion tenderness is noted. Which one of the following would be the next best step in management?

A) Transvaginal ultrasonography.
B) Cervical swabs for culture.
C) Urine analysis and culture.
D) Thyroid stimulating hormone.
E) Abdominal CT scan.

Correct Answer: B) Cervical swabs for culture.

Explanation:
This patient presents with cervical motion tenderness, which is a hallmark sign of pelvic inflammatory disease (PID). She is menstruating, making ectopic pregnancy (EP) less likely, although it should always be considered in the differential if pregnancy is a possibility.

The Centers for Disease Control and Prevention (CDC) diagnostic criteria for PID include:

  • Being at risk for STDs
  • Having lower abdominal or pelvic pain
  • Cervical motion tenderness, uterine tenderness, or adnexal tenderness on exam

Because PID is a clinical diagnosis, the most appropriate next step is to obtain cervical swabs for culture and nucleic acid amplification testing (NAAT) for common pathogens such as Chlamydia trachomatis and Neisseria gonorrhoeae. This allows confirmation of the likely infectious agents while empiric antibiotic treatment is started.

Ultrasound is indicated if ectopic pregnancy is suspected, especially if there is a positive pregnancy test, adnexal mass, or hemodynamic instability. Other tests such as urinalysis, TSH, or CT scan are not first-line investigations in this context.

Question 2

Which one of the following is the least likely site of endometriosis?

A) Ovaries.
B) Cervix.
C) Uterine wall.
D) Pouch of Douglas.
E) Bladder.

Correct Answer: B) Cervix.

Explanation:
Endometriosis refers to the presence of endometrial tissue outside the uterine cavity. It most commonly involves pelvic structures, particularly the:

  • Ovaries (most common site)
  • Pouch of Douglas (posterior cul-de-sac)
  • Uterosacral ligaments
  • Broad ligament
  • Bladder and rectosigmoid colon

The uterine wall is involved in adenomyosis, a related but distinct condition where endometrial tissue grows within the myometrium.

Although endometriosis can occur almost anywhere, involvement of the cervix is rare. It may occasionally be seen in areas of prior surgical trauma (e.g., after cervical procedures), but among the options listed, it is the least likely site for endometrial implantation.

Question 3

Which one of the following is the most common site of endometriosis?

A) Round ligament.
B) Uterosacral ligament.
C) Ovary.
D) Bladder.
E) Broad ligament.

Correct Answer: C) Ovary.

Explanation:
Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity, most often within the pelvis. Among all possible sites, the ovary is the most commonly affected location.

The typical order of frequency for endometriosis sites is:

  1. Ovaries
  2. Posterior cul-de-sac (Pouch of Douglas)
  3. Broad ligament
  4. Uterosacral ligament
  5. Rectosigmoid colon
  6. Bladder

Ovarian endometriosis often forms endometriomas or “chocolate cysts,” filled with old hemorrhagic fluid.

Other locations such as the round ligament, bladder, and broad ligament are less commonly involved. Thus, among the options given, ovary is the most common site.

Previous Next

14. Gynecology Module

14.1 Abnormal Uterine Bleeding

14.2 Amenorrhea

14.3 Subfertility

14.4 Contraception

14.5 Menopause

14.6 Gynecological Oncology

14.7 Other Gynecological Disorders

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