skip to main content

Endometriosis — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePelvic PainEndometriosisMCCQE Part 1

29-year-old woman presents with cyclical pelvic pain and deep dyspareunia. Symptoms worsen before menses and examination shows uterosacral tenderness. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Start empiric hormonal/analgesic management and consider gynaecology referral if refractory or fertility concerns

Start empiric hormonal/analgesic management and consider gynaecology referral if refractory or fertility concerns is best because cyclical pain and dyspareunia suggest endometriosis. Discharge without pregnancy-specific safety-netting is suboptimal because pregnancy-related bleeding, pain or hypertension can deteriorate quickly; Perform a digital vaginal examination before excluding placenta previa or instability is suboptimal because digital examination can precipitate haemorrhage when placenta previa is possible; Use a medication contraindicated in pregnancy as first-line therapy is suboptimal because maternal treatment must account for fetal safety and gestational age; Delay obstetric or gynaecologic consultation despite red flags is suboptimal because specialist involvement is needed when maternal or fetal risk is present. Surgery is not required before all treatment trials.

Reference: SOGC endometriosis guideline