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Fibroid pressure symptoms — DRCOG MCQ

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ModerateGynaecologyFibroid pressure symptomsDRCOG

A 47-year-old woman has heavy bleeding, urinary frequency and a uterus palpable to the umbilicus. Ultrasound shows multiple fibroids, the largest 11 cm. She has iron-deficiency anaemia despite oral iron. When should this patient be referred?

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Correct answer: B — Refer to gynaecology for specialist management options

Large fibroids with pressure symptoms and persistent anaemia warrant gynaecology referral for medical, interventional or surgical options. Continuing ineffective primary-care treatment is inappropriate. Urinary frequency can be a pressure symptom rather than infection. Menopause may reduce fibroid symptoms, but current severity justifies referral.

Reference: NICE NG88