Postmenopausal bleeding — DRCOG MCQ

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EasyGynaecologyPostmenopausal bleedingDRCOG

A 25-year-old woman is 62 and reports new vaginal bleeding 8 years after her last period. What is the most likely diagnosis?

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Correct answer: A — Transvaginal ultrasound via urgent cancer pathway

Transvaginal ultrasound via urgent cancer pathway is the best answer because the vignette is testing Postmenopausal bleeding and the recommended approach is consistent with NICE NG12. The other diagnoses do not explain the combination of timing, examination findings and investigation results as well as the correct diagnosis. Specifically, Uterine fibroids; Bacterial vaginosis; Placental abruption; Pre-eclampsia would be suboptimal in this scenario. The key discriminator is the pattern across symptoms, examination and timing, not a single isolated symptom.

Reference: NICE NG12