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Adenomyosis — DRCOG MCQ

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ModerateGynaecologyAdenomyosisDRCOG

A 39-year-old woman reports heavy painful periods and a bulky tender uterus on bimanual examination. She has completed her family and ultrasound shows a diffusely enlarged uterus without discrete fibroids. What is the most likely diagnosis?

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Correct answer: D — Adenomyosis

Heavy painful periods with a bulky tender uterus and no discrete fibroids are typical of adenomyosis. PCOS causes irregular cycles and hyperandrogenic features rather than a tender enlarged uterus. The pearl is that adenomyosis is often suspected clinically and supported by pelvic imaging.

Reference: NICE NG88