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Endometriosis — MCCQE Part 1 MCQ

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ModeratePelvic PainEndometriosisMCCQE Part 1

A 35-year-old woman has cyclic pelvic pain, deep dyspareunia, and infertility for 18 months. Pelvic examination shows fixed retroverted uterus and tender nodularity in the posterior fornix. What is the most likely diagnosis?

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Correct answer: A — Endometriosis

Cyclic pelvic pain, deep dyspareunia, infertility, fixed retroverted uterus, and posterior fornix nodularity suggest endometriosis. IBS can cause bowel-related pain but does not cause pelvic nodularity or infertility. Interstitial cystitis is bladder-pain dominant. Acute salpingitis presents with fever, discharge, and cervical motion tenderness rather than chronic cyclic symptoms.

Reference: SOGC endometriosis guideline