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Uterine fibroids — DRCOG MCQ

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ModerateGynaecologyUterine fibroidsDRCOG

A 45-year-old woman reports progressively heavier periods and pelvic pressure. Examination reveals a uterus equivalent to 14 weeks' size. Pregnancy test is negative and haemoglobin is 92 g/L. What is the most appropriate investigation?

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

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Correct answer: C — Pelvic ultrasound scan

An enlarged uterus with heavy bleeding and pressure symptoms suggests fibroids, and pelvic ultrasound is the appropriate first-line imaging. Cervical screening is not an investigation for heavy bleeding. CA125 is used in suspected ovarian cancer pathways rather than typical fibroid assessment. The pearl is that examination findings guide whether imaging is needed before treatment.

Reference: NICE NG88