Uterine fibroids
Obstetrics & Gynaecology · Topic 29
Source: NMC CBME Curriculum 2024 · Volume III · Obstetrics & Gynaecology · Topic 29 · combined PDF page 438
Practice questions
- A patient with uterine fibroids reports heavy menstrual bleeding and pelvic pressure. Which approach best reflects current guidance for assessment?
- An incidental uterine fibroid is found in a patient who has no bleeding, pain, pressure symptoms, or fertility concerns. What is the most appropriate general management principle?
- A patient with symptomatic fibroids has heavy bleeding, iron-deficiency anemia, and a strong desire for future pregnancy. Which factor set should principally guide treatment selection?
- Which set of treatment categories is recognized in current guidance for symptomatic uterine fibroids?
- A patient with otherwise unexplained infertility asks whether medication alone is an appropriate definitive strategy to treat fibroids while attempting conception. Which statement best reflects the infertility guideline?
- A patient with otherwise unexplained infertility is found to have a submucosal fibroid. Which management principle is best supported by the infertility guideline?
- A patient with unexplained infertility has an isolated subserosal fibroid and no other indication for surgery. Which recommendation is most appropriate?
- Which statement best summarizes the evidence about intramural fibroids and otherwise unexplained infertility?
- A patient with otherwise unexplained infertility has an intramural fibroid, hysteroscopically confirmed intact endometrium, and no other fertility factor. What does the guideline advise about myomectomy?
- A clinician wants to evaluate and classify fibroids in a patient with unexplained infertility. Which investigation is specifically described as inappropriate for this purpose?
- A patient with infertility has a suspected submucosal fibroid. Which approach is recommended to assess the cavity and fibroid before choosing treatment?
- Before hysteroscopic removal of a submucosal fibroid, which additional feature is specifically important to assess along with its size and cavity location?
- A patient with infertility has a 4-cm submucosal fibroid selected for hysteroscopic treatment. Which statement best reflects the guideline?
- A patient with a submucosal fibroid larger than 5 cm asks whether hysteroscopic treatment is categorically impossible. Which response is most accurate?
- A patient with fibroids strongly wishes to conceive in the future and asks about uterine artery embolization. Which counseling statement best reflects the infertility guideline?
- In the infertility guideline’s comparison of uterine artery embolization with myomectomy, which pattern of reproductive outcomes is reported after UAE?
- A 42-year-old considering UAE asks about a possible effect on ovarian reserve. Which statement is best supported by the infertility guideline?
- In women with infertility undergoing abdominal myomectomy, which approach to choosing the uterine incision is recommended to reduce postoperative adhesions?
- For infertile patients undergoing myomectomy, how do cumulative pregnancy rates compare between laparoscopic and minilaparotomy approaches according to the guideline?
- A surgeon is considering laparoscopic myomectomy for a patient with several fibroids of differing sizes and locations. Which principle best reflects the infertility guideline?
- A patient with fibroids has substantial bleeding and pelvic pressure that are affecting daily life. Which management framework is most appropriate?
- A patient with symptomatic fibroids is deciding between minimally invasive procedures and surgery. Which statement accurately reflects the range of options reviewed in the ACR guideline?
- A patient with fibroids reports painful intercourse and reduced sexual desire in addition to pelvic pressure. What is the best clinical response?
- A patient asks whether a blood biomarker can currently be used to stratify uterine fibroids and guide treatment. Which response best matches the systematic review of biomarker research?
- Which biological pathway group was identified as convergent across multiple omics approaches in uterine fibroid research?
- Which statement about progesterone receptor signaling and uterine fibroids is supported by the supplied systematic review?
- A patient with unexplained infertility has fibroids, but their relationship to the uterine cavity has not been assessed. Which next step best follows the infertility guideline?
- A patient with symptomatic fibroids prioritizes uterine preservation and asks about all minimally invasive and noninvasive choices. Which counseling approach is most evidence-aligned?
- A patient asks whether hysterectomy or myomectomy will invariably improve sexual function. Which response best reflects the supplied review?