July 14, 2010

MRCP 2 Question 11

A 36 yr old woman comes to the physician for evaluation of a 4 year history of infertility, severe dysmenorrhea and increasing pain with sexual intercourse.

On pelvic examination an adnexal mass is felt and nodules are palpated along the uterosacral ligaments.

Which of the following is the most likely diagnosis?
a) dermoid cyst
b) ectopic pregnancy
c) endometriosis
d) follicular cyst
e) corpus luteum cyst

The correct answer is C


Endometriosis commonly occurs in the ovary; when cyclic bleeding occurs, an endometriotic cyst or endometrioma is formed. Accumulation of blood within this cavity results in the classic chocolate cyst.

The pain that is typically produced by endometriosis is similarly produced with endometriomas of the ovary.

Physical examination reveals an adnexal mass and the typical findings of endometriosis, which include uterosacral nodularity and cul-de-sac of Douglas tenderness.

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