Endometriosis: ABFM practice questions

4 board-style questions on endometriosis in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 34-year-old woman with laparoscopically confirmed Stage III endometriosis presents for follow-up. She completed a 6-month course of GnRH agonist therapy with norethindrone add-back, which improved her pain significantly. She has been off therapy for 4 months, and her dysmenorrhea and deep dyspareunia have returned to pre-treatment severity. She does not desire pregnancy at this time but wants to preserve fertility for the future. MRI shows a 4-cm left ovarian endometrioma and deep infiltrating endometriosis of the rectovaginal septum. Which of the following is the most appropriate next step in management?

  1. Laparoscopic excision of endometrioma and deep infiltrating lesions with postoperative hormonal suppression
  2. Definitive surgery with total hysterectomy and bilateral salpingo-oophorectomy
  3. Combined oral contraceptive pills in continuous cycling as long-term suppressive therapy
  4. Repeat GnRH agonist therapy for another 6 months without add-back

Sample question 2

A 33-year-old woman presents with chronic pelvic pain lasting 8 months. The pain is dull, constant, and worsens premenstrually. She has dyspareunia and painful bowel movements during menses. Pelvic examination reveals tenderness in the posterior cul-de-sac with uterosacral nodularity. A urine pregnancy test is negative and urinalysis is normal. What is the most likely diagnosis?

  1. Pelvic inflammatory disease
  2. Endometriosis
  3. Irritable bowel syndrome
  4. Interstitial cystitis

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