OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is Asherman syndrome. While this may seem a odd practice, it is useful to see multiple examples of how Asherman syndrome will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 27-year-old woman, G3P3, comes to the clinic because she has not menstruated since the birth of her third child 13 months ago. It was a vaginal delivery complicated by postpartum hemorrhage requiring dilatation and curettage. She breast-fed the infant for 5 months. She has a long-standing history of bloating and mood changes with menses that she feels “are expected”. She has no other notable past medical history. She is sexually active with her husband and he uses condoms for contraception. Her BMI is 28 kg/m². Her temperature is 98.7°F). pulse is 70/min, and blood pressure is 120/70 mm Hg. Examination shows a normal sized thyroid. The rest of the physical exam is unremarkable. Her semm thyroid-stimulating hormone, follicle-stimulating hormone. and prolactin concentrations are all within the reference range. Qualitative serum beta‐ hCG testing is negative. A progestin challenge test shows no withdrawal bleeding. What is the likely diagnosis?
Explanation: secondary amenorrhea + recent dilation and curettage + unremarkable physical exam + reference range TSH, FSH, prolactin + not pregnant + lack of withdrawal bleeding = Asherman syndrome
Question # 2
A 37 year old woman, G1P1, comes into the clinic with complaints of infertility. She has been unable to conceive a child for the past 13 months. She had a vaginal delivery 1.5 years ago that was complicated by both postpartum hemorrhage and endometritis treated with dilation and curettage. She has not resumed menses either since her delivery, but does experience cyclical abdominal pain. Her physical exam is unremarkable. Her husband has had semen analysis conducted which revealed normal findings. What is the most likely cause of this patient’s symptoms?
Page Updated: 10.19.2016