Contraception: Actinomyces-like organisms on cervical cytology: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

OBG · Contraception: Actinomyces-like organisms on cervical cytology

Sample item

A woman with an intrauterine contraceptive device has a cervical smear reporting Actinomyces-like organisms. She is asymptomatic. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Continue the device with counselling; remove and treat if symptoms of pelvic infection develop

Actinomyces-like organisms are found on cytology in a small proportion of long-term IUCD users and are usually colonisers. In an asymptomatic woman, the device can be retained with advice to report pelvic pain, discharge or fever. If symptomatic, the device is removed and penicillin-based treatment is given.

Option by option

  • A. Perform hysterectomy

    Hysterectomy is not indicated.

  • B. Continue the device with counselling; remove and treat if symptoms of pelvic infection develop (correct)

    Correct. Asymptomatic colonisation does not need removal.

  • C. Remove the device and give a 6-week antibiotic course regardless

    Routine removal and long antibiotics is not required without symptoms.

  • D. Start anti-tuberculosis treatment

    Tuberculosis therapy is unrelated.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Continue the device with counselling; remove and treat if symptoms of pelvic infection develop. Actinomyces-like organisms are found on cytology in a small proportion of long-term IUCD users and are usually colonisers.

Why is "Perform hysterectomy" not the answer?

Hysterectomy is not indicated.

Why is "Remove the device and give a 6-week antibiotic course regardless" not the answer?

Routine removal and long antibiotics is not required without symptoms.

Why is "Start anti-tuberculosis treatment" not the answer?

Tuberculosis therapy is unrelated.

What concept does this question test?

It tests Contraception: Actinomyces-like organisms on cervical cytology in OBG. In an asymptomatic woman, the device can be retained with advice to report pelvic pain, discharge or fever. If symptomatic, the device is removed and penicillin-based treatment is given.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Contraception: Actinomyces-like organisms on cervical cytology?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.