American Board of Internal Medicine (ABIM) Certification Practice Exam

What does a greater endometrial thickness suggest in a postmenopausal woman?

1. Normal hormonal activity

2. Possible need for further evaluation

3. Increased risk of pregnancy

4. Immediate treatment with hormone replacement therapy

The correct answer is: Possible need for further evaluation

A greater endometrial thickness in a postmenopausal woman suggests a possible need for further evaluation. After menopause, the endometrial lining typically becomes thinner due to the decline in estrogen levels, so an increased thickness can indicate abnormal uterine conditions, such as endometrial hyperplasia or even malignancy. It is important to assess further with methods such as transvaginal ultrasound or endometrial biopsy to determine the underlying cause. Normal hormonal activity would not typically be associated with increased thickness in this demographic, as estrogen levels are significantly lower after menopause. The risk of pregnancy is not applicable since postmenopausal women typically cannot conceive. Immediate treatment with hormone replacement therapy may not be warranted solely based on increased endometrial thickness; it requires thorough evaluation to ascertain if there is a pathological condition present that needs management.