A 40-year-old G2P2 woman presents with a 6-month history of heavy menstrual bleeding and progressively worsening pelvic pressure. She denies intermenstrual bleeding or postcoital bleeding. Her physical exam reveals a symmetrically enlarged, firm, and mobile uterus. A urine pregnancy test is negative. What is the most likely diagnosis?

The correct answer to the question "A 40-year-old G2P2 woman presents with a 6-month history of heavy menstrual bleeding and progressively worsening pelvic pressure. She denies intermenstrual bleeding or postcoital bleeding. Her physical exam reveals a symmetrically enlarged, firm, and mobile uterus. A urine pregnancy test is negative. What is the most likely diagnosis?" is Option B: Uterine fibroids (leiomyomas).

The other options — A) Endometrial carcinoma, C) Adenomyosis, D) Endometriosis — are incorrect for this USMLE Exam Prep question. As explained above: Heavy menstrual bleeding (menorrhagia) and pelvic pressure with a symmetrically enlarged, firm, and mobile uterus are classic symptoms and signs of uterine fibroids (leiomyomas). Adenomyosis typicall…