This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Puerperium, Subject name: Gynaecology & Obstetrics
[{'content': 'A patient presents for routine postpaum examination 2 weeks after a normal vaginal delivery with complains of foul smelling vaginal discharge with fever. On abdominal examination, a tender 14 weeks uterus is palpable, breast examination is normal and episiotomy is healthy. What could be the possible diagnosis? \nSelect and explain. \nA. Choriocarcinoma, B. Adenomyosis, C. Fibroid uterus, D. Subinvolution of the uterus', 'role': 'user'}, {'content': 'Answer: D \nExplanation: This is a case of subinvolution of uterus secondary to infection which has resulted in fever and foul smelling lochia SUBINVOLUTION OF UTERUS Normal rate of reduction of size of uterus post delivery: 1-2 cm/ day Uterus becomes pelvic organ by 2 weeks and returns to normal size by 6 weeks Causes: Retained bits of placenta Infection Blood clots Fibroids Clinical features boggy or flabby uterus palpable after 2 weeks per abdomen tender Treatment Uterine evacuation Iv antibiotics Methyl ergometrine', 'role': 'assistant'}]