This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'What is the ideal treatment for a 55-years-female with Simple hyperplasia of the endometrium with Atypia? \nSelect and explain. \nA. Simple hysterectomy, B. Medroxy progesterone acetate (MPA), C. Levonorgesterol (LNG), D. IUCD', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Management of Atypical Endometrial Hyperplasia:\n"Hysterectomy is the best treatment for women at any age with atypical endometrial hyperplasia because the risk of concurrent subclinical invasive disease is high."\nWilliams Gynae 1st ed p 691\n"In presence of atypia, response to progesterone therapy is poor and the relapse rate is high. Nearly one-third of them will progress to cancer and one-fourth may already have associated undiagnosed cancer. In women approaching or post menopause, hysterectomy is a safer choice in those with complex or atypical hyperplasia." \xa0\nJeffcoate 7th/ ed p 425\nSo Remember: Best management of atypical hyperplasia is hysterectomy.\nAlso, Know Management of Endometrial Hyperplasia:\nManagement depends on the patient\'s age and the presence or absence of cytological atypia.\nNon-atypical hyperplasia:\n\nPremenopausal women: Progesterone therapy-\n\noptions: - Medroxyprogesterone acetate for 21 days a month daily for 3 months.\nProgesterone-containing IUCD.\nPostmenopausal women\n\nSimple hyperplasia without atypia - Generally followed without therapy.\nComplex hyperplasia without atypia - Cyclical/continuous progesterone therapy.\nThese patients should be followed annually by endometrial biopsy.\n\n\nAtypical hyperplasia:\n\nThe ideal treatment is a hysterectomy\nPremenopausal women willing to preserve fertility - High dose progesterone therapy after full information of risk of undiagnosed cancer or progression to cancer. In these cases periodic TVS and endometrial biopsy is necessary.', 'role': 'assistant'}]