EXAM #1: CLINICAL ASPECTS OF OVARIAN CANCER

Question 1

What is the most important independent risk factor in ovarian cancer?

Answer 1

Age

Question 2

What should work-up of an adenxal mass include?

Answer 2

1) B-hCG

2) TVUS

Question 3

What do you need to remember about timing for a TVUS in the menstrual cycle?

Answer 3

Don’t do in the luteal phase–Corpus Luteum will give a false positive

Question 4

What finding on an ultrasound would be indicative of adnexal cancer?

Answer 4

1) Excresences
2) Ascites
3) Mural nodules

Question 5

What should you check on any patient that has abnormal uterine bleeding?

Answer 5

B-hCG

Question 6

What imaging study is best to evaluate the pelvic organs?

Answer 6

Ultrasound

Question 7

Endometrial biopsy shows endometrial proliferation. What does this mean?

Answer 7

Patient is in follicular phase

Question 8

Histologically, what is pathognomonic for a granulosa cell tumor?

Answer 8

Call Exner Bodies

Question 9

What labs can be checked for evaluate for recurrence of a Granulosa Tumor?

Answer 9

Inhibin A and Inhibin B

Question 10

What tumor marker is associated with epithelial ovarian cancer?

Answer 10

CA-125

Question 11

What tumor markers are assocaited with malignant germ-cell tumors?

Answer 11

B-hCG
LDH
AFP

Question 12

What tumor markers are associated with embryonal carcinaoma?

Answer 12

AFP

B-hCG

Question 13

What tumor markers is associated with endodermal sinus tumor?

Answer 13

AFP

Question 14

What is the most common type of ovarian cancer?

Answer 14

Epithelial

Question 15

What is the treatment for Epithelial Ovarian Cancer?

Answer 15

1) Cytoreductive therapy

2) Chemotherapy

Question 16

What is the Carbo MOA?

Answer 16

Binds and cross-links DNA; prevents DNA synthesis

Question 17

What is the Taxol MOA?

Answer 17

Binds stable microtubules, inhibiting cell division

Question 18

What are the symptoms of a molar pregnancy?

Answer 18

1) Size of uterus does not match menstrual dates
2) Elevated B-hCG
3) Toxemia i.e. pre-eclampsia prior to 24 weeks
4) Hyperemesis

Question 19

What is the imaging modality of choice for a molar pregnancy?

Answer 19

US

Question 20

What percentage of molar pregnancies are invasive?

Answer 20

5-10%

Question 21

How should you work-up a molar pregnancy?

Answer 21

1) CXR

2) CBC, CMP, clotting studies

Question 22

How do you treat a molar pregnancy?

Answer 22

1) Evacuation
2) B-hCG
3) Chemotherapy (as needed)

Question 23

What is the major complicaiton associated with evacuation of a molar pregnancy?

Answer 23

Massive hemorrhage

Question 24

What do you want to ensure after evacuation of molar pregnancy?

Answer 24

Negative B-hCG levels