GONC Flashcards
Regarding thecoma. Which is wrong?
A - usually benign B - commonly unilateral C - associated with virilisation D - may be associated with endometrial hyperplasia E - usually occurs in pre-pubertal girls
E - usually occurs in pre-pubertal girls
A 59 yo lady with a 6cm ovarian mass. What is the probability of malignancy?
A - 15% B - 30% C - 45% D - 60% E - 80%
A - 15%
16 yo girl presents with pelvic discomfort and a complex cystic mass was found on US. At laparotomy, an immature teratoma was found in the right ovary. Most appropriate Mx:
a - RSO b - R ovarian cystectomy c - R ovarian cystectomy & wedge biopsy of L ovary d - TAH, BSO omentectomy e - RSO & wedge biopsy of L ovary
a - RSO
What percentage of benign mucinous tumour that are bilateral?
<5%
Less than serous cystadenoma (20-25%)
During surgery on an 11yo girl, a stage 1A grade 1 10cm malignant (immature) teratoma is found in the left ovary. Initial therapy should include
a. LSO
b. BSO
c. TAH, BSO, omentectomy, post operative irradiation
d. TAH, BSO, omentectomy, post operative chemotherapy
a. LSO
Current knowledge about HPV indicates that
a. HPV DNA sequences are found in most SCC’s of the vulva and cervix
b. HPV replication in the cytoplasm causes the koilocytic cell
c. Dysplasia associated with HPV infection is not a ‘true’ precursor of cancer
d. HPV16 is generally associated with benign condylomas
a. HPV DNA sequences are found in most SCC’s of the vulva and cervix
- Intraoperative findings that are indications for abandoning radical hysterectomy for cervical cancer include all of the following EXCEPT
a. Stage 2A disease with a unilateral 30mm diameter ovarian cyst
b. Intraperitoneal metastasis
c. Parametrial/pelvic side wall disease
d. Unresectable pelvic nodal disease
a. Stage 2A disease with a unilateral 30mm diameter ovarian cyst
A 28yo woman has USO for a germ cell tumour and completed chemo 6 months ago. She wants to get pregnant. You advise her
a. She has a high risk of malformation because of the chemo
b. She should wait until the effects of the chemo on the residual ovary wear off
c. She is unlikely to be ever able to conceive as the chemo usually causes ovarian failure
d. The chemotherapy used has a variable effect on reproductive function
d. The chemotherapy used has a variable effect on reproductive function
BEP chemotherapy
- Bleomycin
- Etoposide
- Cisplatin (P for platinum)
Which statement regarding Adenocarcinoma In Situ is LEAST correct
a. HPV type 18 is the most commonly associated serotype
b. Cone biopsy with clear margins carries >20% chance of disease above the cervical canal
c. ‘Skip lesions’ are uncommon relative to squamous carcinoma in situ
d. Extrafascial simple hysterectomy is optimal treatment if childbearing complete
c. ‘Skip lesions’ are uncommon relative to squamous carcinoma in situ
HPV 18 accounts 50% of adenocarcinoma (c.f. 15% of SCC)
Endodermal sinus tumours of the ovary (Yolk sac tumours) are characteristically associated with elevated levels of
a. Alpha fetoprotein
b. Beta HCG
c. Carcinoembryonic antigen (CEA)
d. CA125
a. Alpha fetoprotein
Which of the following statements is least correct?
a. The lifetime risk of breast cancer is approximately 9%
b. The lifetime risk of breast cancer is approximately 50% in BRCA1 and BRCA2 gene carriers
c. Hereditary non polyposis colorectal cancer (HNPCC) is associated with an increased risk of endometrial cancer
d. Hereditary non polyposis colorectal cancer (HNPCC) is associated with an increased risk of ovarian cancer
b. The lifetime risk of breast cancer is approximately 50% in BRCA1 and BRCA2 gene carriers
Advantages of surgery over radiation therapy for cervical cancer include all of the following EXCEPT
a. Emotional satisfaction that the tumour has been removed
b. Higher cure rate
c. Accuracy of surgical staging
d. Preservation of the ovaries
b. Higher cure rate
A 27yo presents with acute virilisation and normal pelvic examination. Investigations show serum LH = 2 [4-25], FSH = 3 [3-25], 17-OH progesterone = 2.9 [<5.5], testosterone = 8.9 [0.5-2.5], DHEAS = 5.3 [0.9-11.7]. Which is the MOST LIKELY diagnosis?
a. PCOS with insulin resistance
b. Sertoli Leydig cell tumour
c. Adrenal cortical adenoma
d. Cushing syndrome
e. Late onset Congenital adrenal hyperplasia
b. Sertoli Leydig cell tumour
Pure sertoli cells only produce oestrogen (+/- renin)
- Can be a/w HTN, hypokalaemia
Pure leydig cells are androgen secreting
Each of the following is an ovarian germ cell neoplasm except for
a. Gonadoblastoma
b. Gynandroblastoma
c. Embryonal carcinoma
d. Endodermal sinus tumour
e. Polyembryoma
b. Gynandroblastoma
Gynandroblastoma is a subtype of ovarian sex cord-stromal tumor and is usually observed in young women
The primary group of lymph nodes that drain the vulva are the
a. Deep inguinal
b. Superficial inguinal
c. Deep femoral
d. Obturator
b. Superficial inguinal