Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Part 2 MRCOG (Antenatal) > Gynae oncology > Flashcards

Gynae oncology Flashcards

1
Q
A

A - F
B - T - associated with raised CA-125 in 75% of serous and 30% of mucinous
C- F
D- F
E - T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A

A -T
B - F
C- F
D - T
E -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A

A - T
B - T
C - F
D - T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
A

A - F –> returning to complete surgery when there is post-op diagnosis of BOT does not improve survival. Equally, when a dx of mucinous BOT, do not return for appendicectomy
B - F –> this is what we do to preserve fertility. it is a trade-off, but not acceptable treatment. The treatment is full surgery
C - F –> not robust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
A

A - F
B - T –> there is no evidence that it improves survival, but there is higher recurrence rate
C - T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

About BOTs (True or False)
A) 20% of cases occur in women over 45 years
B) 15% of serous BOTs have peritoneal implants at diagnosis
C) 10% of BOTs identified at frozen section later are found to be invasive
D) in the event of invasive peritoneal implants, 50% of tumours recurr
E) Micropapillary serous BOTs have the worse prognosis
F) If invasive peritoneal implants, survival is still good around 75%
G) Aneuploidy in the tumour increases risks by 5X

A

A) F. 30% occur in women <40yo
B) F. 30% do
C) F. 30% are
D) T
E) T
F) F. Survival is 35%
G) F. Increases by 19x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

About Borderline Ovarian Tumours (True or False)
a) The combined contraceptive pill is a protective factor
b) Lactation is a protective factor
c) The vast majority are of the serous type
d) The serous type tends to be more aggressive
e) BRCA gene mutation increases the risk of BOTs

A

A) F. the pill is not protective. Protective factors are parity and lactation
B) T
C) F. not the vast majority, 50% are serous, 46% mucinous, 4% other types (endometrioid, Brenner, Clear cell, mixed)
D) T. It has a lower survival rate in comparison to mucinous and 30% of them already have peritoneal implants at Dx. Of these, 30% are invasive
E) F.There is no evidence that BRCA mutations increase the risk of BOTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Wha

What are the survival rates for
A) 5 year survival for serous BOT (S1)
B) 10 year survival for serous BOT (S1)
C) 5 year survival for mucinous BOT
D)10 year survival for mucinous BOT

A

A) 97%
B) 80% (90% if early)
C) 100%
D) 97%???

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Question 1: Which of the following is the most appropriate method for staging ovarian cancer according to the FIGO system?

A) CT scan of the abdomen and pelvis
B) MRI of the pelvis
C) Surgical exploration and biopsy
D) Serum CA-125 levels
E) Ultrasound of the abdomen

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Question 2: A 58-year-old woman presents with symptoms of bloating and abdominal discomfort. Imaging reveals a large, complex adnexal mass. Surgical staging is planned. Which of the following is not part of the FIGO staging for ovarian cancer?

A) Examination of the peritoneal cavity
B) Assessment of lymph node involvement
C) Histological confirmation of the tumor type
D) Bilateral salpingo-oophorectomy
E) Intraoperative evaluation of distant metastases

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Question 3: Which of the following is correct regarding the FIGO staging for ovarian cancer?

A) Stage I is limited to the ovaries
B) Stage II involves pelvic organs and inguinal lymph nodes
C) Stage III involves spread to the peritoneum outside the pelvis
D) Stage IV refers to metastasis to lymph nodes and the liver only
E) Stage IV is limited to the ovaries and immediate surrounding structures

A

A) It is more nuanced, as substages also involve spillage (1C) etc
B) Inguinal LFN is stage IV
C) True. Stage III involves abrominal organs but does not extend to chest. IIIA: retroperitoneal LFN; IIIB: peritoneal lesions <2cm; IIIC: peritoneal lesions >2cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Question 4: A patient with ovarian cancer is staged as FIGO Stage III. Which of the following describes the most likely findings?

A) Tumor confined to the ovaries with no lymph node involvement
B) Tumor involves one or both ovaries with microscopic spread to the peritoneum
C) Tumor extends beyond the pelvis to the peritoneum and lymph nodes
D) Distant metastases involving the liver and lungs
E) Tumor confined to one ovary with no evidence of spread

A

Stage III means abrominal structure involvement wihtout reaching the chest.
I: ovary only and any spillage (IC)
II: pelvic structures only
III: abdominal organs
IV: more distant including chest

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Question 5: A 45-year-old woman with ovarian cancer undergoes staging laparotomy. During the procedure, a lesion is found in the omentum. The tumor is grossly confined to the omentum, and there is no involvement of the peritoneal cavity or lymph nodes. The stage of ovarian cancer is most likely:

A) Stage IA
B) Stage IB
C) Stage IIIC
D) Stage IIIA
E) Stage IV

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Question 6: Which of the following factors would indicate that an ovarian cancer is most likely Stage IV rather than Stage III?

A) Involvement of the omentum
B) Presence of peritoneal implants
C) Spread to the diaphragm
D) Distant metastasis to the liver and lungs
E) Involvement of pelvic lymph nodes

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Question 8: Which of the following is true regarding the significance of lymph node involvement in ovarian cancer staging?

A) Lymph node involvement automatically indicates Stage IV disease
B) Lymph node involvement is included in the criteria for Stage III
C) Lymph node involvement is only relevant in Stage I
D) Lymph node involvement does not affect the stage
E) Lymph node involvement always occurs before distant metastases

A

B

Stage 1: ovary only and includes spillage (1C)
Stage 2: pelvis only
Stage 3: Abdominal organs, including retroperitoneal LFN
Stage IV: distant metastases, including inguinal LFN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A 62-year-old woman with ovarian cancer is undergoing surgery for staging. During the procedure, she is found to have peritoneal implants on the diaphragm, along with lymph node enlargement in the para-aortic region. There is no evidence of distant metastasis.
Which of the following is the most likely stage according to the FIGO staging system?

Options:

A) Stage I
B) Stage II
C) Stage III
D) Stage IV
E) Stage IIC

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Question 2:
A 45-year-old woman is diagnosed with ovarian cancer. Imaging shows a unilateral ovarian mass, and during surgery, it is found to be confined to one ovary, with no capsular rupture. There is no evidence of spread to the peritoneum or lymph nodes.
What is the most likely FIGO stage?

Options:

A) Stage I
B) Stage IA
C) Stage IB
D) Stage IC
E) Stage II

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Question 3:
A 58-year-old woman with ovarian cancer is found to have a peritoneal implant in the small bowel during surgery. There is no lymph node involvement, but there is a small tumor on the bladder.
What is the most appropriate FIGO stage for this case?

Options:

A) Stage IA
B) Stage II
C) Stage III
D) Stage IIB
E) Stage IV

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Question 4:
A 70-year-old woman presents with ovarian cancer. Imaging shows extensive spread to the omentum and peritoneum, along with enlarged pelvic and para-aortic lymph nodes. There are also liver and lung metastases.
What is the most likely FIGO stage?

Options:

A) Stage III
B) Stage IIIC
C) Stage IV
D) Stage I
E) Stage II

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A 35-year-old woman is diagnosed with ovarian cancer. During staging laparotomy, there is no peritoneal spread, but she has microscopic disease in the pelvic lymph nodes.
What is the most likely FIGO stage?

Options:

A) Stage IA
B) Stage IB
C) Stage II
D) Stage III
E) Stage IIIC

A

D

23
Q

A 50-year-old woman is diagnosed with advanced ovarian cancer. During surgery, she has multiple peritoneal implants, including to the liver capsule. There is no evidence of distant lymph node involvement.
What is the most appropriate FIGO stage?

Options:

A) Stage III
B) Stage IIIB
C) Stage IIIA
D) Stage IIIC
E) Stage IV

A

E

24
Q

A 40-year-old woman undergoes staging for ovarian cancer. During the procedure, it is found that the tumor has spread to the bladder and rectum but not beyond the pelvis. There is no peritoneal implant or lymph node involvement.
What is the most likely FIGO stage?

Options:

A) Stage I
B) Stage II
C) Stage III
D) Stage IIIA
E) Stage IV

A

B –> spread to pelvis (bladder and rectum)

25
Q

A 55-year-old woman with ovarian cancer has been staged as FIGO Stage IIIA. What does this indicate about the extent of her disease?

Options:

A) Tumor confined to one ovary with no spread
B) Peritoneal implants are confined to the pelvis
C) Peritoneal implants beyond the pelvis are microscopic
D) Inguinal Lymph node involvement is present
E) Distant metastases are present

A

A) This is IA
B) This is II
C) This is III A
D) This is IV
E) This is IV

26
Q

Which of the following is the most common type of ovarian cancer?
A) Mucinous carcinoma
B) Endometrioid carcinoma
C) Clear cell carcinoma
D) High-grade serous carcinoma

A

D - 75% of ovarian CAs.

27
Q

Which of the following is a known risk factor for ovarian cancer?
A) Early menopause
B) Nulliparity
C) High-dose oral contraceptive use
D) Previous tubal ligation

A

B

28
Q

In the management of a patient with suspected ovarian cancer, which of the following is most commonly used as a first-line imaging modality?
A) Magnetic resonance imaging (MRI)
B) Computed tomography (CT) scan
C) Pelvic ultrasound
D) Positron emission tomography (PET) scan

A

C

29
Q

Which of the following is most commonly elevated in patients with epithelial ovarian cancer?
A) Carcinoembryonic antigen (CEA)
B) CA 19-9
C) CA-125
D) Alpha-fetoprotein (AFP)

A

B

30
Q

Which of the following is true regarding the staging of ovarian cancer?
A) Stage I indicates that the cancer is confined to the ovary
B) Stage IV indicates local metastasis
C) Stage III is confined to the peritoneum and pelvic organs
D) Stage II involves lymph node involvement

A

A

31
Q

What is the incidence of ovarian Ca?
* A) 1:33
* B) 1:75
* C) 1:150
* D) 1:80
* E) 1:85

A

D

32
Q

What is the background risk of ovarian CA?
A) 10%
B) 5.2%
C) 8.4%
D) 3.1%
D) 1.3%
E) 4.5%

A

D (1 in 80)

33
Q

What is the risk of ovarian CA with family history of one affected member?
A) 1.3%
B) 4.2%
C) 7%
D) 15%

A

B (4-5%)

34
Q

What is the risk of ovarian CA with family history of two affected members?
A) 1.3%
B) 4.2%
C) 7%
D) 15%

A

C

35
Q

What is the risk of ovarian CA with family history of hereditary cancers?
A) 1.3%
B) 4.2%
C) 7%
D) 15%

A

D (13-50%)

36
Q

What is the risk of ovarian CA with BRCA1 mutation?
A) 15%
B) 20%
C) 45%
D) 58%
E) 69%

A

E

37
Q

What is the risk of ovarian CA with BRCA2 mutation?
A) 17%
B) 20%
C) 45%
D) 58%
E) 69%

A

A

38
Q

A 45-year-old woman with ovarian cancer has been diagnosed
with stage III disease. Which of the following treatments is most
appropriate for first-line therapy?
A) Radical surgery followed by radiotherapy
B) Neoadjuvant chemotherapy followed by
debulking surgery
C) Primary debulking surgery followed by
chemotherapy
D) Hormonal therapy alone

A

C

39
Q

Lead-in: For each patient described, select the most likely type of ovarian tumor from the list below.
Options:

A. Serous cystadenoma
B. Mucinous cystadenoma
C. Dysgerminoma
D. Endometrioid carcinoma
E. Granulosa cell tumor
F. Mature cystic teratoma
G. Clear cell carcinoma
H. Brenner tumor
I. Krukenberg tumor
J. Sertoli-Leydig cell tumor
* Scenarios:
1- A 25-year-old woman presents with an ovarian mass. The tumour markers AFP and LDH are elevated. Histology
shows sheets of large cells with prominent nucleoli.
2-A 55-year-old woman has an ovarian tumour associated with endometriosis. Imaging shows a solid, partially cystic
mass.
3-A 60-year-old woman presents with abdominal pain and bloating. Imaging reveals bilateral ovarian masses, and
histology shows mucin-producing signet ring cells.
4-A 45-year-old woman has an ovarian mass with calcifications. Histology reveals a mix of hair, sebaceous material,
and other mature tissues.
5-A 52-year-old woman has a unilateral, solid ovarian tumor. She reports postmenopausal bleeding. Histology shows
Call-Exner bodies and a high level of inhibin.

A

1 - C. Dysgerminoma = most common malignant GCT. LDH elevated. Fish steak/ cerebriform
2- D
3- I
4- F
5 - E

40
Q

Lead-in: For each patient described, select the most appropriate tumor marker to evaluate or
monitor the condition.
* Options:

A. CA-125
B. CA 19-9
C. AFP
D. LDH
E. Inhibin
F. hCG
G. HE4
H. CEA
I. Thyroglobulin
J. Estrogen

  • Scenarios:
    1. A 65-year-old woman with a complex pelvic mass suspected to be an epithelial ovarian carcinoma.
    2. A 30-year-old woman with an ovarian mass, likely a granulosa cell tumor.
    3. A 28-year-old woman with an ovarian tumor suspected to be a dysgerminoma.
    4. A 45-year-old woman has a mucinous ovarian tumor; malignancy is uncertain.
    5. A young woman with a rapidly growing ovarian mass, without pregnancy
A

1) A
2) E
3) D
4) H
5) F

41
Q

Lead-in: For each clinical scenario, select the most likely FIGO stage of ovarian cancer.
* Options:

  • A. Stage IA
    B. Stage IB
    C. Stage IC
    D. Stage IIA
    E. Stage IIB
    F. Stage IIC
    G. Stage IIIA
    H. Stage IIIB
    I. Stage IIIC
    J. Stage IV
  • Scenarios:
    1. A 60-year-old woman with ovarian cancer confined to one ovary, and malignant cells are found in
    the peritoneal washings.
    2. A 50-year-old woman with cancer in both ovaries, along with spread to the uterine serosa.
    3. A 48-year-old woman with ovarian cancer that has spread to the peritoneum in the upper
    abdomen, with nodules larger than 2 cm.
    4. A 55-year-old woman whose ovarian cancer has spread to the liver parenchyma.
    5. A 63-year-old woman with ovarian cancer limited to one ovary, without any extra-ovarian spread or
    malignant cells in peritoneal washings.
A

1) C
2) D
3) I
4) J
5) A

42
Q

Lead-in: For each patient described, select the most appropriate management option.
* Options:

A. Total abdominal hysterectomy and bilateral salpingo-oophorectomy
B. Unilateral salpingo-oophorectomy
C. Chemotherapy alone
D. Chemotherapy with interval debulking surgery
E. Laparoscopic cystectomy
F. Neoadjuvant chemotherapy followed by debulking surgery
G. Watchful waiting
H. Radiotherapy
I. Hormone therapy
J. Paracentesis

  • Scenarios:
    1. A 50-year-old woman with a diagnosis of advanced ovarian cancer with large-volume ascites and peritoneal
    disease, but unfit for immediate surgery.
    2. A 30-year-old woman with a low-grade, stage IA mucinous ovarian tumor limited to one ovary who wishes to
    retain fertility.
    3. A 45-year-old woman with stage III high-grade serous ovarian cancer. Optimal cytoreduction is not initially
    feasible.
    4. A 70-year-old woman with recurrent ascites and discomfort, receiving palliative care for advanced ovarian cancer.
    5. A 55-year-old woman with a localized ovarian tumor with malignant cells in peritoneal washings and a desire to
    prevent recurrence.
A

1) D
2) B
3) F
4) J
5) A

43
Q
A

B

Chances of different cancers in Lynch:
- Endometrial: 60%
- Coloretal: 45-50%
- Ovarian: 17%

Lynch is autosomal dominant, with 50% inheritance

Chances of different cancers being Lynch:
- Endometrial: 3%
- Colorectal: 3%
- Ovarian: 1%

44
Q
A

E

45
Q
A

D

46
Q
A

B

47
Q
A

D

48
Q
A

A/ ?C

49
Q
A

D

  • 5% over 20 years without atypia
50
Q

Which cases of germ cell cancers should have neoadjuvant chemo?

A

Usually Ic and beyond, to reduce durgical complexity. It should be BEP regimen.

51
Q

What is the recommended surgery for germ cell cancers?

A

If family not complete: unilateral oophorectomy, Peritoneal washing, Omental biopsy, selective removal of enlarged LFN

Metastasis on LFN does not greatly change prognosis, so they should not be removed routinely.

52
Q

What is the recommended management for Ia and Ib germ cell cancers?

A

Surgery and surveillance. 20% of all will relapse, but almost all respond to chemo.
Dysgerminomas relapse more (25-35%)

Exception to this would be immature teratomas - surveillance can be offered for Ic and II, with alternative of BEP chemo. 30-40% will recurr, but again, almost all respond to chemo

53
Q

What is the follow-up for germ cell cancers?

A

3-6w after Sx: CT/MRI CAP + MRI Head (if not done pre-op) + Pelvis Doppler#
3 months: repeat CT/MRI Abdomen and Pelvis
–>in first 6 months after surgery, 2-weekly markers (montlhy for dysgerminoma)
1st year: monthly with markers + Pelvic USS and CXR in alternate visits
2nd year: 2-monthly with markers + CXR on alternate visits (Pelvic USS alternate visits if dysgerminoma)
3rd year: 3-monthly with markers + CXR on alternate visits
4th year: 4-monthly with markers + CXR on alternate visits
5th/6th years: 6-monthly with markers + CXR on alternate visits
7th year and more: yearly with markers + CXR on alternate visits

MRI: on initiral 3w-3 month visits. Then 6 months and yearly for 2 years –> at 36 months if dysgerminoma

Part 2 MRCOG (Antenatal) (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions