Ovarian

Question 1

Upper limit of normal for CA-125?

Answer 1

35 IU/ml

Question 2

Form of physiological cyst which is commonest in patients taking POP?

Answer 2

Follicular cyst

Question 3

Cyst formed by excessive bleeding into the corpus luteum?

Answer 3

Luteal cyst

Question 4

Types of surface epithelium tumours? (5)

Answer 4

Serous
Mucinous
Endometrioid
Clear cell
Brenner

Question 5

Management of cysts detected on US? (3)

Answer 5

Simple cyst less than 5cm- no follow-up needed
Simple cyst 5cm-7cm- annual follow up
Cyst greater than 7cm/solid/multilocular- check CA125 and refer to gynaecology

Question 6

Reproductive factors which increase the risk of ovarian cancer?

Answer 6

Greater exposure to ovulation- e.g. nulliparity

Question 7

Protective factors? (5)

Answer 7

Pregnancy
COCP
Breastfeeding
Tubal ligation
Hysterectomy

Question 8

Tumour markers for germ cell tumours? (2)

Answer 8

AFP

beta HCG

Question 9

Peak incidence of germ cell tumours?

Answer 9

Early 20s

Question 10

Ovarian tumours which often present with excessive hormone production e.g. precocious puberty, virilism, PMB

Answer 10

Sex-cord stromal tumours e.g. Sertoli/Leydig cells

Question 11

Criteria required for diagnosis of PCOS?

Answer 11

Two of:
Oligomenorrhoea and/or anovulation
Hyperandrogenism- clinical and/or biochemical
Polycystic ovaries- 12 or more follicles in each ovary and/or volume greater than 10cm

Question 12

Primary care management of PCOS? (3)

Answer 12

COCP if not contraindicated (with anti-androgen e.g, drosperinone
Cyclical progestogen if oligomenorrhoeic (to induce a withdrawl bleed)
Annual HBa1c/FBG

Question 13

Drugs which may be used to promote fertility in PCOS? (2)

Answer 13

Clomifene

Metformin (unlicensed)