EBCOG Part-1 High Yield questions Oncology

A. Brenner tumour
B. Choriocarcinoma
C. Clear cell tumour of ovary
D. Dysgerminoma
E. Endometriosis
F. Granulosa tumour
G. High-grade serous epithelial cancer
H. Leydig cell tumour
I. Mature cystic ovarian teratoma
J. Ovarian fibroma
K. Ovarian thecoma

For each of the following cases, select the single most likely diagnosis. Each option may be used once, more than once or not at all.

1. A 45-year-old woman undergoes a total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for endometrial cancer. She has a body mass index of 20 and no relevant medical or family history. At the time of surgery her left ovary has a distinct yellow appearance.

2. An 18-year-old woman with a pelvic mass arising from the right adnexa. Lactatedehydrogenase is markedly elevated.

3. A 48-year-old woman undergoes total laparoscopic hysterectomy and bilateralsalpingo-oophorectomy as part of risk-reducing surgery for BRCA1 mutation. The histology of the ovaries shows occult malignancy.

A. 0
B. 10
C. 40
D. 85
E. 90
F. 140
G. 255
H. 315
I. 700
J. 2240
K. 2310
L. 4335

For each of the following cases, select the correct risk of malignancy index score. Each option may be used once, more than once or not at all.

4. A 64-year-old postmenopausal woman with bilateral with a left ovarian cyst measuring 4 cm and containing a single septation and a right simple cyst measuring 6 cm. Her CA-125 is 35 kU/L.

A. 0
B. 10
C. 40
D. 85
E. 90
F. 140
G. 255
H. 315
I. 700
J. 2240
K. 2310
L. 4335

For each of the following cases, select the correct risk of malignancy index score. Each option may be used once, more than once or not at all.

5. A 70-year-old women has a complex 6 cm ovarian cyst with solid and liquid components and multiple septations. There is a small amount of free fluid. Her CA -125 is 10 KU/L

A. Stage IAI
B.Stage IA2
C. Stage IB1
D. Stage IB2
E. Stage IIA1
F. Stage IIA2
G. Stage IIB1
H. Stage IIIA
I. Stage IIIB
J. Stage IVA
K. Stage IVB

For each of the following clinical findings, select the correct stage from the options listed above. Each option may be used once, more than once or not at all.

6. A 3cm squamous cell carcinoma of cervix, no extension to uterus, parametria or vagina on imaging or examination under anaesthetic.

7. A large cervical tumour with involvement of the lower third of the vagina, parametria but no bladder or bowel involvement or distant metastasis.

8. A2cm cervical tumour but with involvement of upper two thirds of the vagina and parametrial invasion. There is no evidence of extension to pelvic side wall or lower third of vagina or distant organs.

A. Azathioprine
B. Canesten cream
C. Cyclosporine
D. Clobetasol cream
E. Imiquimod
F. Methotrexate
G. Moisturisers
H. Mycophenolate
I. Prednisolone
J. Reassurance and counselling to break the itch cycle
K. Wide local excision and groin node dissection

For each of the following cases, select the single most appropriate treatment. Each option may be used once, more than once or not at all.

9. A 70-year-old woman presents with a 3 cm squamous cell cancer on her cell cancer on her right labia

10. A 45-year-old woman presents with multicentric VIN.

11. A 50-year-old woman presents with itching and burning of the vulva. On examination there are lacy reticular lesions on the vulva.

A.Stage IA
B.Stage IB
C. Stage ICI
D. Stage IC2
E. Stage IC3
F. Stage IIA
G. Stage IIB
H. Stage IIIA1
I. Stage IIIA2
J. Stage IIIB
K. Stage IIIC
L. Stage IVA
M. Stage IVB

For each of the following cases, select the stage. Each option may be used once more than once or not at all.

12. An 80-year-old woman presents with a large pelvic mass. Imaging reveals liver metastasis and extensive peritoneal deposits with appearances suggestive of omental cake.

A.Stage IA
B.Stage IB
C. Stage ICI
D. Stage IC2
E. Stage IC3
F. Stage IIA
G. Stage IIB
H. Stage IIIA1
I. Stage IIIA2
J. Stage IIIB
K. Stage IIIC
L. Stage IVA
M. Stage IVB

For each of the following cases, select the stage. Each option may be used once more than once or not at all.

13. A 68-year-old woman presents with bilateral ovarian tumours but no evidence of spread elsewhere.

A.Stage IA
B.Stage IB
C. Stage ICI
D. Stage IC2
E. Stage IC3
F. Stage IIA
G. Stage IIB
H. Stage IIIA1
I. Stage IIIA2
J. Stage IIIB
K. Stage IIIC
L. Stage IVA
M. Stage IVB

For each of the following cases, select the stage. Each option may be used once more than once or not at all.

14. A 70-year-old woman presents with high-grade serous ovarian cancer extending! into uterus and fallopian tubes. No other pelvic organs are involved and there is no evidence of distant metastasis.

A.Stage IA
B.Stage IB
C. Stage ICI
D. Stage IC2
E. Stage IC3
F. Stage IIA
G. Stage IIB
H. Stage IIIA1
I. Stage IIIA2
J. Stage IIIB
K. Stage IIIC
L. Stage IVA
M. Stage IVB

For each of the following cases, select the stage. Each option may be used once more than once or not at all.

15. A 60-year-old woman presents with high-grade serous ovarian cancer extending into uterus and fallopian tubes. In addition, there are multiple peritoneal deposits > 2 cm in the upper abdomen with evidence of tumour on the surface/capsule of the spleen only.

A. Full staging laparotomy in a cancer centre
B. Laparoscopic aspiration of the cyst
C. Laparoscopic bilateral salpingooophorectomy in a generalcancer centre
D. Laparoscopic bilateral salpingooophorectomy in a general gynaecology centre
E. Laparoscopic ovarian cystectomy
F. Laparoscopic unilateral salpingooophorectomy
G. Laparotomy, removal of the ovariancyst and frozen section examination and proceed
H. MRI of pelvis and CA-125 in 1 month
I. MRI of pelvis and CA-125 in 4 months
J. MRI of pelvis and CA-125 in 12 months
K. Ultrasound scan of pelvis and CA-125 in 1 month
L. Ultrasound scan of pelvis and CA-125 in 4 months
M. Ultrasound scan of pelvis and CA-125 in 12 months

For each of the following cases, select the most appropriate treatment. Each option may be used once, more than once or not at all.

16. A 68-year-old woman has a complex bilateral multiloculated cysts. Her CA-125 is 30 kU/L.

A. Additional adhoc cervical smears
B. Annual cervical smears
C. BRCA testing for patient
D. BRCA testing for relative
E. CA-125 blood test
F. No screening is available
G. Pelvic ultrasound
H. Pelvic ultrasound and CA-125 blood test
I. Referral to a genetic counsellor
J. Routine cervical screening

For each of the following cases, select the initial appropriate screening test. Each option may be used once, more than once or not at all.

17. A 30-year-old woman is very anxious because her sister died of cervical canceraged 33 years.

18. A 45-year-old woman has a sister who has recently been diagnosed with breastcancer, and their mother died of ovarian cancer aged 70 years.

19. A 45-year-old woman who had breast cancer and is BRCA1 positive wants to knowif her ovaries are will be affected.

A. I A
B. I B
C. I C1
D. I C2
E. I C3
F. II
G. III A1
H. III A2
I. III B
J. III C1
K. III C2
L. IV A
M. IV B

For each of the following clinical scenarios, choose the single most appropriate stage of disease from the list of options given above. Each option may be used once, more than once or not at all.

20. A 60-year-old woman has a laparoscopic bilateral oophorectomy for a persistent ovarian cyst. Her serum CA125 is 50 IU/ml. The ovarian capsule is noted to be intact, but during the course of the operation, the cyst ruptures. Peritoneal washings prior to the rupture are clear. The contralateral ovary is normal. Histology confirms an ovarian carcinoma.

21. A woman is diagnosed with cervical cancer. The carcinoma has extended into the pelvic sidewall. On rectal examination, there is no cancer- free space between the tumour and the pelvic sidewall. The tumour involves the lower third of the vagina. There is unilateral hydronephrosis.

22. A 90-year-old woman is diagnosed with vulval cancer. Imaging suggests metastases to both inguinofemoral and pelvic lymph nodes.

A. Cancer antigen 19-9 (CA19-9)
B. Cancer antigen 72-4 (CA72-4)
C. Carcinoembryonic antigen (CEA)
D. Epithelial tumour antigen (ETA)
E. α-Fetoprotein (AFP)
F. Homeobox protein CDX2
G. Human chorionic gonadotropin (hCG)
H. Human epididymis protein 4 (HE4)
I. Inhibin J. Lactate dehydrogenase (LDH)
K. Oestradiol
L. Oestriol

For each of the following situations, choose the single most appropriate tumour marker from the list of options above. Each option may be chosen once, more than once or not at all.

23. A compound belonging to the transforming growth factor- β (TGF- β) superfamily, produced by both the Sertoli cells of the testis and granulosa cell tumours of the ovary.

24. A steroid that is almost undetectable in the non- pregnant female, but whose levels rise >1000-fold during pregnancy.

25. A compound that is elevated in women with an ovarian dysgerminoma.