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1. A 62-year-old woman presents to rapid-access gynaecology clinic with bleeding. She has a history of breast cancer and had a wide local excisio axillary clearance 8 years ago followed by 5 years of tamoxifen. She has mass index (BMI) of 30. Her periods stopped at the age of 50 years and she h years of combined hormone replacement therapy. She is an ex-smoker. What is the most significant risk factor for endometrial cancer?CorrectIncorrect
2. A 54-year-old woman presents with a diagnosis of endometrial cancer. On examination you note multiple skin-tag-like lesions. She has also had recent surgery for a growth on her eye, which she said, was benign but related to the skin lesions. She has a history of breast cancer and underwent a wide local excision and tamoxifen 10 years ago.
Which genetic predisposition is she likely to have?CorrectIncorrect
3. A 39-year-old woman has a laparoscopic myomectomy for fibroids and subfertility She is nulliparous and trying for a baby. The histology shows a leiomyosarcoma
What is the next appropriate step?CorrectIncorrect
4. A 32-year-old woman seen in colposcopy is diagnosed with squamous cell cervical cancer width 10 mm, and depth 3 mm. There is no extension to the surrounding structures. She has no children and is keen to preserve her fertility. Her body mass x is 25 and she has no significant co-morbidities.
what is the most appropriate treatment for her?CorrectIncorrect
5. A 68-year-old woman with long-standing lichen sclerosis noticed a new pigmented lesion <1 cm on her left labium. A punch biopsy confirms differentiated VIN with no evidence of invasion. What is the most appropriate management for her?CorrectIncorrect
6. A 71-year-old woman has developed squamous cell carcinoma of the vulva on a background of Paget’s disease. The lesion measures 1 x 5 cm and is located on the right vulva with its innermost margin 2 cm from the midline.
What management would you recommend?CorrectIncorrect
7. A 55-year-old patient has had a colposcopicexamination or a suspicious well-circumscribed vulval lesion and vulvar intraepithelial neoplasia 3 is identif ed at histopathology.What is the most appropriate next step in management?CorrectIncorrect
8. A 65-year-old patient undergoes a TAH+BSO or a suspicious 8-cm right ovarian mass and normal CA-125. She had originally presented with postmenopausal bleeding. Frozen section examination demonstrates
Call–Exner bodies.It is likely that the pathology specimen will also demonstrate which of the following?CorrectIncorrect
9. In counselling a patient who had recently tested positive or BRCA1 mutation, risk-reducing bilateral salpingo-oophorectomy (RRBSO) decreases ovarian cancer risk by:CorrectIncorrect
10. A 25-year-old para 0, who wished to preserve utureertility, underwent a cervical conization a er an unsatisactory colposcopy. e conization specimen demonstrated an invasive carcinoma o the cervix inf ltrating 2.5 mm below the basement membrane. ere was no evidence olymphovascular space involvement, and the margins o the cone were ree o dysplasia or carcinoma. What would be the best strategy of management for this patient?CorrectIncorrect
11. A 45-year-old patient is ound to have a large cervical cancer inf ltrating into the right parametrium. Rectovaginal examination suggests parametrial involvement, although not reaching the pelvic sidewall. A chest x-ray and cystoscopy were both clear. A computed tomography o the abdomen and pelvis, however, shows an enlarged, suspicious le paraaortic lymph node.What stage of disease is this?CorrectIncorrect
12. A 29-year-old patient is ound to have high-grade squamous dyskaryosis at routine cervical smear at 7 weeks’ gestation. Colposcopicbiopsies show early invasive disease. A subsequent cold-kni e conization at 17 weeks shows microinvasive carcinoma o the cervix with clear surgical margins.What would be the most appropriate plan of action?CorrectIncorrect
13. A 60-year-old patient who had previously had a TAH+BSO or benign disease is ound to have an exophytic 1-cm nodule in the upper part o the vagina. Biopsies obtained demonstrate an adenocarcinoma. What is the most likely diagnosis?CorrectIncorrect
14. In cases o cervical cancer, radical hysterectomy with bilateral pelvic lymphadenectomy can potentially be used to treat all o theollowingstages o cervical cancer except:CorrectIncorrect
15. A 47-year-old patient with a history o severe endometriosis is oundto have a le -sided, 10-cm unilocular cystic mass with a solid component arising rom its wall. A computed tomography scan supports this f ndingand the CA-125 is 300 U/ml. These findings raise suspicion of:CorrectIncorrect
16. A 55-year-old patient who has a BMI o 39 is scheduled to have a TAH+BSO and pelvic lymphadenectomy or endometrial cancer.What is the best method to reduce her venous thromboembolic risk?CorrectIncorrect
17. A 40-year-old patient has had a cervical smear showing moderate/severe dyskaryosis. Colposcopic examination and biopsy conf rm CIN II, and she opts or TAH as her amily is complete. Histopathology conf rms completely excised CIN. What is the most appropriate follow-up?CorrectIncorrect
18. In counselling a 45-year-old woman has recently been diagnosed with Stage II cervical squamous carcinoma. It is reasonable to quote a 5-year survival rate of around:CorrectIncorrect
19. A 66-year-old patient presented with vulval pruritus. On examination there was a 1.5-cm lesion on her right labia majora with an irregular border; the lesion was tender to touch. An excision biopsy was obtained which showed squamous cell carcinoma with positive margins and invasive disease to 0.8 mm.What is the most appropriate next step in management?CorrectIncorrect
20. A 60-year-old patient presents with a 3-month history o intermittent vaginal bleeding. She has been menopausal since the age o 55 and is otherwise f t and well. e vaginal bleeding was sudden in onset and heavy, with the passage o blood clots and intermittent lower abdominal pain. She has no history o postcoital or contact bleeding, weight loss or anorexia and she was not on HRT. A transvaginal ultrasound scan shows an endometrial thickness o 15 mm and Pipellebiopsy conf rms endometrial adenocarcinoma. At TAH+BSO, the le ovary was noted to contain solid tumour.What is the most likely diagnosis?CorrectIncorrect