EBCOG Part 1 Oncology – Day 1 SBA

1.With respect to adenocarcinoma of the cervix, which of the following statement is not correct?

a.Accounts for 20% of cervical cancers.
b.It is likely to be diagnosed in younger women
c.Associated with a poorer prognosis in comparison with SCC of cervix.
d.There is a delay in diagnosis as compared to their squamous cell counterparts
e.HPV 16 is commonly related to adenocarcinoma.

2. .A 32 year old nulliparous woman has suffered postcoital & intermenstrual bleeding for 10 weeks before being diagnosed with stgT1a1 cervical cancer. & radiological examination is negative for LVSIWhat is the most appropriate management?

a.Chemoradiation
b.Radical hysterectomy & bilateral pelvic LN dissection
c.Radical trachelectomy & bilateral pelvic LN dissection.
d.conisation
e.Simple hysterectomy.

3.A 37 year old woman is diagnosed with stg1b1 cervical SCC on histological & clinical assessment.What is the most appropriate radiological investigation for this patient?

a.CT of abdomen & pelvis
b.CT of chest,abdomen & pelvis
c.MRI-abdomen & pelvis
d.PET-CT scan
e.Ultrasound-abdomen & pelvis

4.Which type of HPV is strongly associated with squamous cell carcinoma of the cervix?

a. 16 & 18
b. 11 & 16
c. 16 & 19
d. 15 & 17
d. 17 & 19

5.Worldwide cervical cancer is the 2nd most common malignancy in females.At what age does it have a maximum incidence?

a.15-19 yrs
b.22-24 yrs
c.25-29 yrs
d.30-34 yes
e.35-40yrs

6.A 25 year old lady was found to have an early stage cervical cancer.She has not completed her family & wants to have fertility sparing surgery.Tumours which are squamous cell carcinomas & whose diameter is less than how many cm can be considered for fertility sparing surgery?

a.</=0.5 cm
b.</=1cm
c.</=1.5 cm
d.</=2 cm
e.</=2.5 cm

7.18 year old presents with 6 month history of postcoital & intermenstrual bleeding She is using OCPs for 3 years.Her 23 year old sister has just completed treatment for a SCC of cervix.On exam ,the cervix displays a prominent ectropion.screening for STIs is negative.What is the most appropriate course of action?

a.Cervical smear
b.Urgent referral to colposcopy
c.Cautery of the ectropion
d.Cervical biopsy
e. Reassurane that she does not have cancer

8.Mrs xy is 55 years old .She underwent TAH + BSO 4 weeks ago .Her pre operative histology following a prior loop excision of the cervix suggested incompletely excised CIN 3 .She is at consultant led follow up clinic to discuss her further management .Which of the following treatment options are best suited to her ?

a.colposcopy at 6 ,12 and 24 months
b. no further follow up
c.vault cytology at 6 and 12 months
d.vault cytology at 6,12 and 24 months
e.Vault cytology at 6 and 12 months ,followed by 9 annual vault cytology samples .

9. 53 year old woman is diagnosed with stage1A1 cervical squamous cell carcinoma after histology, clinical and radiological assessment . What is the most appropriate management plan ?

a.Conization
b.modified radical hysterectomy with removal of lymph roots
c.Radical trachelectomy
d.total abdominal hysterectomy with bilateral Salpingo-oophorectomy
e. total abdominal hysterectomy with conservation of ovaries .

10. 25 year old P0 ,he who wished to preserve future fertility ,underwent a cervical conization after an unsatisfactory colposcopy . The conization specimen demonstrated an invasive carcinoma of the cervix infiltrating 2.5 mm below the basement membrane .There was no evidence of LVSI ,and the margins of the cone were free of dysplasia or carcinoma .What would be the best strategy of management for this patient ?

a. external beam radiotherapy
b.external radiotherapy followed by brachytherapy
c.no further therapy
d.Radical hysterectomy
e.simple hysterectomy .