Oncology Extra Questions Batch A – MCQ

1. The most common cause of death from gynaecological malignancy in the developed world:

2. The risk of endometrial cancer is increased in the following condition:

3. Oral contraceptive pills reduce the risk of endometrial cancer by:

4. The incidence of occult ovarian cancers detected in women with BRCA mutation who undergo risk reducing salpingo-oophorectomy is:

5. The following statements are true regarding borderline ovarian tumours except:

6. Borderline tumours of the ovary are commonly associated with the following genetic mutation:

7. The recommended first line of treatment in Lichen sclerosus is:

8. Lichen sclerosus commonly presents in the following age group:

9. Flat-topped violaceous purpuric plaques on the vulva are characteristic of:

10. A 50-year-old woman presented with 20 mm mass in the left breast associated with skin indentation. Which one of the following is the next most appropriate action?

11. A 72-year-old woman was diagnosed with 10 mm, grade II, oestrogen receptor negative invasive left breast cancer. She had a palpable left axillary lymph node. Which one of the following is the next most appropriate action?

12. Which one of the following correctly describes the NHS breast cancer screening programme?

13. A 34-year-old woman presents with 6 weeks’ history of a lump in the upper outer quadrant of the right breast. She has a family history of breast cancer. Clinical examination of the breast suggests a benign lump (E2 grading on examination). Which one of the following is the next most appropriate action?

14. What percentage of patients in dedicated vulval cancers present with Lichen sclerosus?

15. Untreated VIN (vulva intraepithelial neoplasia) may progress to carcinoma of vulva in:

16. The commonest HPV type to be associated with vulval carcinoma and vulval intraepithelial carcinoma is:

17. In management of invasive vulval cancer, inguinofemoral lymphadenectomy can be avoided in all except:

18. All the following are true about endometrial cancers except:

19. What percentage of endometrial cancers are inherited?

20. In staging of vulvar carcinoma, a tumour of any size, with or without extension to adjacent perineal structures, and with more than three positive inguinofemoral nodes is:

21. The first malignancy that was recognised to be linked to obesity is:

22. The most prevalent cancer affecting pregnancy and puerperium is:

23. The following are recommended by FIGO for staging of cervical cancer except:

24. All of the following about adenocarcinomas of the cervix are true except:

25. Detection rates of endometrial cancer with the Pipelle in postmenopausal women are:

26. Regarding peritoneal cytology in endometrial cancer, the following is true:

27. Regarding lymphatic involvement in endometrial cancer, pick the incorrect statement.

28. The 5-year overall survival for endometrial cancer is:

29. Call–Exner bodies are found in:

30. Ms. XY is 64 years old, postmenopausal. Her recent TV ultrasound scan reveals the presence of a 4 cm right ovarian cyst. The cyst is multiloculated and shows the presence of a solid area. There is no free fluid. The left ovary is normal. Her CA125 is 50 u/ml. She has been explained of her RMI results. What is her RMI score based on the information provided?

31. Ms. XY is 64 years old, postmenopausal. Her recent TV ultrasound scan reveals the presence of a 4 cm right ovarian cyst. The cyst is multiloculated and shows the pres- ence of a solid area. There is no free fluid. The left ovary is normal. Her CA125 is 50 u/ml. She has been explained of her RMI results (450). Which of the following treatment options are best suited to her?

32. Ms. XY is 64 years old, postmenopausal. Her recent TV ultrasound scan reveals the presence of a 4 cm right ovarian cyst. The cyst shows anechoic fluid with no solid areas. There is no free fluid. The left ovary is normal. Her CA125 is 5 u/ml. Which of the following treatment options are best suited to her?

33. Ms. XY is 35 years old and had a LLETZ recently. The histology results confirm the presence of CIN 2, which has been completely excised. How should she be followed up under the NHS cervical screening programme if her subsequent tests are normal?

34. Lifetime increase in risk of breast cancer with CTPA:

35. Ms. XY is 8 weeks’ pregnant. Her last smear result suggested mild dyskaryosis. She is due for a repeat smear. Which of the following treatment options are best suited to her?

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

37. All of the following statements regarding borderline ovarian tumours are true except:

38. The risk of contralateral lymph node involvement in a laterally placed lesion of vulval carcinoma is:

39. During surgery for ovarian tumour, if the frozen section report is a borderline ovarian tumour, which of the following is not a recommended procedure?

40. The role of the sentinel lymph node mapping is most established in this gynaeco- logical malignancy:

41. Administration of tamoxifen is a cornerstone in the treatment of breast cancer, but it has a weak estrogenic effect on the endometrium. A woman who is taking Tamoxifen presents with post-menopausal bleeding (PMB).
What is her risk of developing endometrial cancer when compared to the general population?

42. PMB is defined as uterine bleeding occurring after at least one year of amenorrhoea. The main purpose of investigating a woman with PMB is to rule out endometrial cancer. What is the risk that a woman presenting with PMB will have endometrial cancer?

43. A 60-year-old woman presents with a first episode of PMB. What is the most appropriate first line of investigation?

44.A 55-year-old woman presents with a first episode of PMB. A transvaginal ultrasound scan showed an endometrial thickness of 3.8mm. What is the most appropriate management plan?

45. A 60 year old undergoes hysterectomy and bilateral salpingo- oophorectomy for grade 1 endometrial cancer. The final histology report confirms tumor invading the uterine serosa.As per the new FIGO staging of endometrial cancer, what is the stage?

46. Ovarian cysts are common in postmenopausal women, although their prevalence is lower than in premenopausal women. A 59-year-old woman is referred to the clinic with fullness in the lower abdomen and a serum CA125 level of 64iu/l. What is the first line of investigation?

47. It is recommended that ‘risk of malignancy index’ (RMI) should be used to triage post-menopausal women with an ovarian cyst to assess low, moderate or high risk of malignancy.
This is calculated as U (ultrasound score) X M (menopausal status) X CA125. What is the RMI of a post-menopausal woman with a CA125 of 15, ultrasound showing 6 cm bilateral, multiloculated cyst?

48. It is recommended that RMI should be used to triage post- menopausal women with ovarian cyst to assess low, moderate or high risk of malignancy. This is calculated as U (ultrasound score) × M (menopausal status) × CA125.
What is the risk of ovarian cancer in a woman who has an RMI of 25–250 (moderate risk)?

49. Who should be responsible for the management of women with intermediate risk of malignancy (RMI of 25–250)?

50. Borderline ovarian tumors are a distinct pathological group of neo- plasms typically seen in younger women. They are often diagnosed at an earlier stage resulting in excellent prognosis.

What is the histologic feature that differentiates borderline ovarian tumors from invasive ovarian cancers?