Part 2 book “Get through Mrcog - Part 2: SBAs” has contents: Gynaecological oncology, gynaecological problems, contraception, sexual and reproductive health, genetic problems, reproductive medicine or subfertility, surgical procedures and core surgical skills, post-operative complications. | 7 GYNAECOLOGICAL ONCOLOGY Questions 1. A 60-year-old woman is referred to the rapid access 2 week wait clinic with vulval itching and soreness. Vulval examination reveals small ivory-coloured slightly raised areas which join to form white patches in a figure-of-eight distribution. Vaginal introitus is narrowed with atrophy of the labia minora. Vulval mapping biopsies reveal lichen sclerosus. Her associated risks include all of the following except which one condition? a. Increased risk of a personal history of autoimmune disorders b. Increased risk of a family history of autoimmune disorders c. An associated thyroid disorder d. An associated pernicious anaemia e. Vesiculobullous autoimmune disease of anogenital site 2. A 40-year-old woman presents with severe vulval pruritus. Vulvoscopy reveals acetowhite areas following application of acetic acid. Vulval mapping biopsy reveals usual type (human papilloma virus [HPV] related) of VIN. She can be treated with which one of the following methods? a. Radical vulvectomy b. Simple vulvectomy c. Therapeutic human papilloma virus vaccine d. Interferon therapy e. Local surgical excision 3. A 24-year-old woman presents to her GP with abdominal pain. Clinical examination reveals a large abdomino-pelvic mass. She is referred to a rapid access 2-week wait clinic. Following investigations, computed tomography (CT) scan reveals left-sided solid ovarian mass with raised serum lactate dehydrogenase (LDH) enzyme levels. She undergoes fertility sparing surgery and the histology reveals nests of tumour cells (vesicular cells with clear cytoplasm and central nuclei) separated by fibrous stroma infiltrated with T lymphocytes. Which is the most likely type of ovarian tumour in her case? a. Brenner tumour b. Immature teratoma 87 Chapter 7 Gynaecological oncology c. Endodermal sinus tumour d. Dysgerminoma e. Embryonal carcinoma 4. A 48-year-old is referred to rapid access clinic with postmenopausal .
