Chemo
Tumor Markers
Genetics
Staging
Grab Bag
100
What cardiac test would you order prior to starting doxorubicin for a patient?
An echo (cardiac toxicity)
100
Name the tumor marker associated with choriocarcinoma
Hcg
100
Name a type of GYN cancer that would prompt you to refer your patient for genetic counseling
Ovarian cancer, endometrial cancer (with MMR deficiency!)
100
What is the 5-year survival associated with local, low-grade endometrioid endometrial cancer?
95%
100
Name one type of ovarian cancer is associated with endometriosis
Clear cell, endometrioid
200
Which chemotherapy drug is associated with hemorrhagic cystitis?
Cyclophosphamide
200
This tumor marker is associated with the most common malignant germ cell tumor
LDH (associated with dysgerminomas)
200
What syndrome is associated with a mutation in tumor suppressor gene P53?
Li-Fraumeni
200
You are in the OR for a laparoscopic ovarian cystectomy for a patient with a large 19cm ovarian cyst. When removing the cyst from the abdomen, there is noted to be spill into the abdomen, though the rest of the abdomen and pelvis appear normal. Frozen pathology returns as a mucinous carcinoma. At her post operative visit, the patient asks if the cyst rupturing affects her diagnosis. How would you counsel her on her stage if there is no evidence of disease elsewhere?
Stage IC1 - surgical spill upstages her from a IA
200
These two oncoproteins are associated with high-risk HPV subtypes
E6 and E7
300
Which chemotherapy drug acts by forming platinum-DNA adducts?
Carboplatin
300
A 31year-old presents with a 9 cm complex adnexal mass and has noted intermittent vaginal bleeding outside of menses. What is the tumor marker that will most aid in diagnosis?
Inhibin
300
What age would you recommend someone with a BRCA1 mutation undergo risk-reducing BSO?
Age 35-40 or after childbearing. For BRCA 2, age 40-45
300
A 45 year-old patient has a large mass extruding from her cervix and an enlarged supraclavicular node on exam. Both are biopsied and are positive for squamous cell carcinoma. What is her stage?
IVB (distant mets)
300
What percentage of patients with EIN will have an underlying cancer on future pathology specimens?
~40%
400
What is the mechanism of action of paclitaxel?
Microtubule stabilization
400
Name the tumor marker associated with placental site trophoblastic tumor
HPL
400
Name the syndrome associated with variations in PTEN
Cowden syndrome
(risk of thyroid, breast, endometrial cancers)
400
A 32 year-old G3P2 with 2 prior uncomplicated SVDs presents to your office at 21 weeks after a diagnosis of clinical stage IB1 squamous cell carcinoma of the cervix. Lymph nodes are negative. She strongly wishes to continue this pregnancy. What is your recommendation in terms of delivery planning and treatment?
Cesarean delivery after fetal maturation followed by radical hysterectomy and LND
400
A 58 year-old patient presents with a new superficial mass on her abdomen. Medical history is significant for stage IA endometrial cancer s/p RATLH, BSO, SLND two years ago and type 2 diabetes. The image below is what you find on abdominal exam. What is your diagnosis?
Port site metastasis
500
What are two contraindications to bevacizumab use for patients?
Uncontrolled HTN, VTE, high risk of GI perforation
500
A 12 year-old presents with a 12 cm adnexal mass and an elevated AFP. What histological feature is diagnostic of her pathology?
Schiller duval body (she likely has a yolk sac tumor)
500
Name (at least) four of the genes associated with Lynch syndrome
MLH1, MSH2, MSH6, PMS2, EPCAM
500
What is considered low risk GTN and how does treatment differ from high risk GTN?
Low risk is a WHO score less than 7 (high risk is greater than or equal to 7) and patients receive single agent chemo vs multi agent for high risk
500
A 48 year-old patient presents with a 5 cm ovarian mass, large-volume ascites, and bilateral pleural effusions. A unilateral salpingo-oophorectomy is performed, and the specimen is sent for frozen section. Pathology is unsure of the diagnosis but reports bland looking fibroblastic cells. What is your diagnosis of the mass?
A fibroma (patient has meigs syndrome - benign!)