Reproduction and Cancer Multiple Choice Questions for Vol. 24, No. 1






  • 1.

    The following statement(s) is/are correct concerning ovarian tissue cryopreservation and transplantation:




    • a) Ovarian tissue cryopreservation is the only current option for fertility preservation in children.



    • b) Heterotopic transplantation may be indicated if the pelvis is not suitable for transplantation due to previous radiation or severe scar formation



    • c) Cryopreservation of intact human ovary with its vascular pedicle is an effective means of fertility preservation in humans



    • d) Animal studies have demonstrated that GnRH agonist treatment does not prevent primordial follicle depletion after the xenografting of ovarian tissue with or without gonadotropin stimulation



    • e) The risk of ovarian metastasis is classified high in patients with leukemia.



  • 2.

    The following statement(s) is/are true about gonadotoxicity:




    • a) Cyclophosphamide is the most cytotoxic agent for gonads



    • b) Procarbazine is a chemotherapeutic agent that does not cause premature ovarian failure (POF).



    • c) Methotrexate is considered to be low risk for gonadal dysfunction.



    • d) Abdominal radiation is less toxic than chemotherapy.



    • e) Bone marrow transplantation is the treatment posing the greatest risk of POF.



  • 3.

    Which fertility preservation option could be proposed to a 6-year-old girl diagnosed with thalassemia major, prior to bone marrow transplantation?




    • a) embryo cryopreservation



    • b) ovarian stimulation with oocyte cryopreservation



    • c) ovarian cortical fragments cryopreservation



    • d) whole ovary cryopreservation



    • e) in vitro maturation



  • 4.

    Which fertility preservation option could be proposed to a 22-year-old woman diagnosed with leukemia, prior to chemotherapy?




    • a) embryo cryopreservation



    • b) ovarian stimulation with oocyte cryopreservation



    • c) ovarian cortical fragments cryopreservation



    • d) whole ovary cryopreservation



    • e) in vitro maturation



  • 5.

    In case of premature ovarian failure (POF) in a patient with stored ovarian tissue who wishes to undergo ovarian tissue transplantation:




    • a) ovarian tissue transplantation is not a safe option after Hodgkins lymphoma.



    • b) orthotopic ovarian fragment transplantation is the most effective way to restore fertility.



    • c) heterotopic transplantation may restore endocrine function, but not natural fertility.



    • d) ovarian fragment transplantation can be proposed if the patient is cured of leukemia.



    • e) whole ovary transplantation has the highest success rate.



  • 6.

    Concerning the administration of chemotherapy, the following statement(s) is/are true:




    • a) All cytotoxic drugs can be used after the first trimester of pregnancy



    • b) Chemotherapy is best avoided after 35 weeks of pregnancy



    • c) Dosages of chemotherapy should be higher during pregnancy



    • d) Administration of chemotherapy during the second or third trimester increases the incidence of congenital malformations



    • e) The placenta is a barrier that protects the fetus



  • 7.

    Concerning surgery during pregnancy, the following statements are true:




    • a) Pregnant patients should be positioned in left lateral tilt.



    • b) Pregnant women have an increased risk of post-surgery thrombosis.



    • c) Pregnant women should not have strong painkillers post-surgery.



    • d) Laparoscopy should be avoided during pregnancy.



    • e) The preferred timing for surgery in pregnancy is the second trimester.



  • 8.

    Concerning the impact of chemotherapy on the fetus /neonate / child, the following statement(s) is/are true:




    • a) Chemotherapy during the second and third trimesters of pregnancy alters the development and neurological, psychological performance of the children



    • b) Anthracyclines administered during pregnancy affect fetal and neonatal cardiac development



    • c) Chemotherapy during the second and third trimester does not increase the rate of fetal malformations during the pregnancy



    • d) Postnatal pancytopenia may occur after administration of chemotherapy during pregnancy



    • e) The birth weight is lower when the children have been exposed to chemotherapy during pregnancy



  • 9.

    Concerning pre-invasive lesions of the cervix during pregnancy, the following statement(s) is/are true:




    • a) The incidence of pre-invasive lesions during pregnancy are extremely rare



    • b) The diagnosis of pre-invasive lesions by colposcopy and cytology is more difficult during pregnancy



    • c) Biopsy of the cervix should be avoided because of the high risk of bleeding and miscarriage



    • d) CIN tends to progress more rapidly during pregnancy



    • e) Conisation is preferably performed in the third trimester



  • 10.

    The following is/are true concerning Doxorubicin and amenorrhea:




    • a) Amenorrhoea is more likely in reduced doses



    • b) Doxorubicin based chemotherapy causes amenorrhea in almost 60%



    • c) Amenorrhoea is more likely with added fluorouracil and cyclophosphamide



    • d) Is less likely in young patients



    • e) Amenorrhoea in older women is usually permanent



  • 11.

    In women younger than 35 years, chemotherapy is likely to induce:




    • a) Temporary amenorrhea



    • b) Permanent amenorrhea



    • c) Menorrhagia



    • d) Irreversible anovulation



    • e) Hot flushes and night sweats



  • 12.

    Aromatase inhibitors induce:




    • a) multiple ovulations



    • b) one ovulation



    • c) permanent amenorrhea



    • d) anovulatory cycles



    • e) irreversible anovulation



  • 13.

    Tamoxifen therapy:




    • a) is used when estrogen receptors (ER) and progesterone receptors (PR) are negative



    • b) is never used with GnRH analogues



    • c) should be continued for 2 years



    • d) may induce hot flushes



    • e) is safe for the embryo if a pregnancy occurs



  • 14.

    Concerning the use of ionizing radiation during pregnancy, the following statement(s) is/are true:




    • a) Diagnostic procedures with an associated radiation dose of less than 100 mSv cause no direct measurable harmful effects.



    • b) The ALARA principle means that all radiation doses should be avoided.



    • c) Standard guidelines exist on the performance and acquisition parameters for diagnostic procedures in pregnant patients



    • d) Radiotherapy is always to be avoided during pregnancy



    • e) Iodinated and gadolinium contrast media can safely be used



  • 15.

    Which of the following tumour types are associated with endometriosis associated ovarian cancer?




    • a) Epithelial endometrioid



    • b) Germ cell tumors



    • c) Clear cell carcinoma



    • d) Granulosa cell tumors



    • e) Theca-stroma cell tumors



  • 16.

    Common genetic alterations in endometriosis and ovarian cancer include:




    • a) Over-expression of the Bcl gene



    • b) Decreased expression of the Bax gene



    • c) Over-expression of the Bax gene



    • d) PTEN inactivating mutations



    • e) P53 inactivating mutations



  • 17.

    The risk for subsequent development of breast cancer in women with endometriosis is increased in:




    • a) Multiparous women



    • b) Women over the age of 40



    • c) Women with severe (stage IV) endometriosis



    • d) Women that had fertility treatments and conceived.



    • e) Women who received treatment with GnRH analogues



  • 18.

    Ovarian cancers in germline mutation BRCA1 carriers are commonly associated with:




    • a) A strong family history of breast cancer



    • b) Mucinous tumours



    • c) High stage



    • d) Poor response to platinum chemotherapy



    • e) Family history of male breast cancer



  • 19.

    With regards to management of women with a BRCA1 or BRCA2 mutation, which of the following statement(s) is/are true:




    • a) Prophylactic oophorectomy totally removes cancer risk



    • b) Prophylactic oophorectomy reduces breast cancer risk in all carriers by 50%



    • c) Following prophylactic oophorectomy, HRT is contraindicated



    • d) Ovarian screening should be performed yearly with TVUS



    • e) Breast screening should be carried out in accordance with the National Breast screening programme



  • 20.

    The following statement(s) regarding ovarian cancer susceptibility genes is/are true:




    • a) Direct sequencing is used to detect all mutations in BRCA1 and BRCA2



    • b) Pathogenic mutations in BRCA1 and BRCA2 are mainly protein truncating mutations



    • c) Mutation analysis should be performed in families with a 20% chance of detecting mutation



    • d) Mutation analysis is only undertaken on individuals affected with cancer



    • e) Individuals with variants of unknown significance should have PBSO



  • 21.

    The following are strong predictors (>20%) of germline mutation in the MMR gene:




    • a) Amsterdam positive family history



    • b) Synchronous colon and endometrial cancer



    • c) Early onset endometrial cancer in a woman with no family history of LS cancers.



    • d) Synchronous endometrial and ovarian cancer



    • e) MSI in a colon tumour from an individual with FH colon cancer



  • 22.

    The following are components of the metabolic syndrome:




    • a) Hyperinsulinaemia



    • b) Hypertension



    • c) High high-density lipoprotein cholesterol



    • d) Hyperglycaemia



    • e) Breast Cancer



  • 23.

    Polycystic ovary syndrome:




    • a) can be diagnosed by the presence of polycystic ovarian appearances on ultrasound alone.



    • b) the combination of anovulation and high testosterone is diagnostic



    • c) affects about 20% of the general population



    • d) always result in obesity, hirsuitism and infertility



    • e) when resulting in prolonged amenorrhoea increases the risk of endometrial cancer.



  • 24.

    Hyperandrogenaemia:




    • a) is the result of adrenal tumours in most cases



    • b) can result in increased oestrogen production through peripheral aromatisation



    • c) has been associated with an increased risk of endometrial cancer in human epidemiological studies.



    • d) can be suspected when the sex hormone binding globulin concentration is reduced, despite androgen concentration being normal.



    • e) increases the risk of breast cancer by direct proliferative action on the mammary epithelium



  • 25.

    Breast cancer:




    • a) is more common in women with type II diabetes



    • b) has been confirmed to be associated with polycystic ovaries



    • c) in premenopausal women has been linked with obesity



    • d) has been associated with hyperinsulinaemia which can induce increased ovarian testosterone production



    • e) is more common in women with increased ovarian testosterone production



  • 26.

    Ovarian cancer relative risk:




    • a) Decreases by 20% for each 5 years of oral contraceptive use



    • b) Women with genetic predisposition to ovarian cancer development do not have any beneficial effect from oral contraceptive use



    • c) It is almost 50% for 15 years of oral contraceptive use



    • d) Remains stable at its reduced levels irrespective of the time passed from oral contraceptive last use



    • e) Is similar between the different histological types of tumours after oral contraceptives use



  • 27.

    Endometrial cancer relative risk:




    • a) Decreases by 50% for 4 years of oral contraceptive use and by 70% for 12 years of use



    • b) Begins to rise from its reduced levels after ceasing oral contraceptive use



    • c) A significant beneficial effect remains a long time after ceasing



    • d) It is similar between the different histological types



    • e) Begins to decrease with the onset of oral contraceptive use



  • 28.

    Which of the below can be considered as advantages of IVM over IVF for fertility preservation in cancer patients:




    • a) Shorter duration of treatment



    • b) Enabling oocyte retrieval at any time of the cycle



    • c) Eliminating the need for medication



    • d) Avoiding the increase in estrogen levels in patients with estrogen sensitive tumors



    • e) A reduced risk of metastases



  • 29.

    Based on currently available data, which treatment below is associated with a higher incidence of congenital abnormalities in children:




    • a) In vitro maturation



    • b) In vitro fertilization



    • c) Oocyte vitrification



    • d) Embryo vitrification



    • e) The incidence of congenital abnormalities is not increased following the above treatments.



  • 30.

    Which of the following statement(s) is/are true for cryopreservation of human oocytes and embryos:




    • a) Slow freezing is associated with lower survival rates for oocytes



    • b) Vitrification has a higher cryo-survival rate for human embryos



    • c) Oocyte vitrification provides higher pregnancy rates than slow freezing



    • d) Current data demonstrates a trend towards increased pregnancy rates following vitrification of embryos as compared with slow freezing



    • e) Improvements in pregnancy rates with vitrification vs slow freezing are statistically significant



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Nov 9, 2017 | Posted by in OBSTETRICS | Comments Off on Reproduction and Cancer Multiple Choice Questions for Vol. 24, No. 1
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