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.


    • 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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