Download Uterine Cancer Module Post Test

Uterine Cancer Module Post Test
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Print off, email or use the drop-box feature in ANGEL when you have completed this
post test. To receive credit for this assignment, this document should go to your
clerkship director. Please return CD by the last day of class.
Please place an “X” next to the answer you feel is correct.
CASE: Ms. Johnson, an obese, 64 year-old, Caucasian woman, gravida 1, para 1, comes
to see you because she is having post menopausal bleeding over the past month. She has
no other symptoms. She has not been receiving hormone replacement therapy with
estrogen or progesterone.
1. Of the following risk factors for developing endometrial cancer, which are the most
significant in the patient’s history:
_____A. Amount of vaginal bleeding
_____B. Obesity
_____C. Patient age
_____D. Number of pregnancies
2. Had this patient been taking oral post menopausal estrogen therapy she would be at
higher risk of developing endometrial cancer. There is an indisputable link between
“unopposed” estrogen therapy and the risk of developing endometrial cancer. Of the
following variables of estrogen usage, which has the significant impact of that risk?
_____A. Types of hormone
_____B. Dose of hormone
_____C. Duration of use (years)
_____D. Age of initiation of therapy
On physical exam, the patient is noted to weigh 232 lbs and her height is 5’5”. On pelvic
exam it is difficult to assess the size of her uterus, however it appears to be slightly
enlarged. You perform an endometrial biopsy and submit it for pathological evaluation.
3. Based on this scenario, the most likely histology is:
_____A. Clear cell
_____B. Endometrioid
_____C. Papillary Serous
_____D. Mixed histology
The results of the biopsy showed an endometrioid adenocarcinoma, moderately
differentiated (grade 2). Based on this result, you recommend that the patient have
surgery.
Copyright 2008 UC Regents
4. The recommended surgery for this condition is exploratory laparotomy, total
abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH & BSO) and:
_____A. No other biopsies
_____B. Pelvic lymphadenectomy
_____C. Para-aortic lymphadenectomy
_____D. Pelvic and para-aortic lymphadenectomy
Patient undergoes a hysterectomy and staging. The tumor is grade 2 and invades one half
of the muscle wall. There are no metastasis to the pelvic or para-aortic lymph nodes.
5. Based on these findings, her stage is:
_____A. Stage I
_____B. Stage II
_____C. Stage III
_____D. Stage IV
Based on these finding this patient was recommended and received pelvic radiation
therapy.
6. Based on her stage and treatment, the probability of her five-year disease-free survival:
_____A. 85%
_____B. 70%
_____C. 50%
_____D. 30%
7. In women with endometrial cancer, the likelihood of cure is lower in AfricanAmerican women compared with Caucasian women in the U.S. What is the difference in
survival at 5 years?
_____A. 5%
_____B. 10%
_____C. 15%
_____D. 25%
8. The treatment of endometrial cancer has an impact on subsequent sexual functioning.
The most significant decrease in the frequency of the sexual activity is found after which
of the following treatments for stage I disease?
_____A. Hysterectomy
_____B. Radiation therapy
_____C. Hysterectomy plus radiation therapy
_____D. Chemotherapy
Copyright 2008 UC Regents
9. Following the treatment of stage I endometrial cancer with a hysterectomy in an obese
woman, the patient should be counseled to lose weight, because obesity increase the
subsequent risk of:
_____A. Recurrent endometrial cancer
_____B. Cervical cancer
_____C. Breast cancer
_____D. Colon cancer
10. Conservative treatment (use of hormonal therapy with preservation of the uterus) is
used for selected young patients (<35 years of age) with well differentiated stage I
endometrial cancer. Compared to a woman who does not have the disease, fertility in
these women is significantly:
_____A. Abrogated
_____B. Decreased
_____C. Unchanged
_____D. Increased
Copyright 2008 UC Regents