Title GYNE ONG Lap July 2025 (FOR DISTRIBUTION).pdf ✅

20th OBGYN ORAL EXAM REVIEW ORAL SIMULATION 3 CT scan of the abdomen/pelvis/chest with contrast: * Left ovarian mass * No evidence of lymphadenopathy * No distant metastases * No peritoneal implants * No ascites CBC, BUN, Crea, Na, K, Cl, Ca, Mg, AST, ALT, Alk Phos: Normal 3. What is the diagnosis?  Ovarian new growth, left, probably benign  Nulligravid 1 POINT 0.75 0.25 4. What tumor markers should be ordered? Give 4.  CA 125 1 POINT 0.25
20th OBGYN ORAL EXAM REVIEW ORAL SIMULATION 4  CA 19-9  HE4  AFP  LDH  B-HCG  Inhibin-B/AMH 0.25 0.25 0.25 0.25 0.25 0.25 CA-125: 30.4 U/mL CA 19-9: 25.2 U/mL HE4: 52.2 pmol/L β-hCG: negative AFP: 380 ng/mL (elevated) LDH: 450 U/L (elevated) AMH: 3.62 ng/mL 5. What should be discussed regarding the management? Give 4.  Surgical access (laparoscopic or open)  Extent of surgery (possible oophorectomy)  Fertility preservation  Fertility implications  Risk of malignancy  Frozen section analysis  Surgical risks 1 POINT 0.25 0.25 0.25 0.25 0.25 0.25 0.25 6. What is the management?  Operative laparoscopy, unilateral oophorocystectomy, +/- frozen section +/- USO, BLND, PALS, IO, RPB 1 POINT Intraoperatively, there was no ascites. The left ovary was enlarged into a cystic mass measuring 10 x 10 cm with note of normal ovarian stroma. The right ovary and bilateral fallopian tubes were grossly normal. Cut section of the left ovarian cyst showed sebum and hair. The capsule was thin. 7. What precautions should be observed during laparoscopic oophorocystectomy? Give 2.  Use specimen retrieval bag  Prevent cyst contents spillage as much as possible  Copious irrigation if cyst rupture occurs 1 POINT 0.5 0.5 0.5