161 - Testicular cancer Mcqs with answers - part 3

11q: find the wrong statement ?


a. involvement of supradiaphragmatic nodal sites in GCTs is stage III
b. klinefelter syndrome is associated with mediastinal GCT
c. In GCTs management ,Orchiopexy should be performed before puberty, if possible
d. Early orchiopexy reduces the risk of GCT and improves the ability to save testis
e. Testicular feminization syndromes do not increase the risk of testicular cancer

answer e is a wrong statement because testicular feminization syndromes are associated with increased risk of testicular cancer

12q: what are the nodes that are involved first by a right testicular tumor ?


a. para-aortic lymph nodes below the left renal vessels
b. interaortocaval lymph nodes just below the renal vessels
c. retrocrural lymph nodes
d. mediastinal lymph nodes

answer b . interaortocaval lymph nodes just below the renal vessels

13q: what are the nodes that are involved first by a left testicular tumor ?


a. para-aortic lymph nodes below the left renal vessels
b. interaortocaval lymph nodes just below the renal vessels
c. retrocrural lymph nodes
d. mediastinal lymph nodes

answer a . para-aortic lymph nodes below the left renal vessels

14q: how will you treat a stage II nonseminoma with resected low volume metastasis (nodes less than 2cm in largest diameter and less than 6 nodes) involved ?


a. orchiectomy followed by surveillance
b. orchiectomy followed by RPLND ( retroperitoneal lymph node dissection )
c. orchiectomy followed by chemotherapy
d. only chemotherapy by BEP regimen

answer a . orchiectomy followed by surveillance, because it is low volume metastases and the probability of relapse is one-third or less .

15q: all of the following are true regarding the complications of four cycles of BEP
( bleomycin/etoposide/cisplatin ) regimen used in the treatment of testicular cancer except ?


a. nausea, vomiting and hair loss are common
b. myelosuppression is a rare complication
c. symptomatic bleomycin pulmonary toxicity occurs in approx 5% patients
d. weekly bleomycin bolus injection may lead to raynaud’s phenomenon
e. nephrotoxicity and ototoxicity are long term complications

answer b , is wrong because myelosuppression is a frequent complication. Mortatlity due to neutropenia with septicemia also occurs . reduced glomerular filtration and persistent magnesium wasting occur due to nephrotoxicity . peripheral neuropathy is also one of the long term complications of the BEP therapy.