[GOQ] Gynecologic Oncology Qualifying
Certification Exam Guide
**Question 1.** Which gene mutation is most strongly associated with hereditary ovarian
cancer risk?
A) KRAS
B) BRCA1
C) EGFR
D) PTEN
Answer: B
Explanation: Germline BRCA1 mutations confer a markedly increased lifetime risk of ovarian
carcinoma, especially high‑grade serous types.
**Question 2.** In the FIGO staging of ovarian cancer, what does Stage IIIA1 indicate?
A) Tumor limited to one ovary with surface involvement
B) Microscopic peritoneal metastasis beyond the pelvis
C) Tumor involving the uterus and/or fallopian tubes
D) Positive retroperitoneal lymph nodes only
Answer: B
Explanation: Stage IIIA1 denotes positive peritoneal washings or microscopic peritoneal
metastasis beyond the pelvis without gross disease.
**Question 3.** Which serum marker is most useful for monitoring epithelial ovarian cancer
recurrence?
A) AFP
B) CA‑125
C) β‑hCG
D) CEA
Answer: B
, [GOQ] Gynecologic Oncology Qualifying
Certification Exam Guide
Explanation: CA‑125 rises in >80% of epithelial ovarian cancer recurrences and is the standard
surveillance marker.
**Question 4.** The presence of which immunohistochemical marker best supports a diagnosis
of clear‑cell carcinoma of the ovary?
A) WT‑1
B) CK7
C) Napsin A
D) p16
Answer: C
Explanation: Napsin A is frequently expressed in clear‑cell carcinoma and helps differentiate it
from other histologies.
**Question 5.** Which of the following best describes the role of PARP inhibitors in
BRCA‑mutated ovarian cancer?
A) They block microtubule assembly.
B) They inhibit angiogenesis.
C) They exploit synthetic lethality by preventing DNA repair.
D) They stimulate immune checkpoint pathways.
Answer: C
Explanation: PARP inhibition leads to accumulation of DNA strand breaks that BRCA‑deficient
cells cannot repair, causing cell death (synthetic lethality).
**Question 6.** In endometrial carcinoma, which molecular subtype is associated with the best
prognosis?
A) POLE ultra‑mutated
B) MSI‑high
, [GOQ] Gynecologic Oncology Qualifying
Certification Exam Guide
C) Copy‑number high (serous‑like)
D) Copy‑number low (endometrioid)
Answer: A
Explanation: POLE ultra‑mutated tumors have an excellent prognosis despite high grade, due to
robust immune response.
**Question 7.** Which surgical technique is recommended for sentinel lymph node mapping in
early‑stage endometrial cancer?
A) Full pelvic and para‑aortic lymphadenectomy
B) Blue dye alone
C) Dual‑tracer (indocyanine green + radiocolloid)
D) No mapping; rely on imaging
Answer: C
Explanation: Dual‑tracer mapping with ICG and radiocolloid provides highest detection rates
and low false‑negative rates.
**Question 8.** A 28‑year‑old woman presents with a pelvic mass, elevated AFP and β‑hCG.
Which tumor is most likely?
A) Dysgerminoma
B) Endodermal sinus tumor (yolk sac)
C) Embryonal carcinoma
D) Mature teratoma
Answer: C
Explanation: Embryonal carcinoma often secretes both AFP and β‑hCG, whereas dysgerminoma
typically only elevates β‑hCG.
, [GOQ] Gynecologic Oncology Qualifying
Certification Exam Guide
**Question 9.** Which of the following is a recognized risk factor for developing vulvar
squamous cell carcinoma?
A) Early menarche
B) Chronic lichen sclerosus
C) Use of oral contraceptives
D) Nulliparity
Answer: B
Explanation: Chronic inflammatory dermatoses such as lichen sclerosus predispose to vulvar
intraepithelial neoplasia and invasive carcinoma.
**Question 10.** In the management of low‑malignant‑potential (LMP) ovarian tumors, which
of the following is true?
A) Routine adjuvant chemotherapy is recommended.
B) Fertility‑preserving surgery is contraindicated.
C) Complete staging is optional in Stage I disease.
D) Recurrence risk is negligible after unilateral oophorectomy.
Answer: C
Explanation: For Stage I LMP tumors, comprehensive surgical staging does not improve
outcomes and may be omitted.
**Question 11.** Which of the following best describes the mechanism of action of
bevacizumab in ovarian cancer?
A) Inhibition of VEGF‑A, reducing angiogenesis
B) Blockade of PD‑1 immune checkpoint
C) Alkylation of DNA strands
D) Microtubule stabilization
Certification Exam Guide
**Question 1.** Which gene mutation is most strongly associated with hereditary ovarian
cancer risk?
A) KRAS
B) BRCA1
C) EGFR
D) PTEN
Answer: B
Explanation: Germline BRCA1 mutations confer a markedly increased lifetime risk of ovarian
carcinoma, especially high‑grade serous types.
**Question 2.** In the FIGO staging of ovarian cancer, what does Stage IIIA1 indicate?
A) Tumor limited to one ovary with surface involvement
B) Microscopic peritoneal metastasis beyond the pelvis
C) Tumor involving the uterus and/or fallopian tubes
D) Positive retroperitoneal lymph nodes only
Answer: B
Explanation: Stage IIIA1 denotes positive peritoneal washings or microscopic peritoneal
metastasis beyond the pelvis without gross disease.
**Question 3.** Which serum marker is most useful for monitoring epithelial ovarian cancer
recurrence?
A) AFP
B) CA‑125
C) β‑hCG
D) CEA
Answer: B
, [GOQ] Gynecologic Oncology Qualifying
Certification Exam Guide
Explanation: CA‑125 rises in >80% of epithelial ovarian cancer recurrences and is the standard
surveillance marker.
**Question 4.** The presence of which immunohistochemical marker best supports a diagnosis
of clear‑cell carcinoma of the ovary?
A) WT‑1
B) CK7
C) Napsin A
D) p16
Answer: C
Explanation: Napsin A is frequently expressed in clear‑cell carcinoma and helps differentiate it
from other histologies.
**Question 5.** Which of the following best describes the role of PARP inhibitors in
BRCA‑mutated ovarian cancer?
A) They block microtubule assembly.
B) They inhibit angiogenesis.
C) They exploit synthetic lethality by preventing DNA repair.
D) They stimulate immune checkpoint pathways.
Answer: C
Explanation: PARP inhibition leads to accumulation of DNA strand breaks that BRCA‑deficient
cells cannot repair, causing cell death (synthetic lethality).
**Question 6.** In endometrial carcinoma, which molecular subtype is associated with the best
prognosis?
A) POLE ultra‑mutated
B) MSI‑high
, [GOQ] Gynecologic Oncology Qualifying
Certification Exam Guide
C) Copy‑number high (serous‑like)
D) Copy‑number low (endometrioid)
Answer: A
Explanation: POLE ultra‑mutated tumors have an excellent prognosis despite high grade, due to
robust immune response.
**Question 7.** Which surgical technique is recommended for sentinel lymph node mapping in
early‑stage endometrial cancer?
A) Full pelvic and para‑aortic lymphadenectomy
B) Blue dye alone
C) Dual‑tracer (indocyanine green + radiocolloid)
D) No mapping; rely on imaging
Answer: C
Explanation: Dual‑tracer mapping with ICG and radiocolloid provides highest detection rates
and low false‑negative rates.
**Question 8.** A 28‑year‑old woman presents with a pelvic mass, elevated AFP and β‑hCG.
Which tumor is most likely?
A) Dysgerminoma
B) Endodermal sinus tumor (yolk sac)
C) Embryonal carcinoma
D) Mature teratoma
Answer: C
Explanation: Embryonal carcinoma often secretes both AFP and β‑hCG, whereas dysgerminoma
typically only elevates β‑hCG.
, [GOQ] Gynecologic Oncology Qualifying
Certification Exam Guide
**Question 9.** Which of the following is a recognized risk factor for developing vulvar
squamous cell carcinoma?
A) Early menarche
B) Chronic lichen sclerosus
C) Use of oral contraceptives
D) Nulliparity
Answer: B
Explanation: Chronic inflammatory dermatoses such as lichen sclerosus predispose to vulvar
intraepithelial neoplasia and invasive carcinoma.
**Question 10.** In the management of low‑malignant‑potential (LMP) ovarian tumors, which
of the following is true?
A) Routine adjuvant chemotherapy is recommended.
B) Fertility‑preserving surgery is contraindicated.
C) Complete staging is optional in Stage I disease.
D) Recurrence risk is negligible after unilateral oophorectomy.
Answer: C
Explanation: For Stage I LMP tumors, comprehensive surgical staging does not improve
outcomes and may be omitted.
**Question 11.** Which of the following best describes the mechanism of action of
bevacizumab in ovarian cancer?
A) Inhibition of VEGF‑A, reducing angiogenesis
B) Blockade of PD‑1 immune checkpoint
C) Alkylation of DNA strands
D) Microtubule stabilization
