1)which of the following statement is wrong regarding endometrial hyperplasia
i) Endometrial hyperplasia without atypia progressing to
endometrial cancer is less than 5% over 20 years
ii)Progestogen treatment is indicated in symptomatic women
iii) Cyclical progestogens should be used for women who decline the LNG-IUS.
iv) Treatment with oral progestogens or the LNG-IUS should be for a minimum of 6 months
v) At least two consecutive 6-monthly negative biopsies should be obtained prior to discharge.
answer
2) hysterectomy is not indicated in women with endometrial hyperplasia without atypia, not wanting to preserve their fertility when
(i) progression to atypical hyperplasia occurs during follow-up
(ii) there is no histological regression of hyperplasia despite 12 months of treatment
(iii) there is relapse of endometrial hyperplasia after completing progestogen treatment
(iv) there is persistence of bleeding symptoms
(v) the woman accepts to undergo endometrial surveillance or comply with medical treatment.
answer
3)what should not be done when managing atypical hyperplasia ?
i) Women with atypical hyperplasia should undergo a total hysterectomy
ii) Postmenopausal women with atypical hyperplasia should be offered bilateral salpingo-oophorectomy
iii) laparoscopic approach to total hysterectomy is preferable to an abdominal approach
iv) There is benefit from intraoperative frozen section analysis of the endometrium or routine
lymphadenectomy
v) Endometrial ablation is not recommended
answer
4) How should women with atypical hyperplasia who wish to preserve their fertility be managed ?
i) First-line treatment with the high dose of oral progesterone should be recommended
ii) Disease regression should be achieved on at least two endometrial samples before women attempt to
conceive.
iii) hyperplastic endometrium may predispose women to conceive
iv) CECT abdomen and pelvis should done
v) Assisted reproduction may be considered as the live birth rate is higher
answer ..
5) How should endometrial hyperplasia be managed in women on adjuvant treatment for
breast cancer?
i) aromatase inhibitors (such as anastrozole, exemestane and letrozole) are known to increase the risk of endometrial hyperplasia and cancer.
ii) LNG-IUS promotes polyp formation
iii) increased risk of breast cancer recurrence associated with use of the LNG-IUS.
iv) tamoxifen may promote the development of fibroids, endometrial polyps and hyperplasia
v) LNG IUS should be routinely for the patients using tamoxifen
answer
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