LATEST OB/GYN – GYNECOLOGIC ONCOLOGY
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 55-year-old female presents with
postmenopausal bleeding. Endometrial biopsy shows
endometrioid adenocarcinoma, grade 1. Pelvic
ultrasound shows endometrial thickness of 12 mm.
MRI shows no myometrial invasion. What is the most
appropriate next step?
A) Total hysterectomy with bilateral salpingo-
oophorectomy (TH/BSO) without lymphadenectomy
B) TH/BSO with pelvic and para-aortic
lymphadenectomy
C) Radiation therapy alone
D) Progestin therapy
Correct answer: A
Rationale: Grade 1 endometrioid adenocarcinoma
with no myometrial invasion (stage IA) has low risk of
lymph node metastasis; lymphadenectomy may be
omitted.
,2. A 62-year-old female with stage IIIC ovarian cancer
(high-grade serous) undergoes optimal debulking
(residual disease <1 cm). She receives adjuvant
carboplatin and paclitaxel. She achieves complete
response. What is the most appropriate next step?
A) Observation (surveillance)
B) Maintenance olaparib (PARP inhibitor) if BRCA
mutated
C) Secondary debulking surgery
D) Intraperitoneal chemotherapy
Correct answer: B
Rationale: Maintenance PARP inhibitor (olaparib,
niraparib, rucaparib) improves progression-free
survival in BRCA-mutated or HRD-positive ovarian
cancer after response to platinum-based
chemotherapy.
3. A 45-year-old female with BRCA1 mutation and a
strong family history of ovarian cancer is considering
risk-reducing surgery. What is the most appropriate
recommendation?
A) Risk-reducing bilateral salpingo-oophorectomy
(RRSO) at age 35-40 (or after childbearing)
B) Annual CA-125 and transvaginal ultrasound
,C) Oral contraceptives
D) Risk-reducing mastectomy only
Correct answer: A
Rationale: RRSO is recommended for BRCA1
mutation carriers between age 35-40 (or after
completion of childbearing) to reduce ovarian cancer
risk.
4. A 48-year-old female with stage IB2 cervical
cancer (tumor 4 cm) desires fertility preservation.
What is the most appropriate surgical option?
A) Radical trachelectomy (with pelvic
lymphadenectomy)
B) Simple hysterectomy
C) Radiation therapy
D) Conization alone
Correct answer: A
Rationale: Radical trachelectomy (cervical resection
with parametrectomy) preserves fertility in early-
stage cervical cancer (tumor ≤2 cm? but up to 4 cm
may be considered).
5. A 58-year-old female with stage III ovarian cancer
(high-grade serous) undergoes primary debulking
, surgery with complete gross resection (R0). She
receives adjuvant carboplatin-paclitaxel. She
develops recurrent disease 18 months later
(platinum-sensitive). What is the most appropriate
next step?
A) Secondary cytoreductive surgery (if isolated,
resectable recurrence) followed by platinum-based
chemotherapy
B) Palliative chemotherapy alone
C) Clinical trial
D) Hospice referral
Correct answer: A
Rationale: Platinum-sensitive recurrence (≥6 months)
with isolated, resectable disease may benefit from
secondary cytoreductive surgery (DESKTOP III, SOC-
1 trials).
6. A 62-year-old female with stage III endometrial
cancer (serous histology) undergoes TH/BSO with
lymphadenectomy. What is the most appropriate
adjuvant therapy?
A) Chemotherapy (carboplatin-paclitaxel) plus
vaginal brachytherapy
B) Pelvic radiation alone
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 55-year-old female presents with
postmenopausal bleeding. Endometrial biopsy shows
endometrioid adenocarcinoma, grade 1. Pelvic
ultrasound shows endometrial thickness of 12 mm.
MRI shows no myometrial invasion. What is the most
appropriate next step?
A) Total hysterectomy with bilateral salpingo-
oophorectomy (TH/BSO) without lymphadenectomy
B) TH/BSO with pelvic and para-aortic
lymphadenectomy
C) Radiation therapy alone
D) Progestin therapy
Correct answer: A
Rationale: Grade 1 endometrioid adenocarcinoma
with no myometrial invasion (stage IA) has low risk of
lymph node metastasis; lymphadenectomy may be
omitted.
,2. A 62-year-old female with stage IIIC ovarian cancer
(high-grade serous) undergoes optimal debulking
(residual disease <1 cm). She receives adjuvant
carboplatin and paclitaxel. She achieves complete
response. What is the most appropriate next step?
A) Observation (surveillance)
B) Maintenance olaparib (PARP inhibitor) if BRCA
mutated
C) Secondary debulking surgery
D) Intraperitoneal chemotherapy
Correct answer: B
Rationale: Maintenance PARP inhibitor (olaparib,
niraparib, rucaparib) improves progression-free
survival in BRCA-mutated or HRD-positive ovarian
cancer after response to platinum-based
chemotherapy.
3. A 45-year-old female with BRCA1 mutation and a
strong family history of ovarian cancer is considering
risk-reducing surgery. What is the most appropriate
recommendation?
A) Risk-reducing bilateral salpingo-oophorectomy
(RRSO) at age 35-40 (or after childbearing)
B) Annual CA-125 and transvaginal ultrasound
,C) Oral contraceptives
D) Risk-reducing mastectomy only
Correct answer: A
Rationale: RRSO is recommended for BRCA1
mutation carriers between age 35-40 (or after
completion of childbearing) to reduce ovarian cancer
risk.
4. A 48-year-old female with stage IB2 cervical
cancer (tumor 4 cm) desires fertility preservation.
What is the most appropriate surgical option?
A) Radical trachelectomy (with pelvic
lymphadenectomy)
B) Simple hysterectomy
C) Radiation therapy
D) Conization alone
Correct answer: A
Rationale: Radical trachelectomy (cervical resection
with parametrectomy) preserves fertility in early-
stage cervical cancer (tumor ≤2 cm? but up to 4 cm
may be considered).
5. A 58-year-old female with stage III ovarian cancer
(high-grade serous) undergoes primary debulking
, surgery with complete gross resection (R0). She
receives adjuvant carboplatin-paclitaxel. She
develops recurrent disease 18 months later
(platinum-sensitive). What is the most appropriate
next step?
A) Secondary cytoreductive surgery (if isolated,
resectable recurrence) followed by platinum-based
chemotherapy
B) Palliative chemotherapy alone
C) Clinical trial
D) Hospice referral
Correct answer: A
Rationale: Platinum-sensitive recurrence (≥6 months)
with isolated, resectable disease may benefit from
secondary cytoreductive surgery (DESKTOP III, SOC-
1 trials).
6. A 62-year-old female with stage III endometrial
cancer (serous histology) undergoes TH/BSO with
lymphadenectomy. What is the most appropriate
adjuvant therapy?
A) Chemotherapy (carboplatin-paclitaxel) plus
vaginal brachytherapy
B) Pelvic radiation alone
