Gynaecological oncology: eligibility for ablative treatment: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: eligibility for ablative treatment

Sample item

Under a screen-and-treat programme, VIA is positive in a 38-year-old woman. Which finding makes her eligible for cryotherapy or thermal ablation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. The lesion is wholly visible, within the transformation zone, with no extension into the endocervical canal, covering less than 75 percent of the cervix

Ablative treatments such as cryotherapy and thermal (cold) coagulation destroy tissue to a limited depth, so they are used for lesions that are fully visible, confined to the ectocervix and not too large. Lesions extending into the canal, large lesions or suspected cancer need excision (LEEP) or referral. WHO recommends screen-and-treat for settings where follow-up is difficult.

Option by option

  • A. Lesion extending deep into the canal

    Canal extension cannot be adequately treated by ablation.

  • B. Lesion extending onto the vaginal wall and parametrium

    Extension to the vagina or parametrium suggests more advanced disease.

  • C. The lesion is wholly visible, within the transformation zone, with no extension into the endocervical canal, covering less than 75 percent of the cervix (correct)

    Correct. Small, wholly visible ectocervical lesions suit ablation.

  • D. Suspected invasive cancer

    Suspected invasive cancer needs biopsy and referral.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, The lesion is wholly visible, within the transformation zone, with no extension into the endocervical canal, covering less than 75 percent of the cervix. Ablative treatments such as cryotherapy and thermal (cold) coagulation destroy tissue to a limited depth, so they are used for lesions that are fully visible, confined to the ectocervix and not too large.

Why is "Lesion extending deep into the canal" not the answer?

Canal extension cannot be adequately treated by ablation.

Why is "Lesion extending onto the vaginal wall and parametrium" not the answer?

Extension to the vagina or parametrium suggests more advanced disease.

Why is "Suspected invasive cancer" not the answer?

Suspected invasive cancer needs biopsy and referral.

What concept does this question test?

It tests Gynaecological oncology: eligibility for ablative treatment in OBG. Lesions extending into the canal, large lesions or suspected cancer need excision (LEEP) or referral. WHO recommends screen-and-treat for settings where follow-up is difficult.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: eligibility for ablative treatment?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.