Gynaecological oncology: stage IVA cervical cancer: 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: stage IVA cervical cancer

Sample item

A woman with locally advanced cervical cancer has haematuria. What is required to diagnose bladder mucosal invasion (stage IVA)?

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

The answer and the reasoning

A. Cystoscopy with biopsy confirming invasion of the bladder mucosa

In FIGO staging, stage IVA is tumour invasion of the bladder or rectal mucosa, and it must be confirmed by biopsy, as bullous oedema of the bladder alone does not indicate invasion. Cystoscopy and sigmoidoscopy are used in advanced disease. Pelvic exenteration or chemoradiation is then considered.

Option by option

  • A. Cystoscopy with biopsy confirming invasion of the bladder mucosa (correct)

    Correct. Biopsy-proven mucosal involvement is required.

  • B. Urine cytology alone

    Urine cytology cannot stage disease.

  • C. Bullous oedema on imaging alone

    Bullous oedema alone does not prove invasion.

  • D. Serum creatinine

    Creatinine reflects renal function and not bladder invasion.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Cystoscopy with biopsy confirming invasion of the bladder mucosa. In FIGO staging, stage IVA is tumour invasion of the bladder or rectal mucosa, and it must be confirmed by biopsy, as bullous oedema of the bladder alone does not indicate invasion.

Why is "Urine cytology alone" not the answer?

Urine cytology cannot stage disease.

Why is "Bullous oedema on imaging alone" not the answer?

Bullous oedema alone does not prove invasion.

Why is "Serum creatinine" not the answer?

Creatinine reflects renal function and not bladder invasion.

What concept does this question test?

It tests Gynaecological oncology: stage IVA cervical cancer in OBG. Cystoscopy and sigmoidoscopy are used in advanced disease. Pelvic exenteration or chemoradiation is then considered.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: stage IVA cervical cancer?

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.