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Obstetric And Gynecology > BENIGN TROPHOBLASTIC DISEASE > Flashcards

BENIGN TROPHOBLASTIC DISEASE Flashcards

1
Q

Define gestational trophoblastic disease (GTD).

A

A spectrum of interrelated tumors caused by abnormal proliferation of trophoblastic tissues.

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2
Q

Fill in the blank: GTD results from abnormal proliferation of ______ tissues.

A

Trophoblastic.

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3
Q

What are the three components of the trophoblast, and their roles?

A

Cytotrophoblast (high mitotic activity, no hormonal synthesis), syncytiotrophoblast (synthesizes 尾-hCG), intermediate trophoblast (responsible for endometrial invasion).

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4
Q

Fill in the blank: GTD is one of the rare human malignancies that can be ______ even with widespread metastases.

A

Cured.

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5
Q

Name the benign types of GTD.

A

Complete mole, partial mole.

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6
Q

Fill in the blank: ______ and ______ are classified as malignant GTD.

A

Invasive mole, choriocarcinoma.

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7
Q

What is a hydatidiform mole (H. mole)?

A

A neoplastic proliferation of trophoblasts with terminal villi transformed into vesicles.

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8
Q

Fill in the blank: The worldwide incidence of hydatidiform mole ranges from ______ to ______ per 1,000 pregnancies.

A

0.5; 2.5.

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9
Q

Which region has the highest reported incidence of hydatidiform mole?

A

Southeast Asia.

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10
Q

What percentage of hydatidiform mole cases have a benign course?

A

0.8

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11
Q

Fill in the blank: About ______% of hydatidiform mole cases progress to invasive mole, and ______% progress to choriocarcinoma.

A

16%; 2.5%.

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12
Q

What are the maternal age-related risk factors for hydatidiform mole?

A

Maternal age <15 years or >35 years.

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13
Q

Fill in the blank: ______ factors like low dietary intake of protein and carotene are associated with hydatidiform mole.

A

Nutritional.

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14
Q

Differentiate between a complete mole and a partial mole based on karyotype and features.

A

Complete mole: 46XX/46XY, no fetal parts; partial mole: 69XXX/69XXY, fetal parts present.

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15
Q

Fill in the blank: A complete mole has a ______ karyotype, usually 46XX or 46XY.

A

Diploid.

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16
Q

How does a partial mole develop cytogenetically?

A

Fertilization of a normal ovum by two sperms, resulting in triploidy.

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17
Q

What are the clinical features commonly associated with molar gestation?

A

Vaginal bleeding, enlarged uterus, theca lutein cysts, hyperthyroidism, preeclampsia.

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18
Q

Fill in the blank: A characteristic “______” pattern on ultrasound indicates a complete mole.

A

Snowstorm.

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19
Q

What role does beta-human chorionic gonadotropin (β-hCG) play in diagnosing hydatidiform mole?

A

Unusually high 尾-hCG levels confirm diagnosis.

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20
Q

Fill in the blank: Theca lutein cysts are observed in about ______% of complete mole cases.

A

25-30%.

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21
Q

List the investigations performed for hydatidiform mole diagnosis.

A

Quantitative 尾-hCG, pelvic ultrasound, blood tests (FBC, LFT, TFT).

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22
Q

Fill in the blank: Serum β-hCG levels in hydatidiform mole often exceed ______ mIU/mL.

A

100000

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23
Q

What are the treatment options for hydatidiform mole?

A

Suction evacuation, supportive therapy, anti-D immunoglobulin, counseling.

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24
Q

Fill in the blank: ______ immunoglobulin should be given to Rh-negative mothers during uterine evacuation.

A

Anti-D.

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25
Q

What are the key differential diagnoses for hydatidiform mole?

A

Threatened abortion, uterine fibroid, ovarian tumor, multiple pregnancy.

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26
Q

Fill in the blank: ______ abortion and ______ fibroid with pregnancy are among the differential diagnoses.

A

Threatened; uterine.

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27
Q

How is follow-up monitoring for hydatidiform mole conducted?

A

Weekly 尾-hCG until undetectable for three weeks, monthly for six months.

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28
Q

Fill in the blank: Patients are advised not to conceive for ______ to ______ months after molar evacuation.

A

6; 12.

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29
Q

Which contraceptive methods are recommended after molar evacuation?

A

Barrier methods, combined oral contraceptives.

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30
Q

Fill in the blank: Intrauterine devices (IUDs) should be avoided after molar evacuation due to the risk of ______.

A

Perforation.

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31
Q

What is the recurrence risk of hydatidiform mole after one, two, and three previous moles?

A

4%, 25%, 100%.

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32
Q

Fill in the blank: A ______ ultrasound scan during the first trimester is recommended for detecting recurrent molar pregnancies.

A

First-trimester.

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33
Q

What histopathological examination is recommended after delivery in subsequent pregnancies?

A

Placenta histopathology.

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34
Q

Fill in the blank: Persistent GTD is defined by hCG values plateauing for ______ or more values over at least three weeks.

A

Four.

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35
Q

What hCG threshold and duration suggest the need for chemotherapy in persistent GTD?

A

hCG >20,000 IU/L at four weeks or persistence after six months.

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36
Q

Fill in the blank: Continued vaginal bleeding after molar evacuation indicates persistent ______ disease.

A

Gestational trophoblastic.

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37
Q

What are the signs of metastasis in persistent GTD?

A

Liver, brain, gastrointestinal metastases.

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38
Q

Fill in the blank: Metastases in the ______, ______, or ______ are considered high-risk in persistent GTD.

A

Liver; brain; gastrointestinal tract.

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39
Q

What histological findings confirm choriocarcinoma?

A

Histologic findings of choriocarcinoma cells.

40
Q

Fill in the blank: Complete mole is suspected based on ______ and ultrasound findings, while partial mole is often diagnosed ______.

A

Clinical; retrospectively.

41
Q

What are the complications associated with complete mole?

A

Severe preeclampsia, hyperthyroidism, uterine rupture.

42
Q

Fill in the blank: Severe and early-onset ______ is a complication of complete mole.

A

Preeclampsia.

43
Q

What are the clinical features of hyperthyroidism in molar pregnancy?

A

Elevated plasma thyroxin, tachycardia, heat intolerance.

44
Q

Fill in the blank: Abnormally enlarged and soft uterus is observed in ______% of molar pregnancies.

A

0.5

45
Q

Describe the snowstorm pattern in ultrasound for hydatidiform mole.

A

Diffuse hydatidiform swelling resembling a snowstorm.

46
Q

Fill in the blank: Focal cystic spaces in the placental tissue indicate ______ molar pregnancy on ultrasound.

A

Partial.

47
Q

What are the histological features of invasive mole?

A

Myometrial invasion with hemorrhage and necrosis.

48
Q

Fill in the blank: An invasive mole may develop after a ______ or ______.

A

Pregnancy; abortion.

49
Q

How does choriocarcinoma differ from invasive mole in terms of aggressiveness?

A

Choriocarcinoma is more aggressive.

50
Q

Fill in the blank: ______ mole has a higher likelihood of malignant transformation compared to ______ mole.

A

Complete; partial.

51
Q

What is the prognosis for hydatidiform mole with timely treatment?

A

Excellent with early treatment.

52
Q

Fill in the blank: Suction evacuation is the preferred method for treating ______ mole.

A

Hydatidiform.

53
Q

What supportive therapies are required post-evacuation for hydatidiform mole?

A

Correction of anemia, infection treatment.

54
Q

Fill in the blank: Histopathology of the uterus specimen helps confirm the diagnosis of ______ mole.

A

Hydatidiform mole.

55
Q

What is the role of regular β-hCG monitoring in molar pregnancies?

A

Detects malignant progression or recurrence.

56
Q

Fill in the blank: β-hCG levels should be monitored weekly until undetectable for ______ consecutive weeks.

A

Three.

57
Q

How does pulmonary trophoblast embolism occur in molar pregnancies?

A

Due to trophoblastic embolism in the lungs.

58
Q

Fill in the blank: Pelvic ultrasound helps detect ______ and ______ changes in molar pregnancies.

A

Uterine; placental.

59
Q

What preventive measures are recommended for future pregnancies after hydatidiform mole?

A

Early ultrasounds, 尾-hCG monitoring postpartum.

60
Q

Fill in the blank: Quantitative β-hCG assay is performed ______ weeks postpartum to rule out occult GTN.

A

Six.

61
Q

What are the criteria for diagnosing gestational trophoblastic neoplasia (GTN)?

A

Rising or plateauing hCG values, metastases, choriocarcinoma histology.

62
Q

Fill in the blank: A rise in hCG of ______% or more for three values over two weeks indicates GTN.

A

0.1

63
Q

What is the significance of chest X-ray in hydatidiform mole evaluation?

A

Detects pulmonary metastases.

64
Q

Fill in the blank: CXR helps rule out ______ in molar pregnancies.

A

Pulmonary embolism.

65
Q

How does socioeconomic status influence hydatidiform mole incidence?

A

Limited access to healthcare and poor nutrition.

66
Q

Fill in the blank: Women of low ______ status are at higher risk of hydatidiform mole.

A

Socioeconomic.

67
Q

What histopathological features distinguish partial from complete mole?

A

Complete: diffuse villous edema; partial: focal villous edema.

68
Q

Fill in the blank: Complete mole has diffuse ______ hyperplasia, while partial mole has focal hyperplasia.

A

Trophoblastic.

69
Q

How does parity affect the risk of hydatidiform mole?

A

High parity increases the risk.

70
Q

Fill in the blank: High ______ increases the risk of hydatidiform mole.

A

Parity.

71
Q

What systemic complications arise from untreated molar pregnancies?

A

Hyperthyroidism, preeclampsia, uterine rupture.

72
Q

Fill in the blank: Untreated molar pregnancies may lead to ______ or ______ complications.

A

Systemic; local.

73
Q

What are the indications for chemotherapy in GTD?

A

Persistent GTD with hCG rise, metastases, or bleeding.

74
Q

Fill in the blank: Persistent GTD with metastases to the ______ requires chemotherapy.

A

Brain.

75
Q

What are the outcomes for pregnancies following treatment for hydatidiform mole?

A

Most result in normal deliveries.

76
Q

Fill in the blank: The majority of post-molar pregnancies result in ______ deliveries.

A

Healthy.

77
Q

How does the prognosis differ between complete mole and choriocarcinoma?

A

Worse for choriocarcinoma due to metastatic potential.

78
Q

Fill in the blank: Choriocarcinoma has a ______ prognosis when metastases are detected early.

A

Better.

79
Q

What measures can prevent recurrence of hydatidiform mole?

A

Early detection and consistent follow-up.

80
Q

Fill in the blank: Early detection through ______ screening reduces the recurrence risk of hydatidiform mole.

A

First-trimester ultrasound.

81
Q

How does age influence the risk of molar pregnancy malignancy?

A

Risk increases with maternal age.

82
Q

Fill in the blank: Maternal age above ______ years is a risk factor for malignant transformation.

A

35

83
Q

What are the common symptoms of invasive mole?

A

Vaginal bleeding, uterine enlargement, 尾-hCG elevation.

84
Q

Fill in the blank: Vaginal ______ and elevated β-hCG levels are key features of invasive mole.

A

Bleeding.

85
Q

How is placental-site trophoblastic tumor (PSTT) diagnosed?

A

Biopsy and histology.

86
Q

Fill in the blank: PSTT is confirmed by histopathological findings of ______ cells.

A

Trophoblastic.

87
Q

What is the significance of chemotherapy in PSTT management?

A

Improves survival in metastatic cases.

88
Q

Fill in the blank: Chemotherapy is less effective for PSTT due to its ______ nature.

A

Chemoresistant.

89
Q

How do hormonal changes contribute to molar pregnancy complications?

A

Cause hyperthyroidism, excessive uterine growth.

90
Q

Fill in the blank: Elevated ______ levels cause hyperthyroidism in molar pregnancies.

A

beta-hCG.

91
Q

What counseling is necessary for patients with molar pregnancies?

A

Address emotional concerns, recurrence, and future pregnancy plans.

92
Q

What monitoring is needed after chemotherapy for GTD?

A

Regular beta-hCG monitoring, imaging for metastases.

93
Q

Fill in the blank: β-hCG levels should remain undetectable for ______ months after GTD chemotherapy.

A

Six.

94
Q

How does invasive mole lead to uterine rupture?

A

Extensive myometrial invasion.

95
Q

Fill in the blank: ______ invasion in invasive mole causes uterine rupture and bleeding.

A

Trophoblastic.

96
Q

What are the features of metastatic choriocarcinoma?

A

Brain and liver involvement, bleeding.

97
Q

Fill in the blank: ______ metastases are common in choriocarcinoma.

A

Pulmonary.

Obstetric And Gynecology (26 decks)

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