Class 6: GTD Flashcards
what is GTD caused by?
GTD is caused by abnormal proliferation of trophoblastic disease due to abnormal karyotype
what is another name for trophoblastic tissue?
placental tissue
2 functions of trophoblasts?
- produce HCG
- make chorionic villi
3 types of GTD
- hydatidiform mole
- invasive mole
- choriocarcinoma
which form of GTD is benign?
hydatidiform mole
which form(s) of GTD are malignant
invasive mole & choriocarcinoma
another name for invasive mole?
chorioadenoma destruens
what type of trophoblastic disease is nongestational?
testicular & ovarian choriocarcinoma
hydatidiform mole & choriocarcinoma are more commonly in which parts of the world?
far east asia & africa
what ages are more at risk for GTD?
<20 yo & >40yo
what blood types are more at risk for GTD?
type A & AB
besides age & blood type, what other factors increase the risk for GTD?
- socioeconomic
- previous molar pregnancy
- multiple sexual partners
- BC pills
2 types of benign hydatidiform mole?
- complete molar pregnancy
- partial/incomplete molar pregnancy
what is the most common type of GTD?
complete hydatidiform mole
2 types of complete molar pregnancy?
- fertilization of 1 defective ovum by 1 sperm that duplicates
- fertilization of 1 defective ovum by 2 sperm
2 types of incomplete molar pregnancy?
- fertilization of 1 normal ovum by 2 sperm
- fertilization of 1 normal ovum by 1 sperm with diploid set
how many chromosomes are in a complete hydatidiform mole?
46 chromosomes
how many chromosomes are in an incomplete hydatidiform?
69 chromosoomes
which type of hydatidiform molar pregnancy has no fetal parts?
complete
which type of hydatidiform molar pregnancy has high malignant potential?
complete
which type of hydatidiform molar pregnancy has high malignant potential?
complete
___ cysts are found in 20-35% of patients with molar pregnancy
theca lutein
lab value related to theca lutein cysts?
high HCG
how long can theca lutein cysts stay in the uterus after evacuation of molar pregnancy?
2-4 months
MC S&S of GTD
irregular vaginal bleeding during pregnancy; possible discharge of mole
size of the uterus in GTD?
large for date
hyperemesis & preeclampsia are common symptoms of GTD. T/F?
true
HCG levels are ___ times higher with GTD than with a normal pregnancy
3x
how long does HCG continue to rise with GTD?
100 days from LMP
the 2nd trimester US appearance of GTD is nonspecific. T/F?
false – 1st trimester is nonspecific findings
what type of pattern can molar pregnancy take on in the 2nd tri?
snow flake/lacey pattern
molar pregnancy in 2nd trimester can look like a ___ mass with ___ areas that represent the chorionic villi
soft tissue mass with anechoic areas
invasive mole is a malignant metastatic type of GTD. T/F?
false – nonmetastatic
when is invasive mole suspected?
when HCG levels remain high even when molar pregnancy is evacuated
choriocarcinoma is an aggressive form of GTD. T/F?
true
what percentage of benign molar pregnancies turn into choriocarcinoma?
2-5%
what percentage of benign molar pregnancies turn into invasive mole?
15-18%
where can choriocarcinoma mets to? (6)
lungs, brain, pelvis, lower GI, liver, urinary tract
4 treatments to molar pregnancy
- D&C
- BC pills for 1 year after evacuation
- HCG tests
- other (depends on stage)