Gestational Trophoblastic Disease

Question 0

Molar pregnancy

Answer 0

Abnl gestation, Villous edema, absence of amniotic membranes, no embryo, dec vascularity, Trophoblastic proliferation.

Question 1

Molar Pregnancy

Answer 1

Benign Hydatiform Mole: complete vs partial

Invasive Mole

Choriocarcinoma

Mole with coexisting fetus

Question 2

MC _____ origin

Answer 2

Paternal origin 46XX. Empty egg fertilized by single sperm that duplicates

Question 3

Clinical

Answer 3

Bleeding 1st trimester 
Passage grape like tissue
Size date discrepancy
Hyperemesis
HCG > 100,000
Dec MSAFP
Hyperthyroid, HTN, toxemia, resp distress

Question 4

HCG

Answer 4

> 100,000

Question 5

US 1st tri

Answer 5

Blighted Ovum, missed abortion, Echogenic mass in uterus

Question 6

US 2nd tri

Answer 6

Soft tissue echogenic mass with cystic spaces, snowflake appearance, Theca Lutein Cyst 50%

Question 7

Treatment

Answer 7

Evacuation, OCP 1 yr, serial HCG levels, HCG should drop 2-3 months unless Cancer. Chemo. Chest X-ray.

Question 8

Partial Mole

Answer 8

Associate with Triploidy 69xxx or 69xxy
Mole with coexisting fetus
Benign

Question 9

Invasive Mole/Chorioadenoma Destruens

Answer 9

Malignant
Not metastatic
Invades into myometrium of uterus
12-15% of molar pg turn into invasive mole

Question 10

Choriocarcinoma

Answer 10

Malignant
Metastatic 
50% from molar pg
50% from normal pg
75% mets to lung

Question 11

Complete mole

Answer 11

Has malignant potential

Diploid 46XX

Question 12

Highest incident

Answer 12

South East Asia

Question 13

Theca Lutein Cyst seen

Answer 13

50%

Multiseptated bilateral

Question 14

Choriocarcinoma MC mets to

Answer 14

Lungs