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Raising The Barr > Gestational trophoblastic disease > Flashcards

Gestational trophoblastic disease Flashcards

1
Q

What is the karyotype associated with partial mole?

A

69XXY with extra haploid set of PATERNAL chromosomes

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2
Q

Which mole has fetal tissue in it?

A

Partial mole

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3
Q

What is the percentage of postmalignant sequelae in partial moles?

A

<5%

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4
Q

Pathology shows focal villous edema and trophoblastic proliferation; what kind of mole?

A

Partial

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5
Q

What does the pathology look like for a partial mole?

A

focal villous edema and trophoblastic proliferation

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6
Q

What is the typical karyotype for a complete mole?

A

46XX with ALL chromosomes from dad

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7
Q

Is the uterus big or small with a complete mole?

A

BIG! with NO fetal tissue

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8
Q

What kind of mole has theca lutein cysts associated with it?

A

Complete moles can have 15-25% of theca lutein cysts

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9
Q

What is the rate of malignant sequelae in a complete mole?

A

20%

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10
Q

What is the MOST common presenting symptom of molar pregnancy?

A

Abnormal vaginal bleeding

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11
Q

What do you check if you suspect a molar pregnancy?

A 
CBC
Clotting factors
Renal and liver function
Type and screen
HCG
Chest XRay
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12
Q

What are the THREE ways to diagnose postmolar gestational trophoblastic disease?

A
  1. HCG plateau of 4 values +/- 10% over three week duration
  2. HCG increases >10% of 3 values over 2 weeks
  3. Persistence of HCG for greater than 6 months
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13
Q

What is the risk of having a future mole when you have had one before?

A

10 fold increase

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14
Q

What gene mutation is associated with familial recurrent molar pregnancy?

A

NLRP7 gene

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15
Q

What are the four types of malignant gestational trophoblastic disease (GTN)?

A
  1. Invasive molar pregnancy
  2. Choriocarcinoma
  3. Post molar gestational trophoblastic disease
  4. Placental site trophoblastic disease
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16
Q

Name five factors that indicate “high risk” metastatic disease for malignant gestational trophoblastic disease

A
  • > 4 months since indicent pregnancy
  • antecedent term pregnancy
  • hcg>40,000
  • BRAIN or LIVER mets
  • prior chemotherapy
17
Q

What medication is used for treatment of LOW risk gestational trophoblastic neoplasia?

A

Methotrexate

18
Q

What medication is used for treatment of HIGH risk gestational trophoblastic neoplasia?

A

Multi-agent chemo: EMA-CO

Etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine/oncovine

19
Q

True or false: Gestational choriocarcinoma requires biopsy confirmation

A

True

20
Q

What is the MOST RARE type of gestational trophoblastic disease?

A

Placental site trophoblastic tumor

21
Q

What does pathology show for placental site trophoblastic tumor?

A
  1. ABSENT villi

2. Proliferation of intermediate trophoblast cells

22
Q

What is the treatment for placental site trophoblastic tumor?

A

Hysterectomy

Raising The Barr (5 decks)

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