Gestational Trophoblastic Disease

Question 1

GTD

Answer 1

abnormal proliferation of trophoblastic disease

Question 2

GTD most often occurs during or after

Answer 2

implantation of a fertilized ovum but can occur months to years after any type of pregnancies

Question 3

What controls the proliferation of trophoblastic tissue?

Answer 3

paternal genomes

Question 4

What controls the growth of the embryo?

Answer 4

maternal genomes

Question 5

Excessive paternal genetic material results from

Answer 5

duplicated chromosomes in the sperm, lack of chromosomes in the ovum or fertilization of the ovum by two sperm may be cause of GTD

Question 6

Clinical findings of GTD

Answer 6

• markedly elevated hCG
• hyperemesis
• absent FHT
• theca lutein cyst
• heacy vag bleeding
• large ut
• hyperthyroidism

Question 7

the chorionic villi are hydropic without identifiable embryonic or fetal tissue

Answer 7

Complete hydatidaform mole

Question 8

most common form of trophoblastic disease

Answer 8

complete hydatidaform mole

Question 9

complete hydatidaform mole sono findings

Answer 9

• enlarged ut filled with echogenic mass
• endo cavity filled with echogenic material thats homogeneous in 1st trim and has cystic areas in 2nd
• hypervascular, low resistnce flow pattern w/ doppler
• ov theca lutein cyst

Question 10

one set of maternal chromosomes and two sets of paternal chromosomes resulting in a triploid karotype

Answer 10

partial mole

Question 11

Partial moles have hydropic chorionic villi as well as

Answer 11

relitively normal villi

Question 12

is there fetal tissue in partial moles

Answer 12

yes

Question 13

partial mole sono findings

Answer 13

• deformed gs
• growth restricted fetus with triploidy anom. (syndactyly and hydrocephalus)
• enlarges plac with multiple cystic areas

Question 14

Mole w/ coexisting fetus

Answer 14

fetus outside the realm of true GTD

Question 15

Mole w/ coexisting fetus how many conceptions occur

Answer 15

2, one developeds normally and on develops into GTD

its rare

Question 16

Mole w/ coexisting fetus sono findings

Answer 16

• similar to partial but normal plac and membrane

- fetus usually has norm. karyotype

Question 17

a complication of pregnancy that most commonly follows GTD

Answer 17

persistent trophoblastic neoplasia

Question 18

what can uncommonly occurs in persistent trophoblastic neoplasia after

Answer 18

normal term delivery
spontatneous abortion
ectopic pregnancy

Question 19

persistent trophoblastic neoplasia is suspected if

Answer 19

hCG levels do not decline after evacuation of pregnancy and persistent heavy vag bleeding

Question 20

persistent trophoblastic neoplasia

type 1: invasive mole (chorioadenoma destruens)

Answer 20

penetrates the myo or adj structures and may cause ut rupture, malignant nonmetastatic GTD

Question 21

most common form of persistent trophoblastic disease 80 - 95%

Answer 21

invasive mole

Question 22

persistent trophoblastic neoplasia

type 1: invasive mole (chorioadenoma destruens) sono findings

Answer 22

• presence of focal or diffuse echogenic materal w/in endo cavity
• extends into myo
• irregular sonolucent area surround trophoblastic tissue

Question 23

persistent trophoblastic neoplasia

type 2: choriocarcinoma

Answer 23

rare, 1: 30,000, 1 in 40 molar pregnancies

Question 24

persistent trophoblastic neoplasia

type 2: choriocarcinoma common occurences

Answer 24

vascular invasion, hemorrhage, necrosis of myo

Question 25

persistent trophoblastic neoplasia

type 2: choriocarcinoma metastasize to

Answer 25

lung, liver, brain, bone, GI tract and skin

Question 26

persistent trophoblastic neoplasia

type 2: choriocarcinoma sono finding

Answer 26

• elevated hCG in a nonpregnant patient
• enlarge ut
• irregular complex mass with marked vascularity